153 Study protocol of the WHIMAS 7 Figure 7.4. Examples of images obtained with the CSF-STREAM sequence as a measure of glymphatic activity. An image of the CSF-signal is shown on the left, and on the right is an example of a CSF-mobility map. 7.4.5 Statistics Linear and logistic regression analyses will be performed to investigate the association between WMH shape and brain clearance/other MRI markers/cognitive functioning. Potentially confounding demographic variables, such as age, sex, level of education and vascular risk factors will be included as covariates for subsequent analyses. The distributions of the variables will be tested for normality. If applicable, appropriate nonparametric test will be used of variables will be log transformed. For the main analyses the significance will be set at p <0.05. 7.5 DISCUSSION SVD in an ageing population has heterogeneous underlying pathology which current MRI markers do not accurately capture. Novel 7T brain MRI markers provide a window of opportunity to study early structural changes and potential determinants of SVD. WMH shape is a relatively novel MRI marker and earlier studies have shown prognostic potential.18,19 However, the exact microstructural changes within or surrounding WMHs or potential determinants related to WMH shape variations remain unknown. Furthermore, impaired brain clearance via the recently discovered brain glymphatic system may be another early change or potential cause of SVD.45 In the WHIMAS study we aim to study the link between WMH and especially their shape with brain clearance and other MRI markers on high field (3T) and ultra-high
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