Abstract:
ABSTRACT:Cerebral small vessel disease (SVD) is a common global brain disease that causes cognitive impairment, ischemic or hemorrhagic stroke, problems with mobility, and neuropsychiatric symptoms. The brain damage, seen as focal white and deep grey matter lesions on brain magnetic resonance imaging (MRI) or computed tomography (CT), typically accumulates "covertly" and may reach an advanced state before being detected incidentally on brain scanning or causing symptoms. Patients have typically presented to different clinical services or been recruited into research focused on one clinical manifestation, perhaps explaining a lack of awareness, until recently, of the full range and complexity of SVD.In this review, we discuss the varied clinical presentations, established and emerging risk factors, relationship to SVD features on MRI or CT, and the current state of knowledge on the effectiveness of a wide range of pharmacological and lifestyle interventions. The core message is that effective assessment and clinical management of patients with SVD, as well as future advances in diagnosis, care, and treatment, will require a more "joined-up"' approach. This approach should integrate clinical expertise in stroke neurology, cognitive, and physical dysfunctions. It requires more clinical trials in order to improve pharmacological interventions, lifestyle and dietary modifications. A deeper understanding of the pathophysiology of SVD is required to steer the identification of novel interventions. An essential prerequisite to accelerating clinical trials is to improve the consistency, and standardization of clinical, cognitive and neuroimaging endpoints.
journal_name
Chin Med J (Engl)journal_title
Chinese medical journalauthors
Clancy U,Appleton JP,Arteaga C,Doubal FN,Bath PM,Wardlaw JMdoi
10.1097/CM9.0000000000001177subject
Has Abstractpub_date
2020-10-06 00:00:00pages
127-142issue
2eissn
0366-6999issn
2542-5641pii
00029330-202101200-00001journal_volume
134pub_type
杂志文章abstract::Lymphocytes from regional lymph nodes of patients with ovarian carcinoma were immortalized by fusing them with a nonsecreting cell line of murine myeloma (Sp2/0-Ag14). The fusion rate was 0-87.5%. By early cloning and recloning, a hybrid cell line, named HMD4, was established. It has stably secreted human IgG for more...
journal_title:Chinese medical journal
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pub_type: 杂志文章,评审
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