01 Jun 21. Featured Paper
Correlations in post-mortem imaging-histopathology studies of sporadic human cerebral small vessel disease: a systematic review
Link to paper on Neuropathology & Applied Neurobiology
Catherine A Humphreys, Colin Smith, Joanna M Wardlaw
Aims: Sporadic human cerebral small vessel disease (SVD) commonly causes stroke & dementia but its pathogenesis is poorly understood.
There are recognised neuroimaging & histopathological features.
However, relatively few studies have examined the relationship between the radiological & pathological correlates of SVD; better correlation would promote greater insight into the underlying biological changes.
Methods: We performed a systematic review to collate & appraise the information derived from studies that correlated histological with neuroimaging-defined SVD lesions.
We searched for studies describing post-mortem imaging & histological tissue examination in adults, extracted data from published studies, categorised the information & compiled this narrative.
Results: We identified 38 relevant studies, including at least 1146 subjects, 342 of these with SVD: 29 studies focussed on neuroradiological white matter lesions (WML), six on microinfarcts & three on dilated perivascular spaces (PVS) & lacunes.
The histopathology terminology was diverse with few robust definitions.
Reporting & methodology varied widely between studies, precluding formal meta-analysis.
PVS & ‘oedema’ were frequent findings in WML, being described in at least 94 & 18 radiological WML respectively, in addition to myelin pallor.
Histopathological changes extended beyond the radiological lesion margins in at least 33 radiological WML.
At least 43 radiological lesions not seen pathologically & at least 178 histological lesions were not identified on imaging.
Conclusions: Histopathological assessment of human SVD is hindered by inconsistent methodological approaches & unstandardised definitions.
The data from this systematic review will help to develop standardised definitions to promote consistency in human SVD research.
- Cerebral small vessel disease
- Systematic review
- Vascular dementia
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Featured paper: Correlations in post-mortem imaging-histopathology studies of sporadic human cerebral small vessel disease: a systematic review