Cerebral small vessel diseases (SVD) are a very frequent group of disorders all characterized by alterations of the structure and/or function of small arteries, veins and capillaries. In these disorders, brain tissue lesions accumulate years before the occurrence of clinical symptoms which can be devastating such as stroke, cognitive disturbances and gait disorders. So far, chronic hypoperfusion was considered to be responsible for the accumulation of such lesions. However, recent results have suggested that the lesions underlying white matter hyperintensities (WMH), the most common MRI marker of SVD visible on conventional MRI in quite every subject with SVD long before the occurrence of clinical events, may depend on the considered brain area and may correspond to various mechanisms. Some WMH may even be associated with less severe clinical manifestations.The aim of the present study is to identify different types of WMH by studying 100 patients with different forms of SVD with the most advanced MRI (including ultra-high-resolution imaging at 7 Tesla, new diffusion protocol, sodium MRI, contrast-enhanced angiography and relaxometry and post-processing techniques), and post-processing techniques (machine learning, deep learning, artificial intelligence).
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
OTHER
Masking
NONE
Enrollment
100
* 3T MRI, maximum 1H30 long duration, including diffusion tensor imaging, susceptibility weighted imaging, multiparametric acquisitions, without contrast perfusion acquisitions. * 7T MRI, maximum 1H30 long duration, including contrast enhanced acquisitions * Neuropsychological battery including chronometric measures obtained through a computer interface
Hopital Lariboisière
Paris, France
RECRUITINGPercentage of patients with a different form of white matter hyperintensities (WMH)
The different forms of white matter hyperintensities will be assessed and identified using MRI imaging.The pattern of co-variation of structural, functional, metabolic imaging modalities, estimated in each voxel of a reference space, both inside and outside the WMH, will be compared through massive statistical approaches, controlled, for multiple testing
Time frame: at the time of specific imaging (between Day 1 to Day 60)
Frequency of different WMH subtypes in different types of small cerebral vessel disease
Distribution of white matter hyperintensities in different brain areas according to the small cerebral vessel disease
Time frame: at the time of specific imaging (between Day 1 to Day 60)
Frequency of large tract involvement
Large tratreconstructed from diffusion imaging) by WMH depending on the the small cerebral vessel disease
Time frame: at the time of specific imaging (between Day 1 to Day 60)
Global cognitive function
The global cognitive functions will be assessed using MOCA. The MoCA assesses different cognitive domains: attention and concentration, executive functions, memory, language, visuoconstructional skills, conceptual thinking, calculations, and orientation to time and place
Time frame: at inclusion
Language
Language assessment will be done using LAST and Boston Naming Test
Time frame: at inclusion
Spatial exploration
The neglect and spatial exploration will be assessed with bells test from the BEN neglect battery
Time frame: at inclusion
Spatial memory
Spatial memory will be assessed using the brief visual-spatial memory test (BVMT-R)
Time frame: at inclusion
Visual memory
Visual memory will be assessed using the brief visual-spatial memory test (BVMT-R)
Time frame: at inclusion
Episodic verbal memory
Episodic verbal memory test by the RL RI 16
Time frame: at inclusion
Working memory
Working memory will be evaluated by the working memory index of the WAIS-IV
Time frame: at inclusion
Executive function
Executive function will be assessed by the versions A and B of the Trail Making Test
Time frame: at inclusion
Attentional Performances status
Attentional Performances will be assessed using a battery on a computer which tests different attentionnal and executive function
Time frame: at inclusion
Depression and Anxiety status
Depression and anxiety will be assessed using Hospital Anxiety and Depression Scale (HADS) questionnaire. The HAD scale is a self-assessment scale for detecting states of depression and anxiety in the setting of an hospital medical outpatient clinic. HADS is a self-administered scale of 14 items which assessed levels of depression and anxiety, divided into 2 subscales of 7 items (Anxiety or HADS-A, Depression or HADS-D). Each item is scored on a scale of 0 to 3. A score is generated for each of the two sub-scales (sum of the 7 items, ranging from 0 to 21). Limit scores, for each of the scores, distinguish: non-cases or asymptomatic ones (score ≤ 7); probable or borderline cases (score 8-10); clearly or clinically symptomatic cases (score ≥ 11).
Time frame: at inclusion
Apathy status
Apathy status will be assessed using the Starkstein scale
Time frame: at inclusion
Pulse wave Velocity count
Arterial stifness will be assessed by measuring the pulse wave velocity
Time frame: at inclusion
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