Prof. Marco Düring Profile

Prof. Marco Düring

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Proceedings Article | 2 April 2024 Poster + Paper

Association between small vessel function and progressive white matter injury in CADASIL using advanced 7T MRI

S. D. Pham, H. van den Brink, A. Kopczak, A. De Luca, J. J. Zwanenburg, N. Dieleman, M. Duering, M. Dichgans, G. Biessels, J. C. Siero

Proceedings Volume 12930, 129301M (2024) https://doi.org/10.1117/12.3005890

KEYWORDS: Magnetic resonance imaging, White matter, Arteries, Injuries, Vascular diseases, Brain diseases, Brain, Blood circulation, Statistical analysis, Neuroimaging

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White Matter Hyperintensities (WMH) are associated with stroke and cognitive decline in cerebral Small Vessel Diseases (cSVDs). Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) is a genetic form of cSVD with observed pathology in small cerebral arteries. CADASIL is mostly studied through MRI lesions such as WMH, but these do not give insight on the disease processes happening in the small vessels. Characterizing the functioning of these vessels in vivo using 7T MRI can give us more insight in the disease processes in cSVDs. In our previous work, small vessel function was found to be impaired in CADASIL and was associated with baseline WMH. Here we studied if impaired small vessel function on 7T MRI was associated with WMH volume change in CADASIL. CADASIL patients (n=23) were recruited through the ZOOM@SVDs study, a prospective observational cohort study with two-year follow-up. Participants underwent a 3T brain MRI at baseline and follow-up to quantify WMHs. 7T brain MRI was performed at baseline to assess small vessel function. WMH volume change was defined as follow-up WMH minus baseline WMH. The potential relations between small vessel function and baseline WMH or WMH change were assessed using linear regression. WMH volume increased with 0.5% of intracranial volume (P<0.001) after two-year follow-up. As reported in previous work by our group, an inverse relationship was found between baseline WMH and small vessel function in terms of mean blood flow velocity within the perforating arteries of the semioval center. In this work, we found no significant associations between small vessel dysfunction and longitudinal WMH change. Further studies assessing the association between small vessel dysfunction and white matter injury markers on a voxelwise level might give us more understanding of the role of small vessel dysfunction in cSVDs pathology.

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