Table 2

Research perspectives

Areas for future researchChallengesClinical implications
Detection of CMBs
  • Harmonising imaging parameters across research studies to improve cross-study comparisons in line with the HARNESS initiative*128

  • Further development of (semi)automated methods for detection and mapping of CMBs

  • Validation of SVD Scores that include CMBs among other markers

  • Building large prospective studies assessing CMB accrual and precise location, with functional/cognitive outcomes

  • Better estimation of prevalence of CMBs among (subtype) populations

  • Better visualisation of incident CMBs and identification of patients at risk

  • Individual-based risks and outcomes trajectories

Therapeutic management
  • RCT integrating CMBs

  • Converting CMBs into biomarkers of treatment effects

  • Strong level of evidence regarding utility of CMBs in guiding therapeutic decisions

  • Monitoring the effect of a potential underlying disease-modifier

Basic sciences
  • Improvement of experimental models

  • In vivo visualisation of vessel disruption

  • Characterisation of brain tissue changes surrounding formation of CMBs

  • Further understanding formation of CMBs and consequences

  • Identification of future target for pharmacomodulation of CMBs

Global health
  • Investigating whether CMBs reflect global (cerebrovascular) health and ageing

  • Integrate monitoring of CMBs in the concept of brain health

  • *HARNESS: HARmoNizing Brain Imaging MEthodS for VaScular Contributions to Neurodegeneration.

  • CMB, cerebral microbleed; RCT, randomised controlled trial; SVD, small vessel disease.