Deep Medullary Vein Density are associated with Paraventricular White Matter Hyperintensities and Brain Atrophy: An Automated Analysis of SWI

Motivation: Periventricular white matter hyperintensities (PWMH) are associated with cerebral small vessel disease (CSVD), yet their pathophysiology remains poorly understood. Recent evidence suggests that microvascular changes, including venous abnormalities could play a significant role in PWMH and brain atrophy. Goal(s): To investigate whether deep medullary veins (DMVs) density, as measured by Susceptibility Weighted Imaging (SWI) correlates with PWMH burden and brain atrophy. Approach: Automatic quantification of DMVs density on SWI images. Results: At cross-section DMVs density was significantly lower in participants with high PWMH burden. In longitudinal analyses lower DMVs density was related to lower brain volume, independently of baseline PWMH burden. Impact: This study underscores the importance of venous health in CSVD, relating reduced DMVs density with PWMH pathology and brain volume, thus providing a potential additional biomarker for neurovascular pathology.