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Cerebrovascular diseases
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Cerebral small vessel disease is a major cause of stroke and dementia in the UK. The causes of progression of the disease are not completely understood. Recently leakiness of the blood brain barrier has been proposed as a mechanism, which itself may cause inflammation of the brain. If we can understand what causes progression of the disease it may be possible to target treatments to reduce these processes and, therefore, progression.
This is an observational study, which attempts to give a greater understanding of the disease. We aim to investigate the prevalence and pattern of leakiness and inflammation in the brain, in people with small vessel disease and controls, using magnetic resonance imaging (MRI) and positron emission tomography (PET). We will calculate the volume and pattern of tissue showing abnormal permeability and inflammation and link them to disease severity as measured with other MRI parameters, such as the volume of white matter hyper-intensities or the health of normal appearing white matter, and measures of cognition, both at the time of the scan and also any change in the disease over one year.
We will recruit controls with no disease as well as people suffering with sporadic small vessel disease and also with CADASIL, a version of small vessel disease caused by a genetic mutation. The study will be performed at the Cambridge Biomedical Campus (Addenbrooke's) site and involve cognitive testing, clinical examination and blood samples being taken, as well as the MRI and PET scans, participants will also undergo a follow-up MRI scan and cognitive testing at one year. The project is funded by the Medical Research Council.
Start dates may differ between countries and research sites. The research team are responsible for keeping the information up-to-date.
The recruitment start and end dates are as follows:
Observational type: Cross-sectional;
You can take part if:
You may not be able to take part if:
SVD and CADASIL group exclusion criteria: 1. Unable/unwilling to consent 2. MMSE <21 (for consent issues) 3. Age<18 4. Lacunar infarcts >1.5cm – as many of these are striatocapsular infarcts caused by embolism 5. Evidence of cortical stroke 6. Any stroke cause other than SVD including: a. Cardioembolic source b. Carotid or vertebral stenosis >50% measured on NASCET criteria 7. Estimated glomerular filtration rate (eGFR) =<59 ml/min/1.73m2 within past 3 months. Estimated GFR will be calculated using the Modification of Diet in Renal Disease (MDRD) equation: 186 x (Creatinine / 88.4)1.154x (Age) - 0.203 x (0.742 if female) x (1.210 if black) 8. Contraindications to taking part in MRI study, e.g., pacemaker 9. Inability to lie still in the PET/MR scanner for up to 75 minutes 10. Women who are of child bearing age, pregnant or breastfeeding Control groups exclusion criteria: 1. Unable/unwilling to consent 2. MMSE <21 (for consent issues) 3. Age<18 4. Any MRI evidence of lacunar infracts or leukoaraiosis ( >grade 1 in either periventricular or deep white matter regions on the Fazekas scale 5. eGFR=<59 within past 3 months 6. Contraindications to taking part in MRI study, e.g., pacemaker 7. Inability to lie still in the PET/MR scanner for up to 75 minutes 8. Women who are of child bearing age, pregnant or breastfeeding
Below are the locations for where you can take part in the trial. Please note that not all sites may be open.
The study is sponsored by CAMBRIDGE UNIVERSITY HOSPITALS NHS FOUNDATION TRUST and funded by Medical Research Council (MRC) .
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for Trial ID: CPMS 32353
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