Cerebrovascular Disease

We aim to recruit 1000 small vessel disease stroke cases as defined by an MRI scan. Details about the stroke, cardiovascular risk factors, family history and other health details will be collected and a small blood sample taken for DNA. A Genome Wide Association Study, which can identify up to one million variants across somebody’s genomes will be carried out on the DNA to look for novel genes associated with these stroke cases.

Further information is on the Health Research Authority website.

We are developing software to help interpret clinical information and brain scans in a way that will allow us to target treatment for acute stroke patients more effectively. More information can be found about this study on the Health Research Authority website.

We are using new genetic screening technology to look for previously unknown genes linked with hereditary cerebral small vessel disease. A fuller summary is available on the Health Research Authority website.

This is a trial to cpompare a strategy of intensive BP treatment guided by telemetric home monitoring versus standard care in adult survivors of Small Vessel Disease related Intra Cerebral Haemorrhage. We will establish feasibility and explore whether the intervention reduces the progression of SVD-injury on brain MRI.

Find out more on the Health Research Authority website.

About 35,000 people each year in the UK have a type of stroke, called ‘lacunar’ or ‘small vessel’ stroke, which is different to other common types of stroke and for which there is no proven treatment. Small vessel stroke is caused by damage to the lining of the tiny blood vessels in the brain that stops the vessels functioning normally and damages the brain. This could be the cause of up to 45% of all dementias. Two drugs that are commonly used in other vessel diseases may help improve small vessel function and prevent worsening of brain damage.

Find out more on the Health Research Authority website.

Aerobic exercise can be undertaken by most people, even if they’re disabled or cannot sit or stand up. Small studies using magnetic resonance imaging (MRI) in chronic stroke patients have shown moderate aerobic exercise increases cerebral blood flow. However, no studies have evaluated the safety of aerobic exercise acutely after stroke, nor whether it affects cerebral blood flow (CBF).
Remote ischaemic conditioning (RIC), ischaemia induced to a limb for short periods of time by inflating pressure cuffs around arms or legs to above systolic pressures (mmHg), often results in improved collateralisation of blood supply and improved efficiencies of cellular metabolism.

This project is listed on the Health Research Authority website. 

The aim of this study is to assess if stroke patients undergoing rehabilitation find it acceptable to undertake chronic remote ischaemic conditioning (CRIC) for a period of 6 weeks. Also to establish if it is feasible to undertake a randomised control trial of CRIC to reduce fatigue and enhance the physical performance of patients undergoing rehabilitation following stroke?

More information on this study can be found on the Health Research Authority website. 

Stroke commonly affects cognition and, by definition, vascular dementia is driven by stroke disease in some way. However, fundamental knowledge about risk factors is widely acknowledged to be missing, restricting mechanistic understanding, prevention, treatment, and design of patient services. We aim to recruit a wide range of patients with stroke, presenting to geographically diverse UK hospitals, into a longitudinal study to determine rates of, and risk factors for, cognitive and related impairments after stroke, to assess mechanisms and improve prediction models.

You can find out more on the Health Research Authority website. 

A quarter of all strokes are recurrent and are associated with greater disability. Despite optimal secondary prevention (antithrombotic, lipid lowering therapy, antihypertensive, lifestyle modification) rates of secondary vascular events remain high; 11.1% at one year in a recent systematic review (Mohan et al 2011). Previous research has shown that 300 days of bilateral arm RIC reduced rates of recurrent stroke from 26.7% to 7.9% in patients with intracranial artery stenosis (Meng et al 2012), however, no study has further evaluated the potential secondary preventative role of RIC after stroke or explored the biological mechanisms for this.\nThis is the first such study to investigate the secondary preventative use of RIC in stroke patients with and without intracranial arterial stenosis, as well as in patients with TIA. Further, we will explore whether a shorter period of RIC (8 weeks) delivered independently by the patient at home using a manual sphygmomanometer, may indicate a protective response.

You can find out more on the Health Research Authority website.