Cao Yingying, Lai Zhenzhen, Wang Jingwen, Ye Bijun, Fan Weiqiang, Ruan Jiajia
Department of Neurology, Tiantai People's Hospital of Zhejiang Province (Tiantai Branch of Zhejiang Provincial People's Hospital), Hangzhou Medical College, Taizhou, China.
Front Neurol. 2025 Aug 18;16:1622274. doi: 10.3389/fneur.2025.1622274. eCollection 2025.
Cerebral small vessel disease (CSVD) has recently garnered extensive attention owing to its significant disease burden, insidious onset, and the absence of effective specific treatments. Poor lifestyle habits and chronic diseases are closely linked to its occurrence and development, eventually resulting in cognitive dysfunction. Therefore, improvement of lifestyle, stable blood pressure, effective glucose lowering, low-salt and low-fat diet, smoking cessation, moderate exercise and adequate sleep are the keys to preventing cognitive dysfunction in cerebral small-vessel disease. Early prevention and intervention are of significant clinical importance and social value, particularly as CSVD represents a major contributor to cognitive dysfunction in approximately 40 million elderly individuals worldwide. This comprehensive review integrates findings across four functional MRI techniques-diffusion tensor imaging (DTI), resting-state functional MRI (rs-fMRI), magnetic resonance spectroscopy (MRS), and arterial spin labeling (ASL)-to provide a holistic framework connecting structural abnormalities with functional deficits in CSVD. This paper aimed to cover four aspects: an overview of CSVD, the correlation between the clinical manifestations of CSVD and cognitive dysfunction, the neuroradiological features of CSVD, and the application of functional magnetic resonance imaging (fMRI) in CSVD patients with cognitive dysfunction. The integration of these complementary techniques offers unprecedented insights into disease mechanisms, enabling improved early diagnosis, establishment of reliable imaging biomarkers for monitoring disease progression, and development of tailored therapeutic strategies to slow or prevent cognitive decline in affected individuals.
脑小血管病（CSVD）因其巨大的疾病负担、隐匿的发病过程以及缺乏有效的特异性治疗方法，近来受到了广泛关注。不良的生活习惯和慢性疾病与其发生发展密切相关，最终导致认知功能障碍。因此，改善生活方式、稳定血压、有效降糖、低盐低脂饮食、戒烟、适度运动和充足睡眠是预防脑小血管病认知功能障碍的关键。早期预防和干预具有重要的临床意义和社会价值，特别是因为CSVD是全球约4000万老年人认知功能障碍的主要原因之一。这篇综述整合了四种功能磁共振成像技术——扩散张量成像（DTI）、静息态功能磁共振成像（rs-fMRI）、磁共振波谱成像（MRS）和动脉自旋标记（ASL）的研究结果，以提供一个将脑小血管病的结构异常与功能缺陷联系起来的整体框架。本文旨在涵盖四个方面：脑小血管病概述、脑小血管病临床表现与认知功能障碍的相关性、脑小血管病的神经放射学特征以及功能磁共振成像（fMRI）在有认知功能障碍的脑小血管病患者中的应用。这些互补技术的整合为疾病机制提供了前所未有的见解，有助于改善早期诊断、建立用于监测疾病进展的可靠影像学生物标志物，并制定针对性的治疗策略，以减缓或预防受影响个体的认知衰退。
