Consensus statement for diagnosis of subcortical small vessel disease

Gary A. Rosenberg*, Anders Wallin, Joanna M. Wardlaw, Hugh S. Markus, Joan Montaner, Leslie Wolfson, Costantino Iadecola, Berislav V. Zlokovic, Anne Joutel, Martin Dichgans, Marco Duering, Reinhold Schmidt, Amos D. Korczyn, Lea T. Grinberg, Helena C. Chui, Vladimir Hachinski

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review


Vascular cognitive impairment (VCI) is the diagnostic term used to describe a heterogeneous group of sporadic and hereditary diseases of the large and small blood vessels. Subcortical small vessel disease (SVD) leads to lacunar infarcts and progressive damage to the white matter. Patients with progressive damage to the white matter, referred to as Binswanger's disease (BD), constitute a spectrum from pure vascular disease to a mixture with neurodegenerative changes. Binswanger's disease patients are a relatively homogeneous subgroup with hypoxic hypoperfusion, lacunar infarcts, and inflammation that act synergistically to disrupt the blood-brain barrier (BBB) and break down myelin. Identification of this subgroup can be facilitated by multimodal disease markers obtained from clinical, cerebrospinal fluid, neuropsychological, and imaging studies. This consensus statement identifies a potential set of biomarkers based on underlying pathologic changes that could facilitate diagnosis and aid patient selection for future collaborative treatment trials.

Original languageEnglish
Pages (from-to)6-25
Number of pages20
JournalJournal of Cerebral Blood Flow and Metabolism
Issue number1
StatePublished - 1 Jan 2016


  • Binswanger's disease
  • blood-brain barrier permeability
  • cerebrospinal fluid
  • inflammation
  • leukoaraiosis


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