Cerebral Small Vessel Disease and Brain Health in an Indigenous African Cohort (cSVD-IAC)

cSVD-IAC: Project Summary
The overarching goal of cSVD- IAC is to characterize the burden of cerebral small vessel disease (SVD) [white
matter hyperintensities (WMH), lacunar infarcts, enlarged perivascular spaces, microbleeds, cerebral atrophy,
and total cSVD score] as defined by brain MRI in a population-based indigenous African cohort. We will test the
relationship between MRI cSVD metrics and retinal imaging cSVD metrics (by fundal photography and optical
coherence tomography-angiography) to determine thresholds for predicting and detecting cSVD with a more
accessible and affordable approach in low - and middle - income countries and among underserved populations
in the US. This will unravel the potential of retinal imaging for prediction and diagnosis of cSVD and cognitive
impairment and dementia. Furthermore, we will unmask the modifiable, sex, genetic and blood-based biomarker
determinants of cSVD and cognitive phenotypes in the cohort.
To achieve this overall goal, we will recruit and characterize an additional 2000 participants to expand an existing
cohort of > 1000 older Nigerians (50 yrs+) participating in the population-based Vascular heALth, fraiLty and
cognItion in Ageing Nigerians sTudy [VALIANT]. We will undertake brain and retinal imaging and evaluate novel
proteomic markers and assess transferability of genetic variants of cSVD among 1200 participants nested within
the enlarged cohort (3000) and bank biological samples for future multi-omics and comparative studies with US
and other global population-based aging cohorts.
We will pursue these aims while training at least 5 African early career researchers (ECRs) and expanding
stakeholder engagement. This project will consolidate and expand the growing African AD/ADRD research
infrastructure by specifically characterizing cSVD in an under-represented African population. The novel data
generated by this study will accelerate deeper understanding of cSVD biology in relation to cognitive impairment
and dementia, identify lifestyles, and drug targets for prevention, disease modification and treatment, and
ultimately enable the design of effective personalized strategies that will be of benefit to African, US and global
populations in keeping with the priorities of the US National Dementia Plan and the recommendation of the
National Academy of Medicine. We will accomplish this goal through an excellent partnership between
experienced and leading US and African investigators.

Grant Number: 1U01AG097746-01
NIH Institute/Center: NIH
Principal Investigator: Rufus Akinyemi