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Cerebrovascular diseasesFalls
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Sporadic cerebral small vessel disease (cSVD) is a common, potentially preventable cause of poor balance and falls in older people. Indeed, falls affect two in five over the age of 65 years and they cost 1% of all healthcare expenditure, equivalent to £28 billion in the UK in 2021. Severe cSVD is a major cause of unsteadiness but early disease often progresses silently. Established measures of cSVD are not sensitive to its early effects on balance control. Furthermore, though research has focused on cSVD, brain measures do not fully explain poor balance. The spinal cord - which connects the brain to the legs - is essential for balance control, and autopsy studies show it is affected by SVD. The aims of this work are therefore to find markers sensitive to the effects of early cSVD on balance control, and to - for the first time - detect SVD effects on the spinal cord in life. Doing this will allow people at highest risk of balance deterioration in SVD to be detected, so treatments can be targetted early to prevent falls.
We will recruit patients with mild and moderate burdens of cSVD from clinics. They will undergo an assessment of balance control using an established protocol in a state-of-the-art laboratory. Brain activation responses will also be recorded. These will help identify measures sensitive to the early effects of small vessel disease on balance control. In a separate experiment, patients known to have severe brain small vessel disease, and those with mild or no small vessel disease will undergo high resolution, high field strength magnetic resonance imaging (MRI) scanning of their spinal cord. This will provide information on whether SVD effects on the spinal cord can be measured in life, and which measures are most sensitive.
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:
For all participants: - Significant neurological illness; - Dementia; - Peripheral neuropathy; - Significant visual impairment; - Inability to stand unaided; - Severe hearing impairment (relevant only to substudy 1); - Known vestibular hypofunction (e.g. established diagnosis of vestibular neuritis, Menieres disease or bilateral vestibular failure). For controls only: - Known severe burden of cerebral small vessel disease.
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 University College London and funded by Guarantors of Brain .
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Read full details
for Trial ID: CPMS 55337
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