Cerebral small vessel disease (CSVD) increases stroke risk and often leads to vascular cognitive impairment. We hypothesized that elevated oxygen extraction fraction (OEF) is a tissue biomarker of chronic ischemia in patients with CSVD. We found that reduction of cerebral blood flow (CBF) in gray matter depends on age, but not on CSVD. In contrast, OEF is increased in watershed and white matter in patients with CSVD and watershed OEF is significantly associated with white matter hyperintensities (WMH) lesion volumes after adjusting for age.
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