Abstract
- Background
Carotid artery stenosis or occlusion (CASO) represents a major primary etiology of vascular cognitive impairment (VCI). Currently, there are no established, highly effective pharmacological treatments specifically available for VCI induced by CASO. Preclinical investigations have demonstrated that resveratrol, a naturally occurring polyphenol, effectively improves cognitive performance in rat CASO models through pleiotropic physiological effects. Furthermore, previous scientific observations identified that the longevity gene SIRT1—which is directly activated by resveratrol—ameliorates cognitive deficits and cerebral blood flow impairments in mouse CASO models via the activation of endothelial nitric oxide synthase. However, direct clinical trial evidence in human patient populations remains severely limited. The Resveratrol for Vascular Cognitive Impairment Investigating Cerebral Metabolism and Perfusion (REVAMP) trial was specifically designed to bridge this gap by evaluating the clinical efficacy of resveratrol.
- Methods
The REVAMP trial is structured as a randomized, double-blind, placebo-controlled clinical trial involving human patients diagnosed with asymptomatic carotid artery stenosis or occlusion (CASO). A total of 100 participants will be recruited and randomized in a 1:1 ratio ($N = 50$ per group) to receive either a standardized daily dose of 150 mg of oral resveratrol or a matched placebo for a continuous duration of 35 weeks. The primary objective of the trial is to determine whether daily resveratrol supplementation significantly improves cognitive impairment, as quantitatively assessed using the Alzheimer’s Disease Assessment Scale–Cognitive Subscale 13 (ADAS-cog13). A key secondary objective is to investigate whether resveratrol improves cerebral hemodynamic impairment, evaluated objectively via specialized 15O-gas positron emission tomography (PET).
- Discussion
The REVAMP trial holds the potential to provide highly valuable clinical insights into novel therapeutic options for vascular cognitive impairment. By demonstrating whether multitarget neuroprotection can concurrently improve cognitive function and enhance cerebral hemodynamic status in patients with asymptomatic CASO, this trial may establish a foundation for evidence-based interventions in cerebrovascular health.
https://pmc.ncbi.nlm.nih.gov/articles/PMC11074349/