STRIVEing to describe small vessel disease

Until just over a decade ago, and sometimes even now, reports of multiple small ischaemic foci in the deep white hemispheric matter and brain atrophy consistent with older age (>60 years), or similar observations, were regularly encountered by neurologists who sent patients with cognitive impairment for a brain MRI scan. Often, the diagnostic conclusion that was thought to fit with these neuroimaging findings was vascular dementia, despite the neuropsychological profile of memory impairment being more consistent with Alzheimer's disease. Unfortunately, in most cases, these diagnoses were made in error. If the Standards for Reporting Vascular Changes on Neuroimaging (STRIVE-1) criteria 1 Wardlaw JM Smith EE Biessels GJ et al. Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegeneration. Lancet Neurol. 2013; 12: 822-838 Summary Full Text Full Text PDF PubMed Scopus (3290) Google Scholar and their pathophysiologically agnostic approach had been available at the time, many incorrect diagnoses would probably have been avoided. Neuroimaging standards for research into small vessel disease—advances since 2013Cerebral small vessel disease (SVD) is common during ageing and can present as stroke, cognitive decline, neurobehavioural symptoms, or functional impairment. SVD frequently coexists with neurodegenerative disease, and can exacerbate cognitive and other symptoms and affect activities of daily living. Standards for Reporting Vascular Changes on Neuroimaging 1 (STRIVE-1) categorised and standardised the diverse features of SVD that are visible on structural MRI. Since then, new information on these established SVD markers and novel MRI sequences and imaging features have emerged. Full-Text PDF