Active clinical trials for "Cerebral Small Vessel Diseases"

Cerebral small vessel disease is a series of clinical, imaging and pathological syndromes caused by various etiologies affecting the arteries, capillaries, venules in the brain. The common causes of cerebral small vessel disease include arteriolosclerosis, cerebral amyloid angiopathy, hereditary cerebral small vessel disease, inflammation-and immune-mediated small vessel disease, venous collagen disease and other small vessel diseases. Of these, age-and hypertension-related cerebral small vessel disease and amyloidosis cerebral small vessel disease are the most common types. The pathophysiological mechanism and clinical manifestations of cerebral small vessel disease are complex. One-fifth of ischemic strokes and the vast majority of nontraumatic parenchymal hemorrhages are due to cerebral small vessel disease. In addition to stroke, patients with cerebral small vessel disease are more often characterized by chronic progressive neurological impairment, which is an important cause of cognitive decline and functional disability in the elderly, and has become one of the important public health problems affecting the quality of life of the elderly. Focusing on cognitive impairment-related diseases, a large number of clinical studies have shown that Tongxinluo capsule has a dual neurovascular protective effect, which can increase the Mini-Mental State Examination (MMSE) score and activities of daily living (ADL) score of patients with lacunar cerebral infarction combined with vascular cognitive impairment, reduce fibrinogen (FIB) concentration, improve whole blood viscosity, improve blood viscosity and FIB level, improve activities of daily living and accelerate intellectual recovery in patients with VD; It can also reduce the levels of ET-1 and homocysteine in AD patients, reduce the whole blood viscosity and thus improve the microcirculation in the elderly, increase cerebral blood flow, increase the scores of MMSE and ADL, improve the intelligence of patients, improve memory disorders and language disorders. Meta-analysis of 3458 patients in 40 published clinical literatures of Tongxinluo capsule both domestically and internationally confirmed that Tongxinluo capsule had the effect of promoting the recovery of neurological function, and was safe without adverse reactions. This project is a randomized, double-blind, placebo-controlled multicenter clinical study to investigate the clinical efficacy and safety of Tongxinluo capsule in the treatment of cerebral small vessel disease. A total of 1052 subjects who met the subject screening criteria are planned to be enrolled, with 526 patients in the test group and 526 patients in the placebo group. The study is conducted using a central randomization method. For the patients who met the inclusion criteria after examination, they are logged into the Interactive Web Response System by their site, entered the relevant information, and randomized and assigned drugs automatically by the central server according to the ratio of 1:1. Once enrolled, all patients receive the study drug (Tongxinluo or placebo) at 4 capsules/tid for up to 12 months. The study is planned to be conducted at approximately 50 centers across the country using central randomized competing enrollment.

The present study aims at verifying the mutual effects between intracranial large artery atherosclerosis and cerebral small vessel disease on disease progression and prognosis by magnetic resonance imaging, and providing biomarkers for the early prevention and treatment of cerebrovascular disease.

The primary objectives of this trial are: Efficacy evaluation of amlodipine folic acid tablets: To assess the effects of amlodipine folic acid tablets 5.8 mg (5 mg amlodipine + 0.8 mg folic acid)versus amlodipine tablets 5 mg in preventing all-cause stroke in cerebral small vascular disease (CSVD) patients with hypertension and elevated homocysteine (Hcy) level. Intensive Antihypertensive Therapy: To assess the effect of intensive antihypertensive therapy (SBP<130 mmHg) versus standard antihypertensive therapy (SBP 130-<140 mmHg) in reducing risk of combined cardio-cerebrovascular events in CSVD patients with hypertension and elevated Hcy level, using two basic anti-hypertensive drugs, amlodipine tablets 5 mg or amlodipine folic acid tablets 5.8 mg.

This study aims to assess the prevalence and severity of dementia in an established cohort of community-dwelling older adults living in three neighboring rural Ecuadorian villages (Atahualpa, El Tambo, and Prosperidad), as well as to evaluate clinical and neuroimaging correlates of dementia in the study population. By the use of the Clinical Dementia Rating Scale (CDRS), the study also aims to assess the lower cutoff of the MoCA that better correlates with the occurrence of dementia in the study population. In addition, this study will provides grounds for the initiation of a prospective cohort study to assess factors influencing the development of dementia in the follow-up.

The CIRCLE study is a single-center prospective observational study that enrolled individuals with cerebral small vessel disease (SVD), while free of known dementia or stroke (both cerebral infarction and hemorrhage). The patients will receive neuropsychological testing, retinal digital images and multimodal magnetic resonance imaging (MRI). Blood samples will also be collected. Recent small subcortical infarcts, lacunes, white matter hyperintensities, perivascular spaces, microbleeds, and brain atrophy will be evaluated on both baseline and follow-up brain MRIs. The investigators will explore the predictors of preogression of SVD and cognitive deficits.

The investigators perform a retro-prospective exploratory cohort study among patients 65 to 85 years old with pre-operative head MRI result after thoracic surgery in Renji Hospital Affiliated to Shanghai Jiaotong University from November 2020 to December 2021. Perioperative data were collected, including preoperative general condition, laboratory examination, auxiliary examination (blood routine, blood coagulation, liver and kidney function, etc.), perioperative indicators （use of anesthetics, anesthetic time, blood pressure, etc.）, postoperative cerebral function follow-up and occurrence of cerebral vascular complications (brain infarction, brain bleed, etc.) of patients.

Cerebral small vessel disease (CSVD) can lead to vascular cognitive impairment and dementia (VCID). The hallmark of CSVD is the appearance and progression of white matter hyperintensities (WMH) on MRI. The goal of this study it to recruit and follow individuals at risk for WMH progression and use serial MRI scanning to gain insights into the pathogenesis of CSVD.

The TAG-SVD enrolled patients with clinical and neuroimaging features of cerebral small vessel disease (CSVD). All enrolled patients will receive next-generation sequence (NGS) with probes designed to target five candidate CSVD genes, and patients will be divided into genetic or non-genetic groups accordingly. Their clinical features and outcome will be followed for at least 2 years.

CamSVD is jointly sponsored by the University of Cambridge and Cambridge University Hospitals NHS Foundation Trust. We aim to explore and understand the underlying arterial pathology in Cerebral Small Vessel Disease (SVD) using ultra-high-field 7 Tesla MRI. We will optimise 7T Time-of-Flight MR angiography, blood suppressed MR sequence and phase-contrast (PC) MR angiography for visualization of perforating lenticulostriate arteries. This optimised sequences will be used to determine the range of arterial pathologies seen in individuals presenting with lacunar strokes. The pathologies of the perforating lenticulostriate arteries will be correlated with conventional clinical risk factors, cognition and radiological markers of SVD.

This cohort study involves the dynamic collection of clinical information, including serum parameters , blood pressure variability, imaging data, and neuropsychological scales, in patients with cerebral small vessel disease (CSVD). The study aims to summarise the clinical and imaging characteristics of the CSVD population and identify novel CSVD risk factors. Additionally, this study intend to uncover the mechanisms underlying the clinical and imaging outcomes of CSVD. Furthermore, a multivariable prediction model for cognitive and mood disorders in patients with CSVD will be established.