J. M. Wardlaw, E. E. Smith, G. J. Biessels, C. Cordonnier, F. Fazekas, R. Frayne, R. I. Lindley, J. T. O'Brien, F. Barkhof, O. R. Benavente, S. E. Black, C. Brayne, M. Breteler, H. Chabriat, C. DeCarli, F. E. de Leeuw, F. Doubal, M. Duering, N. C. Fox, S. Greenberg, V. Hachinski, I. Kilimann, V. Mok, R. van Oostenbrugge, L. Pantoni, O. Speck, B. C. M. Stephan, S. Teipel, A. Viswanathan, D. Werring, C. Chen, C. Smith, M. van Buchem, B. Norrving, P. B. Gorelick, M. Dichgans, STand Reporting Vasc Changes



Publication year



Lancet Neurology

Periodical Number






Author Address

Wardlaw, JM Univ Edinburgh, Western Gen Hosp, Div Neuroimaging Sci, Edinburgh EH4 2XU, Midlothian, Scotland Univ Edinburgh, Edinburgh, Midlothian, Scotland Univ Edinburgh, Ctr Clin Brain Sci, Edinburgh, Midlothian, Scotland Univ Edinburgh, Ctr Cognit Ageing & Cognit Epidemiol, Edinburgh, Midlothian, Scotland Univ Edinburgh, Brain Res Imaging Ctr, Edinburgh, Midlothian, Scotland Univ Calgary, Dept Clin Neurosci & Radiol, Hotchkiss Brain Inst, Calgary, AB, Canada Univ Calgary, Seaman Family MR Res, Calgary, AB, Canada UMC, Rudolf Magnus Inst Neurosci, Dept Neurol, Utrecht, Netherlands Lille Univ Hosp, Dept Neurol, Lille, France Graz Univ, Dept Med Neurol, Graz, Austria Univ Sydney, Westmead Hosp, Sydney, NSW 2006, Australia Univ Cambridge, Dept Psychiat, Addenbrookes Hosp, Cambridge, England Vrije Univ Amsterdam Med Ctr, Dept Radiol & Nucl Med, Amsterdam, Netherlands Univ British Columbia, Dept Med, Div Neurol, Brain Res Ctr, Vancouver, BC, Canada Sunnybrook Hlth Sci Ctr, Toronto, ON M4N 3M5, Canada Cambridge Inst Publ Hlth, Sch Clin Med, Cambridge, England German Ctr Neurodegenerat Dis, Bonn, Germany Univ Paris 07, INSERM, Hop Lariboisiere, Serv Neurol, Paris, France Univ Calif Davis, Dept Neurol, Sacramento, CA 95817 USA Radboud Univ Nijmegen, Med Ctr, Dept Neurol, Donders Inst Brain Cognit & Behav, NL-6525 ED Nijmegen, Netherlands Univ Munich, Inst Stroke & Dementia Res, Klinikum Univ Munchen, Munich, Germany UCL, Inst Neurol, Dept Brain Repair & Rehabil, London, England Massachusetts Gen Hosp, Ctr Stroke Res, Boston, MA 02114 USA Western Univ, Dept Clin Neurol Sci, London, ON, Canada German Ctr Neurodegenerat Dis DZNE Rostock Greifs, Rostock, Germany Chinese Univ Hong, Div Neurol, Dept Med andTherapeut, Prince Wales Hosp, Hong Kong, Hong Kong, Peoples R China Maastricht Univ Med Ctr, Dept Neurol, Sch Mental Hlth & Neurosci, Maastricht, Netherlands Maastricht Univ Med Ctr, Cardiovasc Res Inst Maastricht, Maastricht, Netherlands Univ Florence, Azienda Univ Osped Careggi, Dept Neurosci Pharmacol & Childs Hlth NEUROFA, Florence, Italy Univ Magdeburg, Inst Expt Phys, Fac Nat Sci, Dept Biomed Magnet Resonance, D-39106 Magdeburg, Germany Newcastle Univ, Newcastle Upon Tyne NE1 7RU, Tyne & Wear, England Natl Univ Singapore, Yong Loo Lin Sch Med, Singapore 117595, Singapore Leiden Univ, Dept Radiol, Med Ctr, Leiden, Netherlands Skane Univ Hosp, Dept Clin Sci, Neurol Sect, Lund, Sweden Hauenstein Neurosci Ctr, St Marys Hlth Care, Grand Rapids, MI USA Munich Cluster Syst Neurol SyNergy, Munich, Germany

Full version

Cerebral small vessel disease (SVD) is a common accompaniment of ageing. Features seen on neuroimaging include recent small subcortical infarcts, lacunes, white matter hyperintensities, perivascular spaces, microbleeds, and brain atrophy. SVD can present as a stroke or cognitive decline, or can have few or no symptoms. SVD frequently coexists with neurodegenerative disease, and can exacerbate cognitive deficits, physical disabilities, and other symptoms of neurodegeneration. Terminology and definitions for imaging the features of SVD vary widely, which is also true for protocols for image acquisition and image analysis. This lack of consistency hampers progress in identifying the contribution of SVD to the pathophysiology and clinical features of common neurodegenerative diseases. We are an international working group from the Centres of Excellence in Neurodegeneration. We completed a structured process to develop definitions and imaging standards for markers and consequences of SVD. We aimed to achieve the following: first, to provide a common advisory about terms and definitions for features visible on MRI; second, to suggest minimum standards for image acquisition and analysis; third, to agree on standards for scientific reporting of changes related to SVD on neuroimaging; and fourth, to review emerging imaging methods for detection and quantification of preclinical manifestations of SVD. Our findings and recommendations apply to research studies, and can be used in the clinical setting to standardise image interpretation, acquisition, and reporting. This Position Paper summarises the main outcomes of this international effort to provide the STandards for Reporting Vascular changes on nEuroimaging (STRIVE).