Thesis defense Inge van Uden (Donders series 257)
14 February 2017
Promotors: prof. dr. H. de Leeuw, prof. dr. C.J Klijn,
copromotor: dr. E.J. van Dijk
The behavioral consequences of cerebral small vessel disease. An MRI approach
Cerebral small vessel disease (cSVD) encompasses the pathological processes that affect small vessels in the brain and is frequently seen on MRI scans of older adults. It is difficult to predict which persons with cSVD are at highest risk to develop severe clinical symptoms such as mood disorders or dementia. In this thesis we aimed to investigate imaging markers in relation to clinical symptoms, which can help to gain more insight into the pathophysiological processes that underlie behavioural consequences of cSVD (especially depressive symptoms and dementia), . In the first part of the thesis we showed that white matter and hippocampal volume are related to dementia 5 years later. At the same time we showed the limited additional value of diffusion tensor imaging (investigating white matter microstructural integrity) in predicting cognitive decline. In the second part we showed that lower amygdala volume and low white matter microstructural integrity are associated with depressive symptoms. Interestingly, depressive symptoms that occurred for the first time at older age, might be a first indication of dementia. Finally we reported on the dynamic, non-linear progression of cSVD after 9 years, even showing reduction in some. Possibly this change in cSVD even better correlates with newly developed behavioural consequences, such as dementia or depression, than the baseline imaging markers.