The development of cognitive decline in cerebral small vessel disease (SVD) depends on the extent of disruption to major structural networks within the brain. Anil Man Tuladhar, MD, PhD, Radboud University Medical Center, Nijmegen, Netherlands, explains that structural networks consist of white matter tracts that connect different brain regions. In SVD, disruption to these tracts may affect the efficiency of communication between different brain regions and, with enough damage, could give rise to cognitive impairment and dementia. This interview took place at the European Stroke Organisation Conference (ESOC), 2021.