This research looks at a novel analysis technique for advanced Magnetic Resonance Imaging (MRI) which assesses networks formed by the white matter ‘wiring’ of the brain. This has relevance for two key outstanding questions:

1) How do cognitive impairment and dementia come about in SVD?

2) How can we best monitor small vessel disease in future clinical trials?

These are important for future therapies as better understanding the mechanisms of impairment might lead to new avenues of treatment, and using the most sensitive measures to monitor SVD makes clinical trials more feasible. Pilot data of the novel network analysis shows considerable promise and this research allows us to investigate further. Our research participants (40 SVD, 25 Controls) will undergo a cognitive testing session where they will complete a battery of standard tests with a neuropsychologist (approx. 2 hours). They will then undergo an MRI examination lasting 45 minutes. A subset of participants will complete an identical followup scan within two weeks which we will use to assess the reliability of different analysis methods. Patients are eligible for this study if they have had a particular type of small stroke (lacunar stroke) along with additional clinical neuroimaging evidence of wider small vessel disease (diffuse white matter damage). Furthermore, participants must not have strokes of other types, and must be able to undergo MRI and cognitive testing.