Approved Research

Progression rate of structural brain changes associated with cerebral small vessel disease, and their relationship with longitudinal measures of blood pressure

Lay summary

Many cases of stroke and dementia are related to subtle changes to brain structure caused by damage to small brain vessels. High blood pressure is the main treatable factor responsible for these changes. Most of the existing studies have been done in older people with very high blood pressure. The aim of this project is to use the UK Biobank study to analyse the relationship between blood pressure measured at several visits and the progression of damage to the brain visible on brain scans as areas of scarring in the brain and subtle structural damage visible only as changes in the localised movement of water in the brain tissue. Results of this study would inform us about how much blood pressure affects the progression of injury to the brain, and to plan future clinical trials of treatments to stop or slow down these vascular changes and prevent incidents of stroke and dementia.

The scope of the original application:

The project aims to characterise the progression of neuroimaging markers of cerebral small vessel disease and its determinants:

1. Determine the longitudinal rate of progression of structural brain changes on magnetic resonance imaging (MRI), including the white matter hyperintensities, diffusion-weighed imaging indices, and brain atrophy.
2. Identify determinants of progression of neuroimaging markers of cerebral small vessel disease.
3. Estimate the power required in a clinical trial of novel interventions for the prevention of progression of small vessel disease.

The new scope includes the previous scope:

The project aims to characterise the progression of neuroimaging markers of cerebral small vessel disease and its determinants:

1. Determine the longitudinal rate of progression of structural brain changes on magnetic resonance imaging (MRI), including the white matter hyperintensities, diffusion-weighed imaging indices, and brain atrophy.
2. Identify determinants of progression of neuroimaging markers of cerebral small vessel disease.
3. Estimate the power required in a clinical trial of novel interventions for the prevention of progression of small vessel disease.

and additionally:

4. Determine associations between neuroimaging markers and dementia (one of the main sequelae of small vessel disease)

5.    Test whether adding neuroimaging markers improves prediction of dementia  and cognitive decline in comparison to using just the standard clinical and socioeconomic predictors