We evaluated periventricular white matter (PVWM) cerebral blood flow (CBF) as a mechanistically specific biomarker for small vessel ischemia and demonstrated the feasibility of its measurement using state-of-the-art arterial spin labeling. We constructed the PVWM region of interest and demonstrated that mean CBF in PVWM had higher correlation with lesion volumes than global, grey matter, or white matter CBF, even after correction for global CBF, age, and sex. PVWM CBF also showed higher correlation with Trail A and B processing speed than CBF in other regions, or lesion volumes.
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