Author Interview: Profs. Eric E. Smith and Hugh Markus on “New Treatment Approaches to Modify the Course of Cerebral Small Vessel Diseases”
A conversation with Professor Eric E. Smith, MD, Ph.D., Professor of Neurology, Cumming School of Medicine, University of Calgary, Canada, and Professor Hugh Markus, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.
Interviewed by Shashank Shekhar, MD, MS, Assistant Professor, Division of Vascular Neurology, University of Mississippi Medical Center, USA; @ArtofStroke.
They will be discussing the article “New Treatment Approaches to Modify the Course of Cerebral Small Vessel Diseases,” published in the January 2020 issue of Stroke. The article is part of a Focused Updates in Cerebrovascular Disease series of articles on topics related to cerebral small vessel diseases.
Dr. Shekhar: I would like to thank Prof. Smith and Prof. Markus for agreeing to do this interview. In this interesting review paper, you have discussed in detail the new treatment approaches to modify the course of small vessel disease. Could you tell the readers why you decided to write about this topic?
Prof. Smith: Cerebral small vessel disease is a common condition of aging. We now know that it can cause cognitive decline and stroke. When I chaired a writing group for the American Heart Association that produced a scientific statement on stroke prevention in persons with silent cerebrovascular disease (Smith et al, Stroke 2017; 48:e44-e71), one of the interesting things we found is that there were few clinical trials that focused on small vessel disease. There are no medications specifically indicated for cerebral small vessel disease. The time seemed ripe to review progress in this area, and indeed we found emerging evidence for new treatment strategies in early phase trials.
Prof. Markus: Cerebral small vessel disease is an enormous health problem — it causes a quarter of all strokes and is the most common cause of vascular dementia. Despite this, there are few, if any, treatments for established disease, and it remains one of the great therapeutic challenges in stroke. We wanted to summarize where we were and describe a pathway forwards.