Right-hemisphere gray matter loss predominates in cerebral small vessel disease MRI study

In 56 cerebral small vessel disease patients vs 56 controls, MRI showed right-dominant frontal gray matter loss; right prefrontal volume tracked global cognition and left temporal asymmetry tracked decline, supporting gray matter asymmetry as a vascular cognitive marker.

• The study used a study-specific symmetric template and a gray matter asymmetry index, calculated as (L−R)/(L+R), where higher values mean greater left-sided gray matter.
• Regional asymmetry diverged: leftward shifts in middle temporal, superior frontal, and precuneus; rightward shifts in inferior temporal and fusiform gyri.
• Subcortical nuclei showed corresponding leftward lateralization of perivascular space burden; the right-dominant prefrontal pattern matched a meta-analytic re-synthesis of prior voxel-based morphometry evidence.

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