01 May 21. Featured Paper

Zooming in on cerebral small vessel function in small vessel diseases with 7T MRI: Rationale & design of the “ZOOM@SVDs” study.

Link to paper on Cerebral Circulation - Cognition & Behavior

Authors

Hilde van den Brink, Anna Kopczak, Tine Arts, Laurien Onkenhout, Jeroen C.W. Siero, Jaco J.M. Zwanenburg, Marco Duering, Gordon W. Blair, Fergus N. Doubal, Michael S. Stringer, Michael J. Thrippleton, Hugo J. Kuijf, Alberto de Luca, Jeroen Hendrikse, Joanna M. Wardlaw, Martin Dichgans, Geert Jan Biessels, SVDs@target group

Abstract

Background: Cerebral small vessel diseases (SVDs) are a major cause of stroke & dementia.

Yet, specific treatment strategies are lacking in part because of a limited understanding of the underlying disease processes.

There is therefore an urgent need to study SVDs at their core, the small vessels themselves.

Objective: This paper presents the rationale & design of the ZOOM@SVDs study, which aims to establish measures of cerebral small vessel dysfunction on 7T MRI as novel disease markers of SVDs.

Methods: ZOOM@SVDs is a prospective observational cohort study with two years follow-up.

ZOOM@SVDs recruits participants with Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts & Leukoencephalopathy (CADASIL, N = 20), sporadic SVDs (N = 60), & healthy controls (N = 40).

Participants undergo 7T brain MRI to assess different aspects of small vessel function including small vessel reactivity, cerebral perforating artery flow, & pulsatility.

Extensive work-up at baseline & follow-up further includes clinical & neuropsychological assessment as well as 3T brain MRI to assess conventional SVD imaging markers.

Measures of small vessel dysfunction are compared between patients & controls, & related to the severity of clinical & conventional MRI manifestations of SVDs.

Discussion: ZOOM@SVDs will deliver novel markers of cerebral small vessel function in patients with monogenic & sporadic forms of SVDs, & establish their relation with disease burden & progression.

These small vessel markers can support etiological studies in SVDs & may serve as surrogate outcome measures in future clinical trials to show target engagement of drugs directed at the small vessels.

Keywords

• CADASIL
• Cerebral small vessel disease
• High field strength MRI
• Small vessel function
• Sporadic SVD
• Stroke