CSVD-Clearance

Brain clearance describes the removal of metabolic waste products from the central nervous system. An important role in this process may be played by the so-called glymphatic system, which is considered analogous to the body’s lymphatic system and is involved in the exchange of cerebrospinal and interstitial fluid as well as in the elimination of potentially harmful metabolites.

Cerebral small vessel disease comprises disorders of the small blood vessels in the brain and is associated with characteristic structural changes of the brain as well as clinical manifestations such as cognitive impairment, gait disturbances, and stroke. It is assumed that brain clearance may also be impaired in this condition.

The aim of this study is to investigate, using a special native 7-Tesla MRI sequence, whether brain clearance is altered in patients with cerebral small vessel disease compared with healthy control participants. In addition, the study will examine whether these measures are associated with imaging features of the disease as well as with clinical and neuropsychological findings.

This study aims to investigate whether brain clearance is altered in patients with cerebral small vessel disease compared with healthy control participants. In addition, associations between the imaging-derived measures and clinical as well as neuropsychological findings will be examined.

We include patients with cerebral small vessel disease as well as neurologically healthy control participants.

The following assessments and examinations are planned:

• collection of demographic data, medical history, and standardized questionnaires, including questionnaires on physical activity, diet, and sleep behavior
• brain imaging using native 7-Tesla magnetic resonance imaging (MRI), including a dedicated sequence for the assessment of brain clearance
• clinical neurological examination
• neuropsychological assessment

The data obtained are intended to improve our understanding of cerebral small vessel disease and of potential alterations in brain clearance.

After the inclusion and exclusion criteria have been assessed and written informed consent has been obtained, a study visit takes place at DZNE Bonn. 
During this visit, 

• demographic data, 
• information on medical history, and 
• questionnaires including questions on physical activity, diet, and sleep behavior 

are collected first. This is followed by 

• a clinical neurological examination, 
• a short neuropsychological assessment, and 
• a brain MRI examination on a 7-Tesla scanner. The MRI protocol also includes a dedicated sequence for the assessment of brain clearance. 

The MRI examination takes approximately 50 minutes in total. No contrast agent is administered, and no study-related biomaterial is collected. Participation is only possible if there are no contraindications to MRI

Principal Investigators: 
Prof. Dr. Gabor Petzold
PD Dr. Katerina Deike
Start of the study: 04/2026
Status: monocentric (DZNE Bonn), recruitment active

Study coordination / Contact:
Universitätsklinikum Bonn - Klinik für vaskuläre Neurologie
Dr. Hannah Asperger
asperger.hannah(at)dzne.de
+49 228 287-15780

DZNE Bonn
studienassistenten-bonn(at)dzne.de
+49 228 43302-783