WHIte MAtter Hyperintensity Shape and Glymphatics

Recruiting now

Conditions studied: Cerebral Small Vessel Diseases, Dementia, Mixed, Dementia, Vascular, Mild Cognitive Impairment, Cognitive Impairment, Cognitive Decline

In brief

In a society with increased life expectancy, the economic, social and personal burden of dementia increases. Dementia is often caused by a combination of neurovascular and neurodegenerative diseases. Impaired brain clearance is suggested to be closely related to dementia development, as waste products (e.g. amyloid beta) accumulate in the brain, leading to neurodegeneration. Cerebral small vessel disease (SVD) is the most common neurovascular disease that even contributes to about 45% of dementia pathophysiology in patients with a diagnosis of Alzheimer's dementia. White matter hyperintensities of presumed vascular origin (WMH) are the key brain MRI manifestation of cerebral SVD. There is evidence that the currently known and MRI-visible WMH are landmarks of an already progressed stage of the underlying pathology. The pathophysiology of WMH has been attributed to multiple underlying mechanisms, such as hypoperfusion, defective cerebrovascular reactivity and blood-brain barrier dysfunction. Furthermore, different anatomical locations and different types of WMH are related to different underlying pathological changes. Using ultra-high field 7T MR imaging techniques WMH lesions can be detected with a higher sensitivity and resolution than on 3T MRI. The hypothesis is that different pathological mechanisms of cerebral SVD lead to variations in WMH shape. Moreover, the brain clearance ('glymphatic') system of the brain appears to be tightly connected to dementia pathology. Thus, novel markers of glymphatic activity could aid to describe and understand the pathology.

Key facts

Study ID

NCT06010511

Run by

Leiden University Medical Center

People needed

50

Starts

2023-01-18

Expected to finish

2027-08-31

Last updated by the study team

2025-04-13

Who can join

Age: 65 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Admitted to the memory or the geriatric clinic of the LUMC, the Alrijne Hospital Leiden or the Haga Hospital the Hague
• From 65 years of age
• Eligible for MRI
• Native-level Dutch speaker

You may not qualify if…

• Claustrophobia
• Contraindications for MRI such as metal implants and pacemaker
• Use of benzodiazepines
• Initiated treatment with antidepressants less than 6 weeks prior to inclusion
• Not being able to provide written informed consent (assessed by the treating physician)
• Individuals that have been declared mentally incapacitated
• Other severe neurological disease besides dementia related
• Cognitive impairment due to known other neurological disease
• Previous brain surgery

Where it is running

• Leiden University Medical Center — Leiden, Netherlands (enrolling)

Full record on ClinicalTrials.gov

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