Why is this research needed?
Cerebral small vessel disease (SVD) is a disorder of the small blood vessels in the brain, which is usually associated with high blood pressure. SVD causes 20% of all strokes (lacunar stroke) and is the main cause of cognitive changes and dementia associated with stroke.
In addition, behavioural symptoms such as depression and apathy are common in patients with SVD. These have a major effect on quality of life for a person with SVD. It has been shown that it's more important for the patient to determine quality of life than disability (such as weakness) from the stroke itself.
Apathy after SVD is also very distressing for the family/carer. Despite its importance, it's poorly understood and there are few treatment options which have been shown to work.
What do the researchers hope to do?
This project will bring together a multidisciplinary team (stroke physicians/neurologists, cognitive neuroscientists, clinical neuropsychologists, brain imagers and physiotherapists) to address this area of stroke. An additional component is to build our capacity to conduct stroke research through two multidisciplinary PhD studentships.
They aim to:
- Determine how common apathy is and whether the presence of apathy predicts long term decline in cognition, functional status, disability and quality of life.
- Study which areas of the brain are affected in patients who have apathy with SVD using MRI brain imaging, to help in understanding the underlying mechanisms.
- Study stroke patients to determine whether the presence of apathy interferes with recovery from stroke, and therefore whether intervening to reduce apathy could improve response to physiotherapy.
- Review possible treatments used in neurology, which might be applicable to apathy in SVD, and pilot studies looking at some of these possible treatments.