Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegeneration: A united approach

Joanna Wardlaw, Eric Smith, Geert Biessels, Charlotte Cordonnier, Franz Fazekas, Richard Frayne, Richard Lindley, John O'Brien, Frederik Barkhof, Oscar Benavente, Sandra Black, Carol Brayne, Monique Breteler, Hugues Chabriat, Charles DeCarli, Frank-Erik de Leeuw, Fergus Doubal, Marco Duering, Nick Fox, Steven GreenbergVladimir Hachinski, Ingo Kilimann, Vincent Mok, Robert van Oostenbrugge, Leonardo Pantoni, Oliver Speck, Blossom Stephan, Stefan Teipel, Anand Viswanathan, David Werring, Christopher Chen, Colin Smith, Mark van Buchem, Bo Norrving, Philip Gorelick, Martin Dichgans

Research output: Contribution to journalLiterature reviewpeer-review


Cerebral small vessel disease (SVD) is a common accompaniment of ageing, whose visible neuroimaging features include recent small subcortical infarcts, lacunes, white matter hyperintensities, perivascular spaces, microbleeds and brain atrophy. SVD may present as a stroke or cognitive decline, or may be asymptomatic or minimally symptomatic, and frequently coexists with neurodegenerative disease where it may exacerbate cognitive deficits, physical disabilities, and other symptoms arising from neurodegeneration. The terminology and definitions used to describe imaging features of SVD vary widely as do protocols for image acquisition and image analysis. This lack of consistency obstructs progress in determining the contribution that SVD makes to the pathophysiology and clinical expression of common neurodegenerative diseases. Against this background, an International working group of the Centres of Excellence in Neurodegeneration completed a structured process to develop definitions and imaging standards for specific markers and consequences of SVD. The group was charged with the following tasks: to i) provide a common advisory terminology and definitions for imaging features of SVD visible on magnetic resonance (MR) imaging (MRI), ii) suggest minimum standards for their image acquisition and analysis, iii) agree on standards for scientific reporting of small-vessel-related changes on neuroimaging, iv) review emerging imaging methods for detecting and quantifying preclinical manifestations of SVD. Our findings apply to research studies and in addition can be used in the clinical setting to standardise image interpretation, acquisition, and reporting.
This manuscript summarises the main outcomes of this international effort to provide the STandards for ReportIng Vascular Changes on NEuroimaging (STRIVE).
Original languageEnglish
Pages (from-to)822–838
Number of pages16
JournalLancet Neurology
Issue number8
Publication statusPublished - Aug 2013


  • Cerebral small vessel disease
  • neurodegeneration
  • neuroimaging
  • ageing
  • subcortical infarcts
  • white matter hyperintensitites
  • perivascular spaces
  • microbleeds
  • brain atrophy


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