Edinburgh Imaging

05 Jun 20. Featured Paper

Rationale & design of a longitudinal study of cerebral small vessel diseases, clinical & imaging outcomes in patients presenting with mild ischaemic stroke: Mild Stroke Study 3

Link to paper on European Stroke Journal



Una Clancy, Daniela Jaime Garcia, Michael S Stringer, Michael J Thrippleton, Maria C Valdés-Hernández, Stewart Wiseman, Olivia KL Hamilton, Francesca M Chappell, Rosalind Brown, Gordon W Blair, Will Hewins, Emilie Sleight, Lucia Ballerini, Mark E Bastin, Susana Munoz Maniega, Tom MacGillivray, Kirstie Hetherington, Charlene Hamid, Carmen Arteaga, Alasdair G Morgan, Cameron Manning, Ellen Backhouse, Iona Hamilton, Dominic Job, Ian Marshall, Fergus N Doubal, Joanna M Wardlaw



Background: Cerebral small vessel disease is a major cause of dementiastroke, visible on brain magnetic resonance imaging.

Recent data suggest that small vessel disease lesions may be dynamic, damage extends into normal-appearing brain & microvascular dysfunctions include abnormal blood–brain barrier leakage, vasoreactivity & pulsatility, but much remains unknown regarding underlying pathophysiology, symptoms, clinical features & risk factors of small vessel disease.

Patients and Methods: The Mild Stroke Study 3 is a prospective observational cohort study to identify risk factors for & clinical implications of small vessel disease progression & regression among up to 300 adults with non-disabling stroke.

We perform detailed serial clinical, cognitive, lifestyle, physiological, retinalbrain magnetic resonance imaging assessments over one year; we assess cerebrovascular reactivity, blood flow, pulsatility & blood–brain barrier leakage on magnetic resonance imaging at baseline; we follow up to four years by post & phone.

The study is registered ISRCTN 12113543.

Summary: Factors which influence direction & rate of change of small vessel disease lesions are poorly understood.

We investigate the role of small vessel dysfunction using advanced serial neuroimaging in a deeply phenotyped cohort to increase understanding of the natural history of small vessel disease, identify those at highest risk of early disease progression or regression & uncover novel targets for small vessel disease prevention & therapy.