University of Edinburgh

Chief Scientist Office

DL_2023_052

After a brain scan, many people without any symptoms of a stroke learn they have scan appearances similar to those of a stroke (‘covert cerebrovascular disease’). People with covert cerebrovascular disease have a higher risk of future stroke or dementia, but no treatments are known to reduce this risk. In part, this is because it is difficult to find and ask enough people with covert cerebrovascular disease to take part in trials of new treatments. We have developed new computer methods that can look at massive numbers of brain scan reports. We think these new computer methods could find and invite a large number of people affected by covert cerebrovascular disease to studies to test new treatments. We will test whether this approach is feasible in this project and in later work test if it is acceptable to people with Covert cerebrovascular disease (CCD). If this method is feasible and acceptable, our future work will use brain scans collected in normal clinical practice and invite people to join a study of an existing blood pressure treatment in NHS Lothian.

Apparently asymptomatic, or ‘covert’ cerebrovascular disease (CCD), is a common incidental finding after brain imaging performed for investigations of falls, headaches, or minor neurological symptoms. People with CCD are at double the risk of stroke, dementia and death compared to people without CCD, although there is no certainty about the best strategy to reduce risk. CCD affects 5-10% at ages 50–60; 15–25% at ages 70–89; and silent brain infarction affects ~10%. We have involved members of pre-existing PPI groups in the development of this proposal. They have provided feedback on the acceptability of the method we approach, and have co-produced the lay summary. During the study, and particularly in other parts of the study (outside scope of this application), we will recruit a study reference group of at least 4 people affected by covert cerebrovascular disease or related diseases (stroke/dementia) to co-design the clinical study materials, comment on acceptability of approaches and the practical aspects of the study including how to deal with sensitive information. Once data have been produced the reference group will review the data and implications and guide dissemination of the materials This is the first step to a pathway to prevent vascular dementia by the identification of incidental cerebral small vessel disease. In addition, the better use of data for clinical trials is a priority for the NHS, and this is a test of a novel method.

Public Health Research

16/06/2024

De-Personalised

TRE