Why is this research needed?
As the UK population ages, more and more people will experience seizures or epilepsy late in life, something which is associated with up to a three-times increase in stroke risk.
Josie says, 'We do not understand the mechanisms behind this increased risk and at present we do not address it in routine clinical care. Investigating brain and blood vessel health in these patients will contribute to understanding this link.'
What are the aims of this research?
Josie will investigate why there is an increased risk of stroke with late-onset seizures. Her work will focus on whether people with late-onset seizures also have untreated heart-related or blood circulatory-related conditions like high blood pressure, and if they have problems with the blood vessels of the brain.
Specifically, Josie plans to:
1 - Look at several measures of health, including blood pressure and cholesterol levels in a group of people with late-onset seizures. She will do this at the point that someone is diagnosed with late-onset seizures or epilepsy and again at six and 12 months after diagnosis, to see how this changes over time. She will also look at the same measures in two other groups: people with high blood pressure and people in good health.
2 - Establish a registry of people with late-onset seizures. This will help with future research on their health, brain scans, and rates of stroke and heart disease and could be used to develop artificial intelligence methods to predict cardiovascular problems like strokes.
What is the benefit of this research?
Josie's research will help us understand the links between stroke and late-onset seizures. In the long term, this will help clinicians make better assessments of someone's health at the time they first have a seizure. It could also help to improve interventions to reduce the risk of strokes and heart attacks for people who have late-onset seizures or epilepsy.
What PSP priorities does this research link to?
From 2019 to 2021, we worked with the James Lind Alliance on the Stroke Priority Setting Partnership (PSP). During the PSP process, we collaborated with people with lived experience of stroke and stroke professionals to find out what they thought were the top priorities in stroke research. From this, we identified the top ten priorities in two areas: prevention, diagnosis and short-term care, and rehabilitation and long-term care.
Now, when a researcher applies to us for funding, we require that their work address at least one of these priorities.
Josie's project addresses the following priorities:
- Prevention 1: Stop stroke from happening for the first time (primary prevention).
- Prevention 10: Effect of patients' other health conditions and characteristics on stroke and stroke care.
You can learn more about how the PSP worked and get a full list of stroke research priorities on the Stroke Priority Setting Partnership page.
Meet the researcher
Dr Josie Mayer is a trainee neurologist at The Walton Centre NHS Foundation Trust in Liverpool and a PhD student at the University of Liverpool. During this PhD project, she will be supervised by Professor Tony Marson of the University of Liverpool and Professor Gregory Lip of the University of Liverpool, Aalborg University, Denmark, and Seoul National University and Yonsei University, South Korea.
Josie says, 'I have cared for patients of all ages with stroke throughout my clinical career. Early in my career, I was deeply moved by two young women who suffered similar strokes. One did very well and the other was very unwell after the event. The woman who recovered had received an experimental treatment which is now in routine clinical practice. These patients, amongst many others, have motivated me to work within this field.'