Kristina Shkirkova, BSc
Wyss A, Dawson J, Arba F, Wardlaw JM, Dickie DA, on behalf of the VISTA-Prevention Collaborators. “Combining Neurovascular and Neurodegenerative Magnetic Resonance Imaging Measures in Stroke.” Stroke. 2019; 50:1136-1139.
To characterize age and stroke-related tissue damage, the total small vessel disease score and the brain health index have recently been developed for clinical use. The total small vessel disease score combines presence of lacunes, microbleeds, and moderate to severe white matter hyperintensities (WMH) by visual scoring based on clinical imaging. The brain health index uses automatic processing of MRI scans to quantify visible injury from small vessel disease and brain atrophy. However, the total small vessel disease score is prone to granularity and measurement limitations, whereas the brain health index requires high-resolution T1, T2, T2 gradient echo, and fluid attenuated inversion recovery scans, which are not often available in routine clinical imaging.
The study by Wyss et al. argues that individual markers of cerebral small vessel disease and brain atrophy have limited potential to explain high proportion of variance in neurovascular and neurodegenerative disease. The authors propose to combine markers of white matter hyperintensity and cerebral atrophy, represented by cerebrospinal fluid (CSF) volume, into a single measure capable of more accurate predictions of cognitive impairment.