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Cerebral small vessel disease (SVD) is a major cause of stroke and dementia
.
There is currently no specific treatment to stop the development of the disease
Isosorbide mononitrate (ISMN) and cilostazol have pharmacological effects and can improve these cerebrovascular dysfunctions
.
Cilostazol can reduce the recurrence of stroke and may reduce cognitive impairment
In the LACI-1 trial (LACunar Intervention-1), Gordon W.
Blair of the University of Edinburgh and others measured the lacunar nature of random assignment to receive ISMN or cilostazol monotherapy, combination therapy, or avoidance of these drugs CVR, cerebral blood flow and CSF dynamics in stroke patients
Of the 27 participants (mean age, 68±7.
7; 44% were women), 22 completed cerebrovascular reactivity and pulsation imaging, with a complete data set
White matter cerebrovascular reactivity in ISMN (β=0.
021%/mm Hg [95% CI, 0.
003-0.
040]) and cilostazol (β=0.
035%/mm Hg [95% CI, 0.
014-0.
056]) single agent There was an increase in the treatment group and those who took any drugs and those who did not take drugs (β=0.
021%/mm Hg [95% CI, 0.
005-0.
037])
.
Although limited by small samples, it proves that it is feasible to measure cerebrovascular function with magnetic resonance imaging in clinical trials , and ISMN and cilostazol can improve cerebrovascular function
.
It is feasible to measure cerebral vascular function with magnetic resonance imaging in clinical trials
Original source:
Blair GW, Janssen E, Stringer MS, et al.
Effects of Cilostazol and Isosorbide Mononitrate on Cerebral Hemodynamics in the LACI-1 Randomized Controlled Trial.
Stroke.
Published online December 2021:STROKEAHA.
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