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. 2020 Feb;40(2):231-245.
doi: 10.1177/0271678X19888967. Epub 2019 Nov 20.

Brain atrophy in cerebral small vessel diseases: Extent, consequences, technical limitations and perspectives: The HARNESS initiative

Affiliations

Brain atrophy in cerebral small vessel diseases: Extent, consequences, technical limitations and perspectives: The HARNESS initiative

François De Guio et al. J Cereb Blood Flow Metab. 2020 Feb.

Abstract

Brain atrophy is increasingly evaluated in cerebral small vessel diseases. We aim at systematically reviewing the available data regarding its extent, correlates and cognitive consequences. Given that in this context, brain atrophy measures might be biased, the first part of the review focuses on technical aspects. Thereafter, data from the literature are analyzed in light of these potential limitations, to better understand the relationships between brain atrophy and other MRI markers of cerebral small vessel diseases. In the last part, we review the links between brain atrophy and cognitive alterations in patients with cerebral small vessel diseases.

Keywords: Cerebral small vessel disease; brain atrophy; brain volume; cognitive alterations; cognitive performances; lacunes; segmentation; white matter hyperintensities.

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Figures

Figure 1.
Figure 1.
Comparison between SIENA with default settings (a) and SIENA with lesion filling (b). Hot colors indicate areas of growth and cold colors areas of atrophy. The region of surface atrophy (white arrows) near the infarct is fairly consistent between methods, but lesion filling removes an area of apparent change within the infarct (black arrow). Courtesy of Yassi et al. Reprinted by permission from Springer © 2015.
Figure 2.
Figure 2.
FreeSurfer segmentation of one-month MPRAGE post-stroke (a) with lesion arrowed. FreeSurfer handling of white-matter segmentation and volumetric results in lesion voxels being excluded from segmentation (b). Three-month MPRAGE post-stroke (c) and FreeSurfer white-matter segmentation (d). In this example, brain volumes at one and three months cannot be compared due to inconsistent brain segmentations induced by the lesion. Courtesy of Yassi et al. Reprinted by permission from Springer © 2015.
Figure 3.
Figure 3.
Brain volume is a key imaging marker of cognitive alterations, both in cerebral small vessel disease (SVD) and in Alzheimer’s disease (AD). In SVD, lacunes are the MRI marker whose links with brain volume appear the most consistent. While AD is known to promote both cognitive impairment and brain atrophy, studies in sporadic SVD after exclusion of concomitant AD are lacking. WMH: white matter hyperintensities.

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