Overview
flowchart TD
Vascular_Dementia_Clinical_Tri["Vascular Dementia Clinical Trials"]
Vascular_Dementia_Clinical_Tri["page"]
Vascular_Dementia_Clinical_Tri -->|"related to"| Vascular_Dementia_Clinical_Tri
style Vascular_Dementia_Clinical_Tri fill:#81c784,stroke:#333,color:#000
Vascular_Dementia_Clinical_Tri["tracks"]
Vascular_Dementia_Clinical_Tri -->|"related to"| Vascular_Dementia_Clinical_Tri
style Vascular_Dementia_Clinical_Tri fill:#81c784,stroke:#333,color:#000
Vascular_Dementia_Clinical_Tri["active"]
Vascular_Dementia_Clinical_Tri -->|"related to"| Vascular_Dementia_Clinical_Tri
style Vascular_Dementia_Clinical_Tri fill:#81c784,stroke:#333,color:#000
style Vascular_Dementia_Clinical_Tri fill:#4fc3f7,stroke:#333,color:#000
This page tracks active and recent clinical trials targeting vascular dementia (VaD), vascular cognitive impairment (VCI), and cerebral small vessel disease (CSVD). Unlike Alzheimer's disease, VaD has fewer disease-modifying therapies in development, with current focus on vascular risk modification, neuroprotection, and cognitive enhancement.
Pipeline Summary | Phase | VaD/VCI Trials | Notes |
Phase 3 Trials
Intensive Blood Pressure Control ...
Overview
Mermaid diagram (expand to render)
This page tracks active and recent clinical trials targeting vascular dementia (VaD), vascular cognitive impairment (VCI), and cerebral small vessel disease (CSVD). Unlike Alzheimer's disease, VaD has fewer disease-modifying therapies in development, with current focus on vascular risk modification, neuroprotection, and cognitive enhancement.
Pipeline Summary | Phase | VaD/VCI Trials | Notes |
Phase 3 Trials
Intensive Blood Pressure Control SPRINT-MIND (NCT01206062)
Population : Adults with hypertension, aged ≥55 yearsIntervention : Intensive BP control (SBP <120 mmHg) vs standard (<140 mmHg)Outcome : Incident MCI, all-cause dementia, white matter lesion progressionStatus : CompletedKey Finding : Intensive control reduced risk of mild cognitive impairment by 24% and combined MCI/dementia by 19%Reference : https://clinicaltrials.gov/ct2/show/NCT01206062Cerebral Small Vessel Disease LACI-1 (NCT03131289)
Population : Lacunar stroke patients with small vessel diseaseIntervention : Cilostazol + isosorbide mononitrate vs placeboOutcome : Endothelial function, white matter lesion progressionStatus : CompletedKey Finding : Combination therapy improved cerebrovascular reactivityLACI-2 (ISRCTN10506409)
Population : Lacunar stroke survivorsIntervention : Dual antiplatelet therapy (clopidogrel + aspirin) vs aspirin aloneOutcome : Recurrent stroke, cognitive declineStatus : CompletedReference : https://clinicaltrials.gov/ct2/show/NCT03131289Phase 2 Trials
Neuroprotective Agents Cerebrolysin Studies
Mechanism : Neurotrophic factor mixturePhase : 2-3Population : Vascular dementia patientsOutcomes : Cognitive function, global clinical impressionStatus : Mixed results; larger trials neededCiticoline (CDP-Choline)
Mechanism : Membrane stabilizer, supports acetylcholine synthesisPhase : 2-3Population : Vascular cognitive impairmentOutcomes : Memory, executive functionNote : Historical trials showed mixed resultsAnti-inflammatory Approaches MINDS (NCT02740984)
Population : Small vessel disease with cognitive impairmentIntervention : Minocycline (anti-inflammatory)Outcome : White matter lesion progression, cognitive scoresStatus : CompletedEndothelial Function PROPEL (NCT02831188)
Population : Vascular cognitive impairmentIntervention : Propentofylline (phosphodiesterase inhibitor)Outcome : Cerebral blood flow, cognitive functionStatus : CompletedPhase 1 Trials
Novel Mechanisms | Agent | Mechanism | Target | Status |
Failed/Discontinued Trials
Phase 3 Failures | Drug | Mechanism | Reason for Failure |
Lessons Learned
Single-target approaches limited : Multi-target therapies may be needed given the heterogeneous vascular pathologyTiming matters : Early intervention before significant white matter damage appears more effectiveMixed pathology : Many patients with VaD also have AD pathology, complicating trial design and endpoint selection
Biomarker Endpoints in VaD Trials
Imaging Biomarkers
White matter hyperintensity (WMH) volume : Primary imaging endpointDiffusion tensor imaging (DTI) : Microstructural integrityCerebral blood flow (ASL) : Perfusion measuresSusceptibility-weighted imaging (SWI) : Microbleed detectionFluid Biomarkers | Biomarker | Utility |
Clinical Endpoints
MMSE : Global cognitionMoCA : Executive function sensitiveEXIT25 : Frontal/executive functionVascular Dementia Assessment Scale (VaDAS) : VaD-specificADAS-Cog : Modified for vascular featuresOngoing Trials (2024-2026)
Cognitive Training + Vascular Control Cog-VACS (NCT05287474)
Population : Post-stroke cognitive impairmentIntervention : Computerized cognitive training + BP managementOutcome : Composite cognitive score at 12 monthsStatus : RecruitingNovel Anti-platelet THALES-2 (NCT04676551)
Population : Acute lacunar strokeIntervention : Ticagrelor + aspirin vs aspirin aloneOutcome : New ischemic lesions on MRI, cognitive functionStatus : RecruitingGenetic Subtype Studies CADASIL-BMS (NCT04052737)
Population : CADASIL patientsIntervention : BMS-986012 (anti-Notch3)Outcome : Safety, cognitive endpointsStatus : Phase 1Key Research Centers | Institution | Focus |
See Also
[Vascular Dementia](/diseases/vascular-dementia)
[Cerebral Small Vessel Disease](/diseases/cerebral-small-vessel-disease)
[Vascular Cognitive Impairment](/diseases/vascular-cognitive-impairment)
[Blood-Brain Barrier Breakdown](/mechanisms/blood-brain-barrier)
[White Matter Hyperintensities](/mechanisms/white-matter-hyperintensities)
[Neurofilament Light Chain](/biomarkers/neurofilament-light-chain-nfl)
[CADASIL](/diseases/cadasil)
[Mixed Dementia](/diseases/mixed-dementia)
References
Moore, E. et al. (2019). Clinical Trials in Vascular Dementia: A Scoping Review. Alzheimer's & Dementia.
Pantoni, L. (2010). Cerebral small vessel disease: From pathogenesis to clinical challenges. Lancet Neurology.
Wardlaw, J.M. et al. (2019). Small vessel disease: Mechanisms and clinical implications. Lancet Neurology.
Dichgans, M. & Leys, D. (2017). Vascular Cognitive Impairment. Circulation Research.
Show full description