Researchers uncover potential cause of stroke that affects 35,000 Britons every year

The discovery could also help pave the way for new treatments for lacunar strokes, which are caused by damage to the tiny blood vessels deep within the brain
A potential cause for a type of stroke affecting 35,000 people in the UK annually has been pinpointed by researchers.

It is a discovery that could explain why current treatments fail and pave the way for new therapies.

Lacunar strokes, caused by damage to tiny brain blood vessels, can lead to severe issues with thinking, memory, movement, and ultimately dementia.

Unlike ischaemic strokes, which result from blocked vessels, experts at the University of Edinburgh and the UK Dementia Research Institute suggest lacunar strokes may stem from the widening of arteries deep within the brain.

Their study, involving 229 individuals with lacunar or mild non-lacunar strokes, tracked brain changes and cognitive function over a year.

The analysis revealed no link between lacunar strokes and arterial narrowing.

Instead, patients with widened arteries were found to be four times more likely to suffer this type of stroke , a pivotal finding for future treatment development.

This could explain why usual treatments , such as anti-platelet drugs, which stop blood clots from forming in the arteries, do not work, researchers said.

Elsewhere, widened arteries were also linked to a higher risk of having so-called silent strokes, which happen without obvious symptoms.

More than one in four patients had silent strokes during the study despite having treatment to help prevent further strokes.

The British Heart Foundation estimates that lacunar strokes account for about a fifth of all strokes in the UK, or about 35,000 every year.

Experts have called for new treatments to target the underlying damage to the small blood vessels in the brain.

Joanna Wardlaw, professor of applied neuroimaging at the University of Edinburgh’s Institute for Neuroscience and Cardiovascular Disease and group leader at the UK Dementia Research Institute, said: “This study provides strong evidence that lacunar stroke is not caused by fatty blockage of larger arteries, but by disease of the small vessels within the brain itself.

“Recognising this distinction is crucial, because it explains why conventional treatments like anti-platelet drugs are not as effective for this type of stroke and highlights the urgent need to develop new therapies that target the underlying microvascular damage.”
The findings, published in the journal Circulation, are being used in studies exploring lacunar stroke treatments, including the LACunar Intervention Trial 3 (LACI-3), which is testing if existing drugs are effective against the condition.

Reacting to the study, Maeva May, director of policy at the Stroke Association, said: “Stroke research is chronically underfunded, with less than 1% of total UK research funding spent on the condition.

“Yet these findings illustrate the value of research and the potential it has to change the lives of stroke patients.

“This study – and more of its kind – need to be a national priority across the NHS, government and the wider research community with clear pathways to carry breakthrough discoveries from laboratory to patients.”
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