Abstract
Cerebral small vessel disease (SVD) is a common accompaniment of ageing. Features seen on neuroimaging include recent small subcortical infarcts, lacunes, white matter hyperintensities, perivascular spaces, microbleeds, and brain atrophy. SVD can present as a stroke or cognitive decline, or can have few or no symptoms. SVD frequently coexists with neurodegenerative disease, and can exacerbate cognitive deficits, physical disabilities, and other symptoms of neurodegeneration. Terminology and definitions for imaging the features of SVD vary widely, which is also true for protocols for image acquisition and image analysis. This lack of consistency hampers progress in identifying the contribution of SVD to the pathophysiology and clinical features of common neurodegenerative diseases. We are an international working group from the Centres of Excellence in Neurodegeneration. We completed a structured process to develop definitions and imaging standards for markers and consequences of SVD. We aimed to achieve the following: first, to provide a common advisory about terms and definitions for features visible on MRI; second, to suggest minimum standards for image acquisition and analysis; third, to agree on standards for scientific reporting of changes related to SVD on neuroimaging; and fourth, to review emerging imaging methods for detection and quantification of preclinical manifestations of SVD. Our findings and recommendations apply to research studies, and can be used in the clinical setting to standardise image interpretation, acquisition, and reporting. This Position Paper summarises the main outcomes of this international effort to provide the STandards for ReportIng Vascular changes on nEuroimaging (STRIVE).
| Original language | English (US) |
|---|---|
| Pages (from-to) | 822-838 |
| Number of pages | 17 |
| Journal | The Lancet Neurology |
| Volume | 12 |
| Issue number | 8 |
| DOIs | |
| State | Published - Aug 2013 |
Funding
The following institutions provided funding: the Centres of Excellence in Neurodegeneration (COEN) concordat (UK Medical Research Council, the German Centre for Neurodegenerative Disease [DZNE], and the Canadian Institutes of Health Research [CIHR]) reference COEN017; Royal Society of Edinburgh; Scottish Imaging Network, a Platform for Scientific Excellence (SINAPSE) Collaboration; UK Cross-Council Centre for Cognitive Ageing and Cognitive Epidemiology, Edinburgh, UK; Carl Friedrich von Siemens Foundation; Vascular Dementia Research Foundation; NIHR Biomedical Research Unit in Dementia awarded to Cambridge University Hospitals NHS Trust and the University of Cambridge, Cambridge, UK; NIHR Biomedical Research Unit in Dementia awarded to UCL Hospitals NHS Trust and UCL, London UK; FP6 ERA-NET NEURON grant (01 EW1207); and the Canadian Stroke Network. We thank M Henderson, K Shuler, L Thomas, I Wittko, and Anna Charlton for administrative support. GJB consults for and receives research support from Boehringer Ingelheim. FF serves on scientific advisory boards for Bayer Schering, Biogen Idec, Genzyme, Merck Serono, Pfizer, Novartis, and Teva Pharmaceutical Industries, and as scientific adviser for Perceptive Informatics, he serves on the editorial boards of Cerebrovascular Diseases, Multiple Sclerosis, the Polish Journal of Neurology and Neurosurgery, Stroke, and the Swiss Archives of Neurology and Psychiatry, and has received speaker honoraria and support from Biogen Idec, Bayer Schering, Merck Serono, Novartis, Sanofi-Aventis, and Teva Pharmaceutical Industries. RF receives operating research funding from the Canadian Institutes of Health Research, the Alberta and Pfizer Translational Research Program, the Hotchkiss Brain Institute, and the University of Calgary to support work on imaging SVD. JTOB has been a consultant for GE Healthcare, Lilly, Bayer Healthcare, and TauRx, and has received speakers' honoraria from Pfizer, GE Healthcare, Eisai, Shire, Lundbeck, Lilly, and Novartis. SEB has had research funds to the Cognitive Neurology Research and Stroke Research Units from Pfizer (Wyeth Research), GlaxoSmithKline, Lundbeck, Roche, and Novartis. She has received speakers' honoraria for continuing medical education from Pfizer, Eisai, and Novartis, and honoraria for ad-hoc consulting from Pfizer, Novartis, GlaxoSmithKline, Roche, Elan, and Bristol-Myers Squibb. HC has received honoraria for consultancy from Servier, Lundbeck, and Janssen Research and Development. F-EdL is supported by a Vidi grant (016\u00B7126\u00B7351) from the Netherlands Organisation for Health Research and Development. LP is a member of the editorial boards of Acta Neurologica Scandinavica, International Journal of Alzheimer Disease, and Cerebrovascular Diseases and editor of the vascular cognitive impairment section of Stroke. ST served as a member of the advisory board for Lilly Deutschland. MDi is a consultant for Lilly Deutschland and Boehringer Ingelheim, Biologische Heilmittel Heel, Bristol-Myers Squibb, and Ever Neuro Pharma. He has received honoraria from Bayer Vital, Boehringer Ingelheim Pharma Biologische Heilmittel Heel, Bristol-Myers Squibb, Lundbeck, Sanofi-Aventis Deutschland, Shire Deutschland, German Centre for Neurodegenerative Diseases (DZNE), Georg Thieme Verlag, UpToDate, and W Kohlhammer. He has received Principal Investigator and Research Funding (industry) from Bayer Vital, Eisai Medical Research, Eisai, Essex Pharma, Ferrer Internacional, and ICON Clinical Research. All other authors declare that they have no conflicts of interest.
ASJC Scopus subject areas
- Clinical Neurology
