Evidence mapPaperPMID 34414301Full record

ArticleEuropean stroke journal2021

ESO Guideline on covert cerebral small vessel disease.

Joanna M Wardlaw, Stephanie Debette, Hanna Jokinen, Frank-Erik De Leeuw, Leonardo Pantoni, Hugues Chabriat, Julie Staals, Fergus Doubal, Salvatore Rudilosso, Sebastian Eppinger and 6 more

RetractedOpen access · hybridAbstract read
In one paragraph

Article in European stroke journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It has been retracted, and should not be counted. Cited by 87 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
87citing papers in PubMed, 4 pooled it
10.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

87 citing papers in PubMed, 4 syntheses or guidelines pooled it, 160 citations in OpenAlex.

  1. Pooled it
  2. Guideline
  3. Pooled it
  4. Pooled it
  5. Trial
  6. Article
  7. Review
  8. Article
  9. Article
  10. Review
  11. Article
  12. Review
  13. Article
  14. Article
  15. Article
  16. Vascular cognitive impairment and dementia: Prevention, treatments, mechanisms and management options for the future.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2026
    Review
  17. Article
  18. Article
  19. Article
  20. Observational

27 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 12 institutions in 9 countries.

Joanna M WardlawCentre for Clinical Brain Sciences, UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK.ORCID https://orcid.org/0000-0002-9812-6642
Stephanie DebetteBordeaux Population Health Center, University of Bordeaux, INSERM, UM1219, Team VINTAGE.
Hanna JokinenHUS Neurocenter, Division of Neuropsychology, Helsinki University Hospital, University of Helsinki and Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland.
Frank-Erik De LeeuwRadboud University Medical Center, Department of Neurology; Donders Center for Medical Neuroscience, Nijmegen, The Netherlands.
Leonardo PantoniStroke and Dementia Lab, 'Luigi Sacco' Department of Biomedical and Clinical Sciences, University of Milan, Milano, Italy.ORCID https://orcid.org/0000-0001-7357-8530
Hugues ChabriatDepartment of Neurology, Hopital Lariboisiere, APHP, INSERM U 1161, FHU NeuroVasc, University of Paris, Paris, France.
Julie StaalsDepartment of Neurology, School for Cardiovascular Diseases (CARIM), Maastricht UMC+, AZ Maastricht, the Netherlands.
Fergus DoubalCentre for Clinical Brain Sciences, UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK.
Salvatore RudilossoComprehensive Stroke Center, Department of Neuroscience, Hospital Clínic, Barcelona, Spain.ORCID https://orcid.org/0000-0002-8775-6884
Sebastian EppingerUniversity Clinic of Neurology, Medical University of Graz, Graz, Austria.
Sabrina SchillingBordeaux Population Health Center, University of Bordeaux, INSERM, UM1219, Team VINTAGE.
Raffaele OrnelloDepartment of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L'Aquila, Italy.
Christian EnzingerUniversity Clinic of Neurology, Medical University of Graz, Graz, Austria.
Charlotte CordonnierUniv. Lille, INSERM, CHU Lille, U1172, LilNCog - Lille Neuroscience & Cognition, Lille, France.
Martin Taylor-RowanInstitute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.
Arne G LindgrenDepartment of Clinical Sciences Lund, Neurology, Lund University; Section of Neurology, Skåne University Hospital, Lund, Sweden.
Inserm · FRMedical University of Graz · ATUK Dementia Research Institute · GBUniversité de Bordeaux · FRLund University · SEMaastricht University Medical Centre · NLNeurosciences Institute · USRadboud University Nijmegen · NLUniversity of Glasgow · GBUniversity of Helsinki · FIUniversity of L'Aquila · ITUniversity of Milan · IT

Funding

CNV And Stroke (CaNVAS)R01NS114045 · NINDS · UNIVERSITY OF MARYLAND BALTIMORE · PI JOHN W. COLE · 2022 to 2024
$1.5M
NINDS NIH HHS R01 NS114045
6 · The paper itself

Abstract

'Covert' cerebral small vessel disease (ccSVD) is common on neuroimaging in persons without overt neurological manifestations, and increases the risk of future stroke, cognitive impairment, dependency, and death. These European Stroke Organisation (ESO) guidelines provide evidence-based recommendations to assist with clinical decisions about management of ccSVD, specifically white matter hyperintensities and lacunes, to prevent adverse clinical outcomes. The guidelines were developed according to ESO standard operating procedures and Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. We prioritised the clinical outcomes of stroke, cognitive decline or dementia, dependency, death, mobility and mood disorders, and interventions of blood pressure lowering, antiplatelet drugs, lipid lowering, lifestyle modifications, glucose lowering and conventional treatments for dementia. We systematically reviewed the literature, assessed the evidence, formulated evidence-based recommendations where feasible, and expert consensus statements. We found little direct evidence, mostly of low quality. We recommend patients with ccSVD and hypertension to have their blood pressure well controlled; lower blood pressure targets may reduce ccSVD progression. We do not recommend antiplatelet drugs such as aspirin in ccSVD. We found little evidence on lipid lowering in ccSVD. Smoking cessation is a health priority. We recommend regular exercise which may benefit cognition, and a healthy diet, good sleep habits, avoiding obesity and stress for general health reasons. In ccSVD, we found no evidence for glucose control in the absence of diabetes or for conventional Alzheimer dementia treatments. Randomised controlled trials with clinical endpoints are a priority for ccSVD.

Indexed as

cerebral small vessel diseasecovertdementialacunesleukoaraiosisoutcomepreventionrecommendationssilent brain infarctsstrokeWhite matter hyperintensities

Identifiers

PMID34414301
PMCPMC8370079
OpenAlexW3161563824

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.