Inclusion Criteria:

1. Age ≥18 years.

2. Evidence of cerebral small vessel disease (CSVD) on brain MRI, meeting at least one of the following imaging criteria:

   • White matter hyperintensities (WMH) with a total Fazekas score ≥2;
   • Fazekas score =1 with at least two vascular risk factors (hypertension, hyperlipidemia, diabetes mellitus, obesity, current smoking, or a history of vascular events other than stroke);
   • Fazekas score =1 accompanied by the presence of lacunes;
   • Imaging evidence of a recent subcortical lacunar infarction.

3. Independent in activities of daily living (modified Rankin Scale [mRS] ≤2).

4. Able and willing to provide written informed consent.

Exclusion Criteria:

1. Acute ischemic stroke with a diffusion-weighted imaging (DWI) lesion >20 mm in diameter.
2. Acute intracerebral hemorrhage.
3. Acute subarachnoid hemorrhage, a history of aneurysmal subarachnoid hemorrhage or cerebrovascular malformation, or the presence of an untreated intracranial aneurysm >3 mm in diameter.
4. Previously diagnosed neurodegenerative disorders, such as Alzheimer's disease (AD) or Parkinson's disease (PD).
5. Definite non-vascular white matter diseases, including multiple sclerosis, adult-onset leukodystrophy, metabolic encephalopathy, or other non-vascular white matter disorders.
6. Major psychiatric disorders diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).
7. Contraindications to MRI (e.g., severe claustrophobia or MRI-incompatible implants).
8. Severe systemic diseases (e.g., active malignancy) with an expected life expectancy of less than 5 years.
9. Inability to complete scheduled follow-up because of geographic, logistical, or other reasons.
10. Concurrent participation in another interventional clinical trial.