Population Imaging of Cerebral Small Vessel Disease

textabstractAs we grow older, our brain tends to shrink. We become increasingly vul nerable to dementia and stroke, two common disorders in the elderly that have great impact on brain functioning and the way people live their lives. The burden of these diseases will rapidly grow over the coming years as a result of aging populations worldwide. Currently, dementia (11.2%) and stroke (9.5%) already contribute substantially to the number of years lived with disability of people aged 60 and older; this is considerably more than the years of disability caused by cardiovascular disease (5.0%) or by all forms of cancer (2.4%) together. Since few therapeutic possibilities exist for these neurological diseases in the elderly, effective prevention strategies are urgently needed. In order to develop successful approaches to prevent dementia and stroke, it is crucial to explore the early presymptomatic phases of these diseases. Markers that enable us to detect disease in an early stage before the clinical syndromes of dementia and stroke become apparent are strongly needed to gain more insight in the causes of dementia and stroke, to identify persons who will develop these diseases, and to provide opportunities to alter or stop the disease process. Magnetic resonance imaging (MRI) has proven to be a very suitable technique for the investigation of these presymptomatic phases as it offers detailed information about presymptomatic pathology in the brain without exposure to radiation.