Objective:

This scoping review aimed to identify and discuss relevant studies focused on clarifying the association between PWV and CSVD.

Background:

Cerebral small vessel disease (CSVD) is the most common cerebrovascular disease, and the most common vascular cause of dementia. Its prevalence increases with age, contributing to approximately 45% of dementia cases and 25% of strokes. Noninvasive predictors of CSVD are crucial for early intervention and management. Arterial stiffness, commonly measured via pulse wave velocity (PWV), has been proposed as a potential marker of CSVD. However, different methods of measuring PWV, variability in CSVD markers, and confounding factors such as age and arterial risk factors complicate the understanding of this relationship.

Design/Methods:

Four databases (EMBASE, Ovid MEDLINE, Web of Science, and CINAHL) were searched for peer-reviewed English articles published between 2014 and 2024 that included PWV measurements by any method and at least one major CSVD biomarker: (1) white matter hyperintensities (WMH), (2) lacunar infarcts (LI), (3) fractional anisotropy (FA), (4) cerebral microbleeds (CMB), or (5) perivascular spaces (PVS).

Results:

A total of 1,345 articles were identified, and after de-duplication and full-text review, 53 met the inclusion criteria. Findings indicate that higher PWV is associated with increased WMH volume, greater PVS severity, reduced FA, and the presence of LI. Several studies also linked PWV-CSVD associations to cognitive decline, stroke recurrence, and depression, with the strongest evidence found between PWV and WMH.

Conclusions:

These findings support PWV’s potential utility for early prediction of CSVD and assessment of its severity and progression, pending standardized measurements and further longitudinal research. Its association with cognitive decline, stroke risk, and recovery underscores PWV as a predictive marker. Recognizing PWV as a modifiable risk factor highlights the importance of early detection, lifestyle interventions, and cardiovascular risk management to reduce CSVD progression and related outcomes.