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PSMD (Peak width of Skeletonized Mean Diffusivity)

PSMD is a robust, fully-automated and easy-to-implement marker for cerebral small vessel disease based on diffusion tensor imaging, white matter tract skeletonization (as implemented in FSL-TBSS) and histogram analysis.

For more information on usage, including FAQ, please visit


PSMD is NOT a medical device and therefore for research use only. Do not use PSMD for diagnosis, prognosis, monitoring or any other clinical routine use. Any application in clinical routine is forbidden by law, e.g. by Medical Device Regulation article 5 in the EU.


Download one of our releases. For a new project, take the latest release. It is best practice to stick with one release version throughout a project.

For even better replicability and traceability, we strongly recommend using a container for the software dependencies, e.g. the PSMD container recipe for Apptainer/Singularity.

For more information, please see the project website at or type ./ -h at the command line.

Contents of download packages

  • - PSMD script
  • skeleton_mask_2019.nii.gz - Updated (2019) skeleton mask image
  • LICENSE - Please take a minute to read the license file
  • Folder examples - Sample dataset for testing
  • Folder container - Apptainer/Singularity container recipe

Version history

Starting with version 1.6, all development is done in this GitHub repository. See the GitHub releases page for the latest and previous releases.

Roadmap of future development

See the GitHub issues page for current development topics. If you found a bug or have suggestions for new features, please feel free to open an issue.


The script itself is published under the BSD 3-clause license. Please see the LICENSE file provided in this repository.

An FSL license is required to run PSMD.


The PSMD project was initiated at the Institue for Stroke and Dementia Research (ISD), Munich, Germany, with funding support by the LMU FöFoLe program (grant 808), the Else Kröner-Fresenius-Stiftung (EKFS, grant 2014_A200), and the Vascular Dementia Research Foundation.

The ongoing development of PSMD is supported by Medical Image Analysis Center (MIAC), Basel, Switzerland.

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