Trial ready small vessel mri markers: proof of concept
Problem: 
Cerebral small vessel disease (SVD) is a hallmark of serious brain diseases such as acute stroke and dementia. It has a major impact on society, since it affects quality of life of many ageing individuals, and increasingly challenges the healthcare resources. Current image-based biomarkers do not reflect SVD itself, but rather macroscopic, irreversible brain damage, secondary to the abnormalities of the small vessels. This greatly hampers development of new drugs as clinical trials lack effective biomarkers directly reflecting SVD. 
Solution: 
The SmallVesselMRI  ERC project (337333), yielded 7T MRI methods with the potential to offer a paradigm shift in SVD research. We have developed new MRI measures that, for the first time, allow non-invasive assessment of the condition of the small vessels themselves, including blood flow velocity pulsation in small perforating vessels, which informs on vessel stiffness. The current proof-of-concept project ‘trial-ready Small vEsseL MRI MArkers (SELMA) aims to make these novel promising vascular parameters ready for use in phase II/III clinical trials. Our ambition is to bridge the gap between high end imaging research platforms and widespread clinical MRI, in order to enable drug-target engagement studies in clinical trials for newly developed drugs.
SELMA will: 
1) Port the small-vessel 7T MRI pulse sequences to clinically ubiquitous 3T MRI scanners. 2) Develop a software tool that can provide robust, automated data analysis. 3) Determine the reproducibility of the SELMA biomarkers in a group of 35 healthy individuals with scan-rescan experiments. 4) Provide clinical proof of concept by a pilot study in 15 patients with SVD, measuring the vascular parameters before and after administration of a pharmaceutical agent.  Using results of our proof of concept study, we will develop a business plan to approach the pharmaceutical industry to change the paradigm in drug development for SVD treatment.