Cerebral small vessel disease: A review focusing on pathophysiology, biomarkers, and machine learning strategies

Elisa Cuadrado-Godia*, Pratistha Dwivedi, Sanjiv Sharma, Angel Ois Santiago, Jaume Roquer Gonzalez, Mercedes Balcells, John Laird, Monika Turk, Harman S. Suri, Andrew Nicolaides, Luca Saba, Narendra N. Khanna, Jasjit S. Suri

*Corresponding author for this work

Research output: Indexed journal article Reviewpeer-review

216 Citations (Scopus)

Abstract

Cerebral small vessel disease (cSVD) has a crucial role in lacunar stroke and brain hemorrhages and is a leading cause of cognitive decline and functional loss in elderly patients. Based on underlying pathophysiology, cSVD can be subdivided into amyloidal and non-amyloidal subtypes. Genetic factors of cSVD play a pivotal role in terms of unraveling molecular mechanism. An important pathophysiological mechanism of cSVD is blood-brain barrier leakage and endothelium dysfunction which gives a clue in identification of the disease through circulating biological markers. Detection of cSVD is routinely carried out by key neuroimaging markers including white matter hyperintensities, lacunes, small subcortical infarcts, perivascular spaces, cerebral microbleeds, and brain atrophy. Application of neural networking, machine learning and deep learning in image processing have increased significantly for correct severity of cSVD. A linkage between cSVD and other neurological disorder, such as Alzheimer’s and Parkinson’s disease and non-cerebral disease, has also been investigated recently. This review draws a broad picture of cSVD, aiming to inculcate new insights into its pathogenesis and biomarkers. It also focuses on the role of deep machine strategies and other dimensions of cSVD by linking it with several cerebral and non-cerebral diseases as well as recent advances in the field to achieve sensitive detection, effective prevention and disease management.

Original languageEnglish
Pages (from-to)302-320
Number of pages19
JournalJournal of Stroke
Volume20
Issue number3
DOIs
Publication statusPublished - Sept 2018

Keywords

  • Biomarkers
  • Blood-brain barrier
  • Machine learning
  • Neuroimaging
  • Small vessel disease

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