ArticleCerebral circulation - cognition and behavior2025
Cognitive outcomes after tadalafil treatment in patients with cerebral small vessel disease: ETLAS-2 sub-study.
Article in Cerebral circulation - cognition and behavior, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05173896 (Improving Cerebral Blood Flow and Cognition in Patients with Cerebral Small Vessel Disease. the ETLAS-2 Trial), which is not on this map. Cited by 2 papers.
What it found
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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.
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.
Improving Cerebral Blood Flow and Cognition in Patients with Cerebral Small Vessel Disease. the ETLAS-2 Trial
Who cites it
2 citing papers in PubMed.
- Neurovascular effects of tadalafil in patients with cerebral small vessel disease: ETLAS-2 substudy.Brain communications · 2026Trial
- Pentoxifylline targets TLR4/MyD88/NF-κB signaling to ameliorate neuroinflammation and metabolic dysfunction in a rat model of chronic hypoperfusion-induced vascular cognitive impairment.Metabolic brain disease · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Cerebral small vessel disease (CSVD) is the dominant cause of vascular cognitive impairment and dementia. We aimed to test whether continuous daily treatment with the vasoactive phosphodiesterase 5 inhibitor tadalafil improved cognitive performance in patients with CSVD. Methods: This is a pre-registered sub-study on cognitive outcomes from the ETLAS-2 trial, a randomized, placebo-controlled, double-blind, parallel study investigating 3 months of daily tadalafil (20 mg) treatment against placebo in patients with CSVD and previous stroke or transient ischemic attack. Outcomes were assessed twice, at baseline and after 3 months of treatment. The primary outcomes were changes in the cognitive domains of processing speed, attention, memory, and executive functions assessed by the Symbol Digit Modalities test, digit span forward, and tests from the computer-based Cambridge Neuropsychological Test Automated Battery (CANTAB). Results: The per-protocol sub-study analysis comprised 60 participants, 28 of whom received tadalafil and 32 received placebo. Baseline cognitive impairments involved reduced processing speed and impaired visual learning and memory. At follow-up, we found a slower mean simple reaction time in the tadalafil group compared to placebo (28.8 ± 13.8 ms, Conclusion: We found no overall difference in cognitive outcomes between groups over 3-month treatment. In the tadalafil group, a slower reaction time in a single test was observed, which may be a spurious finding. A longer treatment time may be required to identify potential effects on cognitive outcomes, which could be secondary to improved blood flow. Clinical trial registration: URL: https://www.clinicaltrials.gov, Unique identifier: NCT05173896.
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