Stroke Association Priority Programme Award (Apathy after SVD)
Description of research
Cerebral small vessel disease (SVD) describes 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. Apathy describes a person's loss of initiative, a failure to engage in normal activities and a lack of emotional reactivity. It has a major effect on quality of life for a person with SVD - it has been shown that for the patient it is more important in determining quality of life than is disability (such as weakness) from the stroke itself.
Apathy after SVD is also very distressing for the family/carer. Despite its importance it is poorly understood, and there are few treatment options which have been shown to work.
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 will be to build our capacity to conduct stroke research through two multidisciplinary PhD studentships.
Components of the programme will be:
- Determining how common apathy is and whether the presence of apathy predicts long term decline in cognition, functional status, disability and quality of life.
- A study using MRI brain imaging to look at which areas of the brain are affected in patients who have apathy in SVD to help in understanding the underlying mechanisms.
- A study in 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.
- A review of possible treatments used in neurology which might be applicable to apathy in SVD, and pilot studies looking at some of these possible treatments.