CADASIL is a paradigmatic cerebral small vessel disease responsible for white-matter lesions,
accumulation of lacunes, microbleeds and cerebral atrophy. The disease is responsible for
stroke and cognitive decline associated with motor disability. The number of incident
lacunes, and amount of cerebral atrophy were recently found to have a strong relationship to
cognitive decline and disability progression over 3 years in a large sample of patients. Palm
tocotrienols has previously shown evidence of therapeutic effect in attenuating the
progression of WMH related to sporadic cerebral small vessel disease in a randomized
controlled clinical trial. We hypothesize that palm tocotrienols complex (HOV-12020) can
reduce the clinical progression in CADASIL.