In a recent study, Arba et al. showed that increasing the grade of SVD sustains higher levels of TIMP-4 and supports the involvement of TIMP-4 in the pathologic process of SVD; they studied a population of an ischemic stroke patient, reporting that brain atrophy was associated with baseline TIMP-4 levels and leukoaraiosis was associated with 90-day TIMP-4 levels. The gene discussed is TIMP4; the disease is ischemic stroke.