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Incidental covert cerebral small vessel disease: Detection and management
Alina González‐Quevedo, Tania Arrieta Hernández, Marisol Peña Sánchez, Zenaida Milagros Hernández Díaz, Marianela Arteche-Prior, Javier Sánchez López. Advanced Neurology, 2025-01-16
Topic: Risk, prevention and care in population studies
Cerebral small vessel disease (CSVD) is one of the most common vascular diseases of the brain, primarily diagnosed using magnetic resonance imaging biomarkers. Advanced brain imaging techniques have enabled the detection of asymptomatic or covert CSVD in individuals without neurological symptoms. CSVD is highly prevalent among the elderly and healthy community-dwelling adults with vascular risk factors. It increases the risk of stroke, cognitive decline, and vascular dementia, and exacerbates the severity of Alzheimer’s disease. Covert CSVD is generally considered incidental, leading to a lack of intervention, especially among non-neurological physicians. The relevance of CSVD in asymptomatic healthy populations remains a contentious issue. Despite identifying covert CSVD, management strategies are poorly established, posing challenges for neurologists and primary care physicians. Key debated issues are: (i) the advantages of screening asymptomatic individuals concerning reduced adverse health events or cost-effectiveness, (ii) effective community screening strategies, including the development of non-imaging biomarkers, and (iii) the clinical and therapeutic implications of covert CSVD. Currently, limited scientific evidence addresses these issues, necessitating more high-quality longitudinal studies. Increased awareness regarding the importance of detecting, treating, and systematically monitoring covert CVDS is essential. Screening procedures should be more active, utilizing more accessible non-imaging biomarkers such as blood tests, retinal assessments, and ambulatory blood pressure monitoring. The early detection of CSVD presents an opportunity to implement more effective preventive strategies.
Key findings
- Key debated issues are: (i) the advantages of screening asymptomatic individuals concerning reduced adverse health events or cost-effectiveness, (ii) effective community screening strategies, including the development of non-imaging biomarkers, and (iii) the clinical and therapeutic implications of covert CSVD.
- Currently, limited scientific evidence addresses these issues, necessitating more high-quality longitudinal studies.
- Increased awareness regarding the importance of detecting, treating, and systematically monitoring covert CVDS is essential.
- Screening procedures should be more active, utilizing more accessible non-imaging biomarkers such as blood tests, retinal assessments, and ambulatory blood pressure monitoring.
- The early detection of CSVD presents an opportunity to implement more effective preventive strategies.
Why it matters
This review discusses covert cerebral small vessel disease, which is common in older adults and increases the risk of stroke, cognitive decline, and vascular dementia. It states that management strategies for covert cerebral small vessel disease are poorly established and that limited scientific evidence exists, so more high-quality longitudinal studies are needed.
Study details
- Study designlongitudinal study
- Evidence strengthModerate
How this study scored 39/100
Published in a peer-reviewed journal, and it is a longitudinal study following the same people over time. Scored zero for sample size, effect reported, studied in people and randomised / blinded because the record does not state it. We have no data on senior author's track record and institution's track record, so those were left out: it earned 36 of the 93 points we could judge it on, which is 39 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Advanced Neurology) |
| Journal's citation record | 0 / 4 | Advanced Neurology: journal h-index 7 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A longitudinal study following the same people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 1 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.3 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 1 / 6 | Cited 0.6× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 1 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 0 institution(s) in 0 countries — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 2 / 2 | Free to read |
| Points | 36 / 93 | Scored on 18 of 20 parts. We have no data for the rest, so they are left out: 36 of the 93 points we could judge it on is 39 out of 100. |
| Total | 39 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
González‐Quevedo, A., Hernández, T. A., Sánchez, M. P., Díaz, Z. M. H., Arteche-Prior, M., & López, J. S. (2025). Incidental covert cerebral small vessel disease: Detection and management. Advanced Neurology. https://doi.org/10.36922/an.4841
Vancouver
González‐Quevedo A, Hernández TA, Sánchez MP, Díaz ZMH, Arteche-Prior M, López JS. Incidental covert cerebral small vessel disease: Detection and management. Advanced Neurology. 2025. doi:10.36922/an.4841.
BibTeX
@article{gonzalezquevedo2025-b43f515c,
author = {González‐Quevedo, Alina and Hernández, Tania Arrieta and Sánchez, Marisol Peña and Díaz, Zenaida Milagros Hernández and Arteche-Prior, Marianela and López, Javier Sánchez},
title = {{Incidental covert cerebral small vessel disease: Detection and management}},
journal = {Advanced Neurology},
year = {2025},
doi = {10.36922/an.4841},
url = {https://doi.org/10.36922/an.4841}
}
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