Cerebral small vessel disease (SVD) is considered the most important vascular contributor to the development of dementia. Comprehensive characterization of the time course of disease progression will result in better understanding of aetiology and clinical consequences of SVD. SVD progression has been studied extensively over the years, usually describing change in SVD markers over time using neuroimaging at two time points. As a consequence, SVD is usually seen as a rather linear, continuously progressive process. This assumption of continuous progression of SVD markers was recently challenged by several studies that showed regression of SVD markers. Here, we provide a review on disease progression in sporadic SVD, thereby taking into account both progression and regression of SVD markers with emphasis on white matter hyperintensities (WMH), lacunes and microbleeds. We will elaborate on temporal dynamics of SVD progression and discuss the view of SVD progression as a dynamic process, rather than the traditional view of SVD as a continuous progressive process, that might better fit evidence from longitudinal neuroimaging studies. We will discuss possible mechanisms and clinical implications of a dynamic time course of SVD, with both progression and regression of SVD markers.
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June 2017
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The accompanying caption is: Image demonstrates a 3D reconstruction of the neurovascular unit in a hippocampal artery in the mouse brain. For further details, see article by Nizari et al in this issue, pages 1207-1214. Image kindly provided by Cheryl Hawkes.
Review Article|
May 31 2017
Disease progression and regression in sporadic small vessel disease–insights from neuroimaging
Esther M.C. van Leijsen;
Esther M.C. van Leijsen
1Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroscience, Radboud university medical centre, Nijmegen, the Netherlands
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Frank-Erik de Leeuw;
1Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroscience, Radboud university medical centre, Nijmegen, the Netherlands
Correspondence: Frank-Erik de Leeuw ([email protected])
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Anil M. Tuladhar
Anil M. Tuladhar
1Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroscience, Radboud university medical centre, Nijmegen, the Netherlands
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Publisher: Portland Press Ltd
Received:
November 29 2016
Revision Received:
February 23 2017
Accepted:
February 27 2017
Online ISSN: 1470-8736
Print ISSN: 0143-5221
© 2017 The Author(s); published by Portland Press Limited on behalf of the Biochemical Society
2017
Clin Sci (Lond) (2017) 131 (12): 1191–1206.
Article history
Received:
November 29 2016
Revision Received:
February 23 2017
Accepted:
February 27 2017
Citation
Esther M.C. van Leijsen, Frank-Erik de Leeuw, Anil M. Tuladhar; Disease progression and regression in sporadic small vessel disease–insights from neuroimaging. Clin Sci (Lond) 1 June 2017; 131 (12): 1191–1206. doi: https://doi.org/10.1042/CS20160384
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