In shape: a novel approach to white matter hyperintensity analysis

Abstract

Cerebral small vessel disease (SVD) refers to a group of pathological changes affecting the cerebral small arteries, arterioles, capillaries and venules of the brain. SVD is a major contributor to ischemic stroke, cognitive decline, and dementia. The most common SVD-related brain changes are white matter hyperintensities (WMH), lacunes, microbleeds, enlarged perivascular spaces, and also atrophy. WMH appear as hyperintense lesions on fluid-attenuated inversion recovery (FLAIR) MRI. The overarching aim of this thesis is to exploit the shape of WMHs to better characterize WMH and thereby to improve the clinical interpretation of WMHs and to investigate whether it could predict clinical outcome. This thesis is mostly based on non-demented and community-dwelling older individuals. Moreover, a study set up focusing on a memory-clinic population will be discussed to get more pathology focused insights into the formation of WMH.