Regional diffusion imaging measures to disentangle SVD-related hypertensive arteriopathy versus cerebral amyloid angiopathy.
Overview
- Department of Radiology, Mayo Clinic,200 First Street SW, Rochester, MN 55905 USA
- Department of Quantitative Health Sciences, Mayo Clinic,Rochester, MN 55905 USA
- Department of Information Technology, Mayo Clinic,Rochester, MN 55905 USA
- Department of Medicine, The MIND Center, University of Mississippi Medical Center,Jackson, FL 39216 USA
- Department of Laboratory Medicine and Pathology, Mayo Clinic,Rochester, MN 55905 USA
- Department of Laboratory Medicine and Pathology, Mayo Clinic,Jacksonville, FL 32224 USA
- Department of Neurology, Mayo Clinic,Rochester, MN 55905 USA
Abstract
Background: Detecting and distinguishing early changes due to the two key subtypes of cerebral small vessel disease (SVD), hypertensive arteriopathy (HA) and cerebral amyloid angiopathy (CAA), has significant clinical implications. Our goal was to develop and validate dMRI signatures associated with HA-SVD and CAA-SVD proxies and assess their clinical utility using Alzheimer’s disease and SVD biomarkers, pathology, and cognition.
Methods: Two independent cohorts with baseline dMRI scans, T2* gradient-echo MRI, and vascular risk measures were analyzed: Mayo Clinic Study of Aging (MCSA, N = 1080) and Alzheimer’s Disease Neuroimaging Initiative (ADNI, N = 549). In MCSA, regional dMRI measures associated with proxies of HA-SVD (hypertension) and CAA-SVD (lobar cerebral microbleeds) were identified using logistic regression models. The top regional features were then used to compute composite dMRI indices for HA-SVD and CAA-SVD. These dMRI indices were validated in ADNI and in an independent pathology sample of MCSA (N = 147). In MCSA, we also computed standard global SVD indices from diffusion and FLAIR MRI and compared them with dMRI indices to reflect SVD subtypes. Next, we evaluated the association of these indices with cognitive performance (global, attention, and memory) using regression models, after adjusting demographics, white matter hyperintensities (WMH) and amyloid.
Results: Hypertension was associated with reduced microstructural integrity predominantly in fronto-parieto-projectio
Conclusions: Using three datasets, (population-based sample, independent cohort, pathology sample), we found that regional dMRI signatures can capture distinct SVD processes of HA and CAA. These dMRI signatures offer potential for early differential identification of SVD subtypes and can aid in guiding clinical decision making and prevention.
Supplementary Information: The online version contains supplementary material available at 10.1186/
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Data
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Data availability
All the imaging datasets for MCSA are available for download from GAAIN.org. ADNI data are available for download from (https://
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Version 1, 29 September 2026: the first record
Recorded: type, language, journal, volume, issue, pages, dates, 17 authors, 6 keywords, 12 MeSH terms, 2 funders, 91 references.
Cite
This paper
Raghavan, S., Przybelski, S. A., Gebre, R. K., Low, A., Hu, M., Reid, R. I., Windham, B. G., Wiste, H. J., Fought, A. J., Kamykowski, M. G., Nguyen, A. T., Murray, M. E., Lowe, V. J., Jack, C. R. J., Petersen, R. C., Graff-Radford, J., & Vemuri, P. (2026). Regional diffusion imaging measures to disentangle SVD-related hypertensive arteriopathy versus cerebral amyloid angiopathy. Molecular neurodegeneration, 21(1), 27. https://
BibTeX
@article{raghavan2026reg
author = {Raghavan, Sheelakumari and Przybelski, Scott A. and Gebre, Robel K. and Low, Audrey and Hu, Mingzhao and Reid, Robert. I. and Windham, B. Gwen and Wiste, Heather J. and Fought, Angela J. and Kamykowski, Michael G. and Nguyen, Aivi T. and Murray, Melissa E. and Lowe, Val J. and Jack, Clifford R. Jr and Petersen, Ronald C. and Graff-Radford, Jonathan and Vemuri, Prashanthi},
title = {{Regional diffusion imaging measures to disentangle SVD-related hypertensive arteriopathy versus cerebral amyloid angiopathy}},
journal = {Molecular neurodegeneration},
year = {2026},
month = apr,
volume = {21},
number = {1},
pages = {27},
publisher = {BMC},
issn = {1750-1326},
doi = {10.1186/
url = {https://
pmid = {41975517},
pmcid = {PMC13185335}
}
RIS
TY - JOUR
AU - Raghavan, Sheelakumari
AU - Przybelski, Scott A.
AU - Gebre, Robel K.
AU - Low, Audrey
AU - Hu, Mingzhao
AU - Reid, Robert. I.
AU - Windham, B. Gwen
AU - Wiste, Heather J.
AU - Fought, Angela J.
AU - Kamykowski, Michael G.
AU - Nguyen, Aivi T.
AU - Murray, Melissa E.
AU - Lowe, Val J.
AU - Jack, Clifford R. Jr
AU - Petersen, Ronald C.
AU - Graff-Radford, Jonathan
AU - Vemuri, Prashanthi
TI - Regional diffusion imaging measures to disentangle SVD-related hypertensive arteriopathy versus cerebral amyloid angiopathy
T2 - Molecular neurodegeneration
J2 - Mol Neurodegener
PY - 2026
DA - 2026/
VL - 21
IS - 1
SP - 27
SN - 1750-1326
PB - BMC
DO - 10.1186/
UR - https://
LA - en
ER -
CSL-JSON
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