20. 54. Severity of white matter hyperintensities and length of hospital stay in patients with cognitive impairment: a CREDOS (Clinical Research Center for, 52. [76], Brain and cognitive reserves in later life are influenced by lifetime experiences, including those early in life. These include: 2. Policy. [7,15] How patients report, and clinicians interpret, these symptoms is poorly understood and inter-individual factors influencing accurate reporting are complex. 123. On therapeutic approaches to SVD, we searched Ovid MEDLINE using the terms Cerebral small vessel disease OR White matter hyperintense OR lacunar OR vascular cognitive impairment up to 12th May 2020. [14] Furthermore, a comprehensive history and examination, including collateral history from an informant, may yield more subtle, associated features such as apathy, abrupt or insidious cognitive decline, fatigue or gait disturbances that do not necessarily meet diagnostic criteria for stroke or dementia but have been linked temporally with acute lesions on Diffusion-Weighted Imaging (DWI) MRI (n = 6/649 community sample, n = 10/30 vascular dementia population). Prevention of, 15. Heye AK, Thrippleton MJ, Chappell FM, Valdes Hernandez MC, Armitage PA, Makin SD, et al. Talk to your healthcare provider about developing a personalized plan for you. 10. Tolerability, safety and intermediary pharmacological effects of cilostazol and isosorbide mononitrate, alone and combined, in patients with lacunar ischaemic, 109. [93] The secondary prevention of small subcortical stroke (SPS3) trial randomized 3020 patients with a symptomatic lacunar stroke to chronic aspirin and clopidogrel versus aspirin alone and was stopped early due to excess bleeding and death in the dual antiplatelet group. [110] However, when administered within 4 h of stroke onset in the pre-hospital arena in a subsequent trial, GTN had a neutral effect on clinical outcomes. Type 2 diabetes, change in depressive, 65. Understanding the role of the perivascular space in cerebral. [47] The subcortical vascular cognitive impairment (VCI) subtype is supported by symptoms such as impaired problem-solving, personality changes including apathy, mood disorders, pseudobulbar palsy, dysarthria, subtle sensory and motor deficits, urinary symptoms, and gait deterioration including postural instability. Adopting a more integrated, holistic approach to identifying early and intermediate clinical brain damage markers is essential to permit prognostication, supportive management strategies, identification of patients for emerging treatment trials, and future refinement of targeted prevention and management strategies. Fandler S, Gattringer T, Eppinger S, Doppelhofer K, Pinter D, Niederkorn K, et al. Despite being almost ubiquitous in brain imaging, the clinicoradiologic association of small vessel disease is weak, and the underlying pathogenesis is poorly understood. Correspondence to: Prof. Joanna M. Wardlaw, Centre for Clinical Brain Sciences, and UK Dementia Research Institute, University of Edinburgh, Chancellor's Building, 49 LIttle France Crescent, Edinburgh, EH16 4SP, UK E-Mail: [emailprotected], How to cite this article: Clancy U, Appleton JP, Arteaga C, Doubal FN, Bath PM, Wardlaw JM. [54] People with type 2 diabetes have a 1.5 times increased risk of dementia, and high HbA1c, concentration and glucose variability are negatively associated with cognitive function. al. This will allow us to research targeted interventions earlier in the SVD course, preventing progression before its most disabling manifestations develop. 4 results found to treat cerebrovascular disease Vascular subcortical dementias: clinical aspects. It can be useful to work with a physical therapist or fitness trainer. Genetic, environmental/lifestyle and cultural risk factors are likely related to SVD burden and to its associated outcomes such as cognitive impairment.