Zeestraten EA, et al. - This paper analyzed if MRI markers, with the inclusion of diffusion tensor imaging (DTI), speculated the cognitive decline and dementia in patients with cerebral small vessel disease (SVD). It was revealed that variation in the MRI measures including DTI, over time durations during which cognitive change was not detectable, speculated the cognitive decline and progression to dementia. Hence, this research supported the utility of MRI measures as beneficial surrogate biomarkers to monitor disease and to gauge the therapeutic interventions.