# Development, Validation, and Application of an Imaging based CVD Scale

> **NIH NIH R01** · MAYO CLINIC ROCHESTER · 2020 · $613,328

## Abstract

PROJECT SUMMARY / ABSTRACT
Cerebrovascular Pathologies (CVP) and Alzheimer's disease (AD) pathologies (ADP) (amyloid and tau) are the
two principal processes that drive cognitive impairment in the elderly. Even though CVP features have been
available for decades, there is no scheme that integrates the multiplicity of CVD features into a metric that has
predictive power comparable to the AD biomarkers and correlates with cognitive functioning. The primary
objective of this grant is to develop and validate an imaging based metric for quantifying CVP which we call
the “CVD scale” [CVD - Cerebrovascular Disease]. We will use a stepwise approach to develop several CVD
scales based on incremental information going from simple to more complex MRI metrics - FLAIR (white
matter hyperintensities (WMH), size and location of infarctions), T2* GRE (subcortical microbleeds), and DTI
(Fractional anisotropy and mean diffusivity underlying WMH and surrounding WMH to measure white matter
integrity). The models will be developed by weighting each of these imaging features according to their
contribution to cognitive performance and the final CVD scale will be analytically selected based on its ability to
predict cognition. We will use additional independent datasets to ensure the generalizability of our models and
improve them if necessary. Since autopsy based scales for cerebrovascular lesions have not found to be
predictive of cognition and/or difficult to evaluate antemortem, pathology outcomes will not be used for the
development of the scale, but instead for confirmation. The secondary objective of the grant is to apply the
CVD scale to understand a) the impact of sex, APOE4, and resilience measures (intellectual and physical
activity lifestyle) on the evolution of CVP after accounting for traditional risk factors (diabetes, hypertension,
dyslipidemia, atrial fibrillation, smoking), and b) investigate interactions between CVP and ADP. We will
capitalize on the existing population-based and prospective Mayo Clinic Study of Aging (MCSA) cohort and
acquire new imaging data (PIB PET, Tau PET, MRI) for the development of the CVD scale. The population-
based nature of the MCSA sample is ideally suited for the development and generalizability of the scale
because it captures the range of CVP. One of the strengths of the proposal is the planned dissemination of
the CVD scale to the scientific community.

## Key facts

- **NIH application ID:** 9971592
- **Project number:** 5R01NS097495-05
- **Recipient organization:** MAYO CLINIC ROCHESTER
- **Principal Investigator:** PRASHANTHI VEMURI
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $613,328
- **Award type:** 5
- **Project period:** 2016-09-01 → 2023-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9971592

## Citation

> US National Institutes of Health, RePORTER application 9971592, Development, Validation, and Application of an Imaging based CVD Scale (5R01NS097495-05). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9971592. Licensed CC0.

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