{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:09:31Z","timestamp":1790788171313,"version":"4.1.0"},"reference-count":39,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,12,27]],"date-time":"2022-12-27T00:00:00Z","timestamp":1672099200000},"content-version":"vor","delay-in-days":360,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["alz-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["A&amp;D Transl Res &amp; Clin Interv"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Cerebral small vessel disease (SVD) is an important cause of dementia that lacks effective treatment. We evaluated the efficacy and safety of cilostazol, an antiplatelet agent with potential neurovascular protective effects, in slowing the progression of white matter hyperintensities (WMHs) in stroke\u2010 and dementia\u2010free subjects harboring confluent WMH on magnetic resonance imaging (MRI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this single\u2010center, randomized, double\u2010blind, placebo\u2010controlled study, we randomized stroke\u2010 and dementia\u2010free subjects with confluent WMHs to receive cilostazol or placebo for 2 years in a 1:1 ratio. The primary outcome was change in WMH volume over 2 years. Secondary outcomes were changes in brain volumes, lacunes, cerebral microbleeds, perivascular space, and alterations in white matter microstructural integrity, cognition, motor function, and mood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We recruited 120 subjects from October 27, 2014, to January 21, 2019. A total of 55 subjects in the cilostazol group and 54 subjects in the control group were included for intention\u2010to\u2010treat analysis. At 2\u2010year follow\u2010up, the changes in WMH volume were not statistically different between cilostazol treatment and placebo (0.3\u00b11.0\u00a0mL vs \u22120.1\u00b10.8\u00a0mL,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.167). Secondary outcomes, bleeding and vascular events, were also not statistically different between the two groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>In this trial with stroke\u2010 and dementia\u2010free subjects with confluent WMHs, cilostazol did not impact WMH progression but demonstrated an acceptable safety profile. Future studies should address the treatment effects of cilostazol on subjects at different clinical stages of SVD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/trc2.12369","type":"journal-article","created":{"date-parts":[[2022,12,27]],"date-time":"2022-12-27T09:39:20Z","timestamp":1672133960000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Efficacy and safety of cilostazol in decreasing progression of cerebral white matter hyperintensities\u2014A randomized controlled trial"],"prefix":"10.1002","volume":"8","author":[{"given":"Bonaventure Y. M.","family":"Ip","sequence":"first","affiliation":[{"name":"Division of Neurology Department of Medicine and Therapeutics The Chinese University of Hong Kong  Shatin Hong Kong SAR China"},{"name":"Gerald Choa Neuroscience Institute Margaret K.L. Cheung Research Centre for Management of Parkinsonism Therese Pei Fong Chow Research Centre for Prevention of Dementia Lui Che Woo Institute of Innovative Medicine Li Ka Shing Institute of Health Science Lau Tat\u2010chuen Research Centre of Brain Degenerative Diseases in Chinese Faculty of Medicine The Chinese University of Hong Kong  Shatin Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bonnie Y. K.","family":"Lam","sequence":"additional","affiliation":[{"name":"Division of Neurology Department of Medicine and Therapeutics The Chinese University of Hong Kong  Shatin Hong Kong SAR China"},{"name":"Gerald Choa Neuroscience Institute Margaret K.L. Cheung Research Centre for Management of Parkinsonism Therese Pei Fong Chow Research Centre for Prevention of Dementia Lui Che Woo Institute of Innovative Medicine Li Ka Shing Institute of Health Science Lau Tat\u2010chuen Research Centre of Brain Degenerative Diseases in Chinese Faculty of Medicine The Chinese University of Hong Kong  Shatin Hong Kong SAR China"},{"name":"Nuffield Department of Clinical Neurosciences Wellcome Centre for Integrative Neuroimaging University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent M. H.","family":"Hui","sequence":"additional","affiliation":[{"name":"Division of Neurology Department of Medicine and Therapeutics The Chinese University of Hong Kong  Shatin Hong Kong SAR China"},{"name":"Gerald Choa Neuroscience Institute Margaret K.L. Cheung Research Centre for Management of Parkinsonism Therese Pei Fong Chow Research Centre for Prevention of Dementia Lui Che Woo Institute of Innovative Medicine Li Ka Shing Institute of Health Science Lau Tat\u2010chuen Research Centre of Brain Degenerative Diseases in Chinese Faculty of Medicine The Chinese University of Hong Kong  Shatin Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa W. C.","family":"Au","sequence":"additional","affiliation":[{"name":"Division of Neurology Department of Medicine and Therapeutics The Chinese University of Hong Kong  Shatin Hong Kong SAR China"},{"name":"Gerald Choa Neuroscience Institute Margaret K.L. Cheung Research Centre for Management of Parkinsonism Therese Pei Fong Chow Research Centre for Prevention of Dementia Lui Che Woo Institute of Innovative Medicine Li Ka Shing Institute of Health Science Lau Tat\u2010chuen Research Centre of Brain Degenerative Diseases in Chinese Faculty of Medicine The Chinese University of Hong Kong  Shatin Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mandy W. T.","family":"Liu","sequence":"additional","affiliation":[{"name":"Division of Neurology Department of Medicine and Therapeutics The Chinese University of Hong Kong  Shatin Hong Kong SAR China"},{"name":"Gerald Choa Neuroscience Institute Margaret K.L. Cheung Research Centre for Management of Parkinsonism Therese Pei Fong Chow Research Centre for Prevention of Dementia Lui Che Woo Institute of Innovative Medicine Li Ka Shing Institute of Health Science Lau Tat\u2010chuen Research Centre of Brain Degenerative Diseases in Chinese Faculty of Medicine The Chinese University of Hong Kong  Shatin Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Imaging and Interventional Radiology The Prince of Wale Hospital The Chinese University of Hong Kong  Shatin Hong Kong SAR China"},{"name":"BrainNow Research Institute  Shenzhen Guangdong Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivian W. Y.","family":"Lee","sequence":"additional","affiliation":[{"name":"Centre for Learning Enhancement and Research The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Winnie C. W.","family":"Chu","sequence":"additional","affiliation":[{"name":"Department of Imaging and Interventional Radiology The Prince of Wale Hospital The Chinese University of Hong Kong  Shatin Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas W.","family":"Leung","sequence":"additional","affiliation":[{"name":"Division of Neurology Department of Medicine and Therapeutics The Chinese University of Hong Kong  Shatin Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ho","family":"Ko","sequence":"additional","affiliation":[{"name":"Division of Neurology Department of Medicine and Therapeutics The Chinese University of Hong Kong  Shatin Hong Kong SAR China"},{"name":"Gerald Choa Neuroscience Institute Margaret K.L. Cheung Research Centre for Management of Parkinsonism Therese Pei Fong Chow Research Centre for Prevention of Dementia Lui Che Woo Institute of Innovative Medicine Li Ka Shing Institute of Health Science Lau Tat\u2010chuen Research Centre of Brain Degenerative Diseases in Chinese Faculty of Medicine The Chinese University of Hong Kong  Shatin Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent C. T.","family":"Mok","sequence":"additional","affiliation":[{"name":"Division of Neurology Department of Medicine and Therapeutics The Chinese University of Hong Kong  Shatin Hong Kong SAR China"},{"name":"Gerald Choa Neuroscience Institute Margaret K.L. 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