ArticleFrontiers in neurology2026
Perivascular diffusion and white matter free water improve identification of cognitive impairment in cerebral small vessel disease.
Article in Frontiers in neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Inroduction: Cerebral small vessel disease contributes substantially to cognitive decline in older adults, but conventional structural magnetic resonance imaging markers mainly reflect accumulated lesion burden and do not directly characterize diffusion-derived alterations in brain fluid homeostasis. We investigated whether combining diffusion imaging along the perivascular space and white matter free-water imaging improves identification of Montreal Cognitive Assessment (MoCA)-defined cognitive impairment in elderly patients with cerebral small vessel disease. Methods: This prospective study included 100 patients with cerebral small vessel disease and 50 healthy controls. According to MoCA scores, patients were classified as cognitively normal ( Results: Analysis along the perivascular space decreased progressively from healthy controls to cognitively normal patients and cognitively impaired patients, whereas white matter free water increased in the opposite direction (all Discussion: Perivascular diffusion imaging and white matter free water capture complementary aspects of altered perivascular diffusion and extracellular free-water accumulation in cerebral small vessel disease and improve identification of MoCA-defined cognitive impairment beyond conventional structural magnetic resonance imaging markers.
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