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Record W4407689796 · doi:10.1152/physrev.00028.2024

The pathogenesis of cerebral small vessel disease and vascular cognitive impairment

2025· review· en· W4407689796 on OpenAlex

Why this work is in the frame

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

affAt least one author lists a Canadian institution in the pinned OpenAlex snapshot.

Bibliographic record

VenuePhysiological Reviews · 2025
Typereview
Languageen
FieldMedicine
TopicCerebrovascular and genetic disorders
Canadian institutionsSte. Anne's Hospital
FundersBritish Heart Foundation Centre of Regenerative MedicineNational Institute of Neurological Disorders and StrokeNational Institutes of HealthFondation pour la Recherche MédicaleFondation LeducqAgence Nationale de la RechercheBritish Heart FoundationNational Institute for Health and Care Research
KeywordsHyperintensityNeuroscienceNeuroimagingDiseaseCognitionMedicineCognitive impairmentPathologyPsychologyMagnetic resonance imagingRadiology

Abstract

fetched live from OpenAlex

Cerebral small vessel disease (cSVD) is the broadly accepted term nowadays to designate a heterogeneous group of diseases caused by in situ damage of small brain vessels commonly related to aging, hypertension, or genetic factors. Cardinal neuroimaging features include small (<20 mm) infarcts or lacunes, cerebral microbleeds, white matter hyperintensities, enlarged perivascular spaces, and brain atrophy. Overall, cSVD represents one of the major problems facing global society today, causing a quarter of all ischemic strokes and the vast majority of spontaneous hemorrhages and accounting for 20% or more of all dementias. Yet mechanisms of cSVD are still incompletely understood, and we have no effective proven treatments other than risk factor modification. Recently, major progress in understanding the underlying disease mechanisms has occurred thanks to novel approaches including advanced molecular, genetic, and imaging tools. Here, we provide a comprehensive and critical appraisal of the biggest advances in our understanding of how cSVD affects the structure and function of small brain vessels, causes brain lesions, and alters cognition. To set the stage, we begin by reviewing the molecular anatomy and physiology of healthy small brain vessels and report on the milestones from the medical literature, starting in the 1850s, that have laid the foundation for the "modern" definition of cSVD. We conclude by discussing the framework for clinical interventions that will emerge from these novel insights. We also highlight the outstanding questions to address and challenges to tackle to move the field forward.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.001
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: none
GenreCandidate signal: Review · Consensus signal: Review
Teacher disagreement score0.954
Threshold uncertainty score0.893

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0010.001
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0030.002
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.057
GPT teacher head0.338
Teacher spread0.281 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it