Cerebral small vessel disease (CSVD) is a common feature of the ageing brain. It affects the small vessels of the brain and causes up to 45% of dementia and 20% of strokes. Management of the traditional risk factors of CSVD is still the main approach for treating or preventing CSVD, because there is evidence that brain damage can be reversed or delayed in the early stages of the disease.

The diagnosis and monitoring of CSVD relies on imaging findings. However, there is currently no MRI protocol able to identify early stage CSVD or to monitor disease progression in the early stages, when disease management would be of most benefit. In fact, more advanced imaging techniques are required to detect a subtler level of damage, when brain damage can still be reversed with medical and lifestyle interventions.

Thus, the aim of this project is to develop an advanced imaging protocol to characterise the burden of early CSVD in mid-life. Each MR imaging technique in this new protocol focuses on one mechanistic aspect of vascular damage including gross structural changes in the grey and white matter, fine structural changes in white matter and brain microvasculature neurochemical and perfusion abnormalities.