Correlations in post-mortem imaging-histopathology studies of sporadic human cerebral small vessel disease: a systematic review Link to paper on Neuropathology & Applied Neurobiology Authors Catherine A Humphreys, Colin Smith, Joanna M Wardlaw Abstract Aims: Sporadic human cerebral small vessel disease (SVD) commonly causes stroke & dementia but its pathogenesis is poorly understood. There are recognised neuroimaging & histopathological features. However, relatively few studies have examined the relationship between the radiological & pathological correlates of SVD; better correlation would promote greater insight into the underlying biological changes. Methods: We performed a systematic review to collate & appraise the information derived from studies that correlated histological with neuroimaging-defined SVD lesions. We searched for studies describing post-mortem imaging & histological tissue examination in adults, extracted data from published studies, categorised the information & compiled this narrative. Results: We identified 38 relevant studies, including at least 1146 subjects, 342 of these with SVD: 29 studies focussed on neuroradiological white matter lesions (WML), six on microinfarcts & three on dilated perivascular spaces (PVS) & lacunes. The histopathology terminology was diverse with few robust definitions. Reporting & methodology varied widely between studies, precluding formal meta-analysis. PVS & ‘oedema’ were frequent findings in WML, being described in at least 94 & 18 radiological WML respectively, in addition to myelin pallor. Histopathological changes extended beyond the radiological lesion margins in at least 33 radiological WML. At least 43 radiological lesions not seen pathologically & at least 178 histological lesions were not identified on imaging. Conclusions: Histopathological assessment of human SVD is hindered by inconsistent methodological approaches & unstandardised definitions. The data from this systematic review will help to develop standardised definitions to promote consistency in human SVD research. Keywords Cerebral small vessel disease Neuroimaging Neuropathology Radiology Systematic review Vascular dementia Related links Link to paper on Neuropathology & Applied Neurobiology Professor Joanna Wardlaw Brain & nervous system Small vessel disease (SVD) Stroke Dementia Social media tags & titles Featured paper: Correlations in post-mortem imaging-histopathology studies of sporadic human cerebral small vessel disease: a systematic review @EdinUniBrainSci @SVDResearch Publication date 09 Jun, 2021
