Disease of the small blood vessels in the brain (cerebral small vessel disease or SVD) causes a quarter of all strokes and is the most common cause of vascular dementia. Despite its importance there are few effective treatments for SVD. A major reason for this lack of treatments is that we do not fully understand what causes the disease. Only by better understanding it will be able develop better treatments.
Two newly identified processes that may contribute to SVD, and which could represent new therapeutic targets, are leakiness of the barrier between the small blood vessels and the brain (the blood brain barrier), and inflammation within the brain. It is now possible to measure both processes in the brain using advanced brain imaging techniques (MRI and PET).
The MINocyclinE to Reduce inflammation and blood brain barrier leakage in small Vessel diseAse (MINERVA) trial aims to test whether these processes can be reversed, using Minocycline (a medicine that was designed as an antibiotic but is known to have anti-inflammatory effects within the brain). To do this we are recruiting patients with symptomatic small vessel disease who will undergo PET and MRI brain scans and blood tests before and after a three month course of treatment of Minocycline.
The MINERVA study is funded by the Medical Research Council.