Cerebral SVD is characterized on neuroimaging by either WML or lacunar infarcts. Symptoms of SVD include acute symptoms, such as transient ischemic attack (TIA) or lacunar syndromes, but also subacute manifestations such as cognitive and motor (gait) disturbances [5 (link)]. As the onset of cerebral SVD is often insidious, clinically heterogeneous, and typically with mild symptoms, it has been suggested that the selection of subjects with cerebral SVD in clinical studies should be based on the more consistent brain imaging features [20 (link)].
Accordingly, in 2006, consecutive individuals referred to the Department of Neurology between October 2002 and November 2006, were selected for possible participation. Inclusion criteria were: (a) age between 50 and 85 years; (b) cerebral SVD on neuroimaging (WML and/or lacunar infarcts). Subsequently, the above mentioned acute and subacute clinical symptoms of SVD were assessed by standardized structured assessments (a questionnaire for TIA and stroke [21 (link)]; for cognition the Cognitive Failures Questionnaire [22 (link)]; for gait the Falls Questionnaire [23 (link)] and the Freezing of Gait Questionnaire [24 (link)]) Subjects who were eligible because of a lacunar syndrome were included only > 6 months after the event to avoid acute effects on the outcomes.
To be able to detect incident dementia and parkinsonism we applied the following exclusion criteria: (a) presence of dementia [25 ] and (b) parkinson(-ism)[26 (link),27 (link)]. In addition patients with (c)intracranial hemorrhage; (d) life expectancy of less than six months; (e) intracranial space occupying lesion; (f) (psychiatric) disease interfering with cognitive testing or follow-up; (g) recent or current use of acetylcholine-esterase inhibitors, neuroleptic agents, L-dopa or dopa-a(nta)gonists; (h) non-SVD related WML (e.g. multiple sclerosis); (i) prominent visual or hearing impairment; (j) language barrier; (k) MRI contraindications or known claustrophobia were excluded.
All participants signed an informed consent form. The Medical Review Ethics Committee region Arnhem-Nijmegen approved the study.
Accordingly, in 2006, consecutive individuals referred to the Department of Neurology between October 2002 and November 2006, were selected for possible participation. Inclusion criteria were: (a) age between 50 and 85 years; (b) cerebral SVD on neuroimaging (WML and/or lacunar infarcts). Subsequently, the above mentioned acute and subacute clinical symptoms of SVD were assessed by standardized structured assessments (a questionnaire for TIA and stroke [21 (link)]; for cognition the Cognitive Failures Questionnaire [22 (link)]; for gait the Falls Questionnaire [23 (link)] and the Freezing of Gait Questionnaire [24 (link)]) Subjects who were eligible because of a lacunar syndrome were included only > 6 months after the event to avoid acute effects on the outcomes.
To be able to detect incident dementia and parkinsonism we applied the following exclusion criteria: (a) presence of dementia [25 ] and (b) parkinson(-ism)[26 (link),27 (link)]. In addition patients with (c)intracranial hemorrhage; (d) life expectancy of less than six months; (e) intracranial space occupying lesion; (f) (psychiatric) disease interfering with cognitive testing or follow-up; (g) recent or current use of acetylcholine-esterase inhibitors, neuroleptic agents, L-dopa or dopa-a(nta)gonists; (h) non-SVD related WML (e.g. multiple sclerosis); (i) prominent visual or hearing impairment; (j) language barrier; (k) MRI contraindications or known claustrophobia were excluded.
All participants signed an informed consent form. The Medical Review Ethics Committee region Arnhem-Nijmegen approved the study.
Free full text: Click here
