{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T22:52:36Z","timestamp":1787698356081,"version":"build-2784847793"},"reference-count":49,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2022,2,8]],"date-time":"2022-02-08T00:00:00Z","timestamp":1644278400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["alz-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alzheimer's &amp;amp; Dementia"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>There are few randomized clinical trials in vascular cognitive impairment (VCI). This trial tested the hypothesis that the PDE5 inhibitor tadalafil, a widely used vasodilator, increases cerebral blood flow (CBF) in older people with symptomatic small vessel disease, the main cause of VCI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a double\u2010blind, placebo\u2010controlled, cross\u2010over trial, participants received tadalafil (20\u00a0mg) and placebo on two visits \u22657 days apart (randomized to order of treatment). The primary endpoint, change in subcortical CBF, was measured by arterial spin labelling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Tadalafil increased CBF non\u2010significantly in all subcortical areas (N\u00a0=\u00a055, age: 66.8 (8.6) years) with greatest treatment effect within white matter hyperintensities (+9.8%,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a0.0960). There were incidental treatment effects on systolic and diastolic blood pressure (\u20137.8, \u20134.9\u00a0mmHg;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a0.001). No serious adverse events were observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This trial did not identify a significant treatment effect of single\u2010administration tadalafil on subcortical CBF. To detect treatment effects may require different dosing regimens.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alz.12559","type":"journal-article","created":{"date-parts":[[2022,2,8]],"date-time":"2022-02-08T19:00:19Z","timestamp":1644346819000},"page":"2393-2402","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["The PASTIS trial: Testing tadalafil for possible use in vascular cognitive impairment"],"prefix":"10.1002","volume":"18","author":[{"given":"Mathilde M.H.","family":"Pauls","sequence":"first","affiliation":[{"name":"Molecular &amp; Clinical Sciences Research Institute St George's University of London  London UK"},{"name":"Department of Neurology St George's University Hospitals NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren R.","family":"Binnie","sequence":"additional","affiliation":[{"name":"Molecular &amp; Clinical Sciences Research 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