Causes and consequences of cerebral small vessel disease. The RUN DMC study: a prospective cohort study. Study rationale and protocol

Anouk GW van Norden, Karlijn F de Laat, Rob AR Gons, Inge WM van Uden, Ewoud J van Dijk, Lucas JB van Oudheusden, Rianne AJ Esselink, Bastiaan R Bloem, Baziel GM van Engelen, Machiel J Zwarts, Indira Tendolkar, Marcel G Olde-Rikkert, Maureen J van der Vlugt, Marcel P Zwiers, David G Norris, Frank-Erik de Leeuw

Cerebral small vessel disease (SVD) is a frequent finding on CT and MRI scans of elderly people and is related to vascular risk factors and cognitive and motor impairment, ultimately leading to dementia or parkinsonism in some. In general, the relations are weak, and not all subjects with SVD become demented or get parkinsonism. This might be explained by the diversity of underlying pathology of both white matter lesions (WML) and the normal appearing white matter (NAWM). Both cannot be properly appreciated with conventional MRI. Diffusion tensor imaging (DTI) provides alternative information on microstructural white matter integrity. The association between SVD, its microstructural integrity, and incident dementia and parkinsonism has never been investigated.