Resting-State fMRI-based Perfusion-Timing Analysis in Cerebral Small Vessel Disease: Biomarker Potential and Mechanistic Implications

• Novel rs-fMRI method maps venous perfusion using endogenous blood signals. • Venous perfusion delay identified as early hallmark of CSVD pathophysiology. • Distinct perfusion phenotypes discriminate CSVD subtypes and pathophysiology. • Non-invasive biomarker potential for early neurovascular dysfunction detection.