Cerebral small vessel disease Circulatory System
Conditions
Interventions
The study is a prospective hospital based cohort including all consenting patients with imaging manifestations of cSVD. Any patient with evident imaging changes will be included in the overall cohort,
cognition
function and mobility
imaging
cardiovascular physiology
fluid biomarkers and genetics. This detailed phenotyping will provide the first study with detailed data within each of these domains, particularly the physiological assessment, to differentiate patte
Sponsors
Imperial College London
Eligibility
Sex/Gender
All
Age
18 Years to 120 Years
Inclusion criteria
Inclusion criteria: 1. 1 or more acute or chronic lacunar strokes 2. ‘Non-negligible’ white matter hyperintensities: 2.1. Fazekas score =2 at any age or =1 below the age of 50 years, with definite white matter hyperintensities confirmed by review of imaging 2.2. Modified Blennow score of =2 at any age or =1 below the age of 50 (on CT) 3. At least two microbleeds 4. Previous intracerebral haemorrhage not due to a secondary cause (arteriovenous malformation [AVM], aneurysm, tumour etc) after complete investigation, or evidence of previous asymptomatic haemorrhage (i.e., superficial siderosis) 5. >5 dilated perivascular spaces 6. Willing to provide consent, or assent from next of kin or legal representative for participants who do not have capacity to consent 7. Resident in the area of the North West London ICS or registered with a GP within the ICS 8. Aged 18-120 years
Exclusion criteria
Exclusion criteria: 1. Confounding conditions on imaging: multiple sclerosis; significant regions of gliosis (eg prior trauma); brain tumour with potential to cause oedema; symptomatic territorial infarct; leukodystrophy. 2. Monogenic cause of cerebral small vessel disease (cSVD) defined by positive gene test, pathognomic imaging features (temporal pole white matter change) or strongly suggestive family history of probable autosomal dominant inheritance affecting 2 1st degree relatives with onset before 50 years. 3. Alternative causes of incident stroke where the stroke results in significant disability (modified Rankin scale [mRS] >2): critical steno-occlusive cerebrovascular disease (>70% in end vessel) in territory of incident, disabling stroke; dissection; vasculitis; causative carotid web etc;. Participants with atrial fibrillation with an embolic stroke can be included if there is no associated symptomatic territorial infarct. 4. Already dependent for personal activities of daily living (ADLs) prior to admission to hospital. 5. Diagnosis of dementia at identification. 6. Women who are currently pregnant at time of recruitment (but may be recruited after delivery). If a woman becomes pregnant during the study they will remain in the study but no study specific procedures will be performed.
Countries
England, United Kingdom
Contacts
Public ContactAlastair Webb
Outcome results
None listed