MRI-Based Small Vessel Disease Score Predicts Risk for Dementia

A study in Neurology found that a simple small vessel disease (SVD) score based on routine clinical magnetic resonance imaging (MRI) scans may help identify persons with SVD who are susceptible to cognitive decline and dementia, reports Neurology Advisor . The researchers looked at three prospective longitudinal cohorts of people with SVD ranging from mild and asymptomatic to severe and symptomatic. MRI was conducted at baseline, cognitive tests repeated during follow-up, and progression to dementia prospectively documented. Adding the simple SVD score to a model that covered age, sex, and education years enhanced the prediction of dementia as area under the curve from 0.76 to 0.81 and to 0.83 with a revised score in which there were a number of categories for both the number of lacunar infarcts and the severity of white matter hyperintensities. The researchers also sought to ascertain whether using the SVD score to select a group of individuals with more severe disease would reduce sample sizes for clinical intervention trials, and by using dementia onset as the outcome measure, the preselection of subjects with higher SVD score lowered sample size by 57 percent.