000280259 001__ 280259 000280259 005__ 20250831001837.0 000280259 0247_ $$2doi$$a10.1186/s13195-025-01815-6 000280259 0247_ $$2pmid$$apmid:40775365 000280259 0247_ $$2altmetric$$aaltmetric:180264341 000280259 037__ $$aDZNE-2025-00937 000280259 041__ $$aEnglish 000280259 082__ $$a610 000280259 1001_ $$0P:(DE-2719)2811856$$aLohner, Valerie$$b0 000280259 245__ $$aMachine learning applications in vascular neuroimaging for the diagnosis and prognosis of cognitive impairment and dementia: a systematic review and meta-analysis. 000280259 260__ $$aLondon$$bBioMed Central$$c2025 000280259 3367_ $$2DRIVER$$aarticle 000280259 3367_ $$2DataCite$$aOutput Types/Journal article 000280259 3367_ $$0PUB:(DE-HGF)16$$2PUB:(DE-HGF)$$aJournal Article$$bjournal$$mjournal$$s1756287941_2228 000280259 3367_ $$2BibTeX$$aARTICLE 000280259 3367_ $$2ORCID$$aJOURNAL_ARTICLE 000280259 3367_ $$00$$2EndNote$$aJournal Article 000280259 520__ $$aBackground:Cerebral small vessel disease (CSVD) is a common neurological condition that contributes to strokes, dementia, disability, and mortality worldwide. We conducted a systematic review and meta-analysis to investigate the use of neuroimaging CSVD markers in machine learning (ML) based diagnosis and prognosis of cognitive impairment and dementia, and identify both methodological changes over time and barriers to clinical translation.Methods:Following the PRISMA guidelines, we systematically searched for original studies that used both neuroimaging CSVD markers and ML methods for diagnosing and prognosing neurodegenerative diseases (preregistration in PROSPERO: CRD42022366767). Each paper was independently reviewed by a pair of reviewers at all stages, with a third consulted to resolve conflicts. We meta-analysed the effectiveness of ML models to distinguish healthy controls from Alzheimer’s dementia and cognitive impairment, using area under the curve (AUC) as the performance metric.Results:We identified 75 studies: 43 on diagnosis, 27 on prognosis, and 5 on both. Nearly 60% of studies were published in the past two years, reflecting a growing interest in using CSVD markers in ML-based diagnosis and prognosis of neurodegenerative diseases, especially Alzheimer’s dementia. This rising interest may be linked to the strong performance of such models: according to our meta-analysis, ML approaches using CSVD markers perform well in differentiating healthy controls from Alzheimer’s dementia (AUC 0.88 [95%-CI 0.85–0.92]) and cognitive impairment (AUC 0.84 [95%-CI 0.74–0.95]). However, the growing interest has not been matched by methodological rigour: only 16 studies met the criteria for inclusion in the meta-analysis due to inconsistent reporting, only five assessed the generalisability of their models on external datasets, and six lacked clear diagnostic criteria.Conclusions:Interest in incorporating CSVD markers into ML models for neurodegenerative disease classification is on the rise, and their performance suggests that this is worth further exploration. Serious methodological issues, including inconsistent reporting, limited generalisability testing, and other potential biases, are unfortunately common and hinder further adoption. Our targeted recommendations provide a roadmap to accelerate the integration of ML into clinical practice. 000280259 536__ $$0G:(DE-HGF)POF4-353$$a353 - Clinical and Health Care Research (POF4-353)$$cPOF4-353$$fPOF IV$$x0 000280259 588__ $$aDataset connected to CrossRef, PubMed, , Journals: pub.dzne.de 000280259 650_7 $$2Other$$aAlzheimer’s dementia 000280259 650_7 $$2Other$$aArtificial intelligence 000280259 650_7 $$2Other$$aCerebral small vessel disease 000280259 650_7 $$2Other$$aCognitive impairment 000280259 650_7 $$2Other$$aDementia 000280259 650_7 $$2Other$$aMachine learning 000280259 650_7 $$2Other$$aNeurodegenerative diseases 000280259 650_7 $$2Other$$aNeuroimaging 000280259 7001_ $$00000-0003-3414-3395$$aBadhwar, Amanpreet$$b1 000280259 7001_ $$00000-0002-9909-9754$$aDetcheverry, Flavie E$$b2 000280259 7001_ $$aGarcía, Cindy L$$b3 000280259 7001_ $$0P:(DE-2719)9002125$$aGellersen, Helena M$$b4 000280259 7001_ $$aKhodakarami, Zahra$$b5 000280259 7001_ $$0P:(DE-2719)9001995$$aLattmann, Rene$$b6$$udzne 000280259 7001_ $$aLi, Rui$$b7 000280259 7001_ $$00000-0002-9960-9849$$aLow, Audrey$$b8 000280259 7001_ $$00000-0003-1703-8964$$aMazo, Claudia$$b9 000280259 7001_ $$00000-0001-9104-5383$$aMetz, Amelie$$b10 000280259 7001_ $$00000-0002-3177-0353$$aParent, Olivier$$b11 000280259 7001_ $$00000-0002-4383-9434$$aPhillips, Veronica$$b12 000280259 7001_ $$aSaeed, Usman$$b13 000280259 7001_ $$aTan, Sean Y W$$b14 000280259 7001_ $$00000-0002-1561-2187$$aTamburin, Stefano$$b15 000280259 7001_ $$aLlewellyn, David J$$b16 000280259 7001_ $$00000-0003-1063-6937$$aRittman, Timothy$$b17 000280259 7001_ $$00000-0001-7241-2272$$aWaters, Sheena$$b18 000280259 7001_ $$0P:(DE-2719)9001989$$aBernal, Jose$$b19$$eLast author 000280259 773__ $$0PERI:(DE-600)2506521-X$$a10.1186/s13195-025-01815-6$$gVol. 17, no. 1, p. 183$$n1$$p183$$tAlzheimer's research & therapy$$v17$$x1758-9193$$y2025 000280259 8564_ $$uhttps://pub.dzne.de/record/280259/files/DZNE-2025-00937%20SUP1.pdf 000280259 8564_ $$uhttps://pub.dzne.de/record/280259/files/DZNE-2025-00937%20SUP2.xlsx 000280259 8564_ $$uhttps://pub.dzne.de/record/280259/files/DZNE-2025-00937%20SUP1.pdf?subformat=pdfa$$xpdfa 000280259 8564_ $$uhttps://pub.dzne.de/record/280259/files/DZNE-2025-00937.pdf$$yOpenAccess 000280259 8564_ $$uhttps://pub.dzne.de/record/280259/files/DZNE-2025-00937%20SUP2.csv 000280259 8564_ $$uhttps://pub.dzne.de/record/280259/files/DZNE-2025-00937%20SUP2.ods 000280259 8564_ $$uhttps://pub.dzne.de/record/280259/files/DZNE-2025-00937%20SUP2.xls 000280259 8564_ $$uhttps://pub.dzne.de/record/280259/files/DZNE-2025-00937.pdf?subformat=pdfa$$xpdfa$$yOpenAccess 000280259 909CO $$ooai:pub.dzne.de:280259$$pdnbdelivery$$pdriver$$pVDB$$popen_access$$popenaire 000280259 9101_ $$0I:(DE-588)1065079516$$6P:(DE-2719)9002125$$aDeutsches Zentrum für Neurodegenerative Erkrankungen$$b4$$kDZNE 000280259 9101_ $$0I:(DE-588)1065079516$$6P:(DE-2719)9001995$$aDeutsches Zentrum für Neurodegenerative Erkrankungen$$b6$$kDZNE 000280259 9101_ $$0I:(DE-588)1065079516$$6P:(DE-2719)9001989$$aDeutsches Zentrum für Neurodegenerative Erkrankungen$$b19$$kDZNE 000280259 9131_ $$0G:(DE-HGF)POF4-353$$1G:(DE-HGF)POF4-350$$2G:(DE-HGF)POF4-300$$3G:(DE-HGF)POF4$$4G:(DE-HGF)POF$$aDE-HGF$$bGesundheit$$lNeurodegenerative Diseases$$vClinical and Health Care Research$$x0 000280259 9141_ $$y2025 000280259 915__ $$0StatID:(DE-HGF)0200$$2StatID$$aDBCoverage$$bSCOPUS$$d2024-12-13 000280259 915__ $$0StatID:(DE-HGF)0160$$2StatID$$aDBCoverage$$bEssential Science Indicators$$d2024-12-13 000280259 915__ $$0LIC:(DE-HGF)CCBY4$$2HGFVOC$$aCreative Commons Attribution CC BY 4.0 000280259 915__ $$0StatID:(DE-HGF)0600$$2StatID$$aDBCoverage$$bEbsco Academic Search$$d2024-12-13 000280259 915__ $$0StatID:(DE-HGF)0100$$2StatID$$aJCR$$bALZHEIMERS RES THER : 2022$$d2024-12-13 000280259 915__ $$0StatID:(DE-HGF)0501$$2StatID$$aDBCoverage$$bDOAJ Seal$$d2024-04-10T15:32:54Z 000280259 915__ $$0StatID:(DE-HGF)0500$$2StatID$$aDBCoverage$$bDOAJ$$d2024-04-10T15:32:54Z 000280259 915__ $$0StatID:(DE-HGF)0113$$2StatID$$aWoS$$bScience Citation Index Expanded$$d2024-12-13 000280259 915__ $$0StatID:(DE-HGF)0700$$2StatID$$aFees$$d2024-12-13 000280259 915__ $$0StatID:(DE-HGF)0150$$2StatID$$aDBCoverage$$bWeb of Science Core Collection$$d2024-12-13 000280259 915__ $$0StatID:(DE-HGF)0510$$2StatID$$aOpenAccess 000280259 915__ $$0StatID:(DE-HGF)0030$$2StatID$$aPeer Review$$bASC$$d2024-12-13 000280259 915__ $$0StatID:(DE-HGF)0561$$2StatID$$aArticle Processing Charges$$d2024-12-13 000280259 915__ $$0StatID:(DE-HGF)9905$$2StatID$$aIF >= 5$$bALZHEIMERS RES THER : 2022$$d2024-12-13 000280259 915__ $$0StatID:(DE-HGF)0300$$2StatID$$aDBCoverage$$bMedline$$d2024-12-13 000280259 915__ $$0StatID:(DE-HGF)1110$$2StatID$$aDBCoverage$$bCurrent Contents - 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