Rationale & design of a longitudinal study of cerebral small vessel diseases, clinical & imaging outcomes in patients presenting with mild ischaemic stroke: Mild Stroke Study 3 Link to paper on European Stroke Journal Authors Una Clancy, Daniela Jaime Garcia, Michael S Stringer, Michael J Thrippleton, Maria C Valdés-Hernández, Stewart Wiseman, Olivia KL Hamilton, Francesca M Chappell, Rosalind Brown, Gordon W Blair, Will Hewins, Emilie Sleight, Lucia Ballerini, Mark E Bastin, Susana Munoz Maniega, Tom MacGillivray, Kirstie Hetherington, Charlene Hamid, Carmen Arteaga, Alasdair G Morgan, Cameron Manning, Ellen Backhouse, Iona Hamilton, Dominic Job, Ian Marshall, Fergus N Doubal, Joanna M Wardlaw Abstract Background: Cerebral small vessel disease is a major cause of dementia & stroke, visible on brain magnetic resonance imaging. Recent data suggest that small vessel disease lesions may be dynamic, damage extends into normal-appearing brain & microvascular dysfunctions include abnormal blood–brain barrier leakage, vasoreactivity & pulsatility, but much remains unknown regarding underlying pathophysiology, symptoms, clinical features & risk factors of small vessel disease. Patients and Methods: The Mild Stroke Study 3 is a prospective observational cohort study to identify risk factors for & clinical implications of small vessel disease progression & regression among up to 300 adults with non-disabling stroke. We perform detailed serial clinical, cognitive, lifestyle, physiological, retinal & brain magnetic resonance imaging assessments over one year; we assess cerebrovascular reactivity, blood flow, pulsatility & blood–brain barrier leakage on magnetic resonance imaging at baseline; we follow up to four years by post & phone. The study is registered ISRCTN 12113543. Summary: Factors which influence direction & rate of change of small vessel disease lesions are poorly understood. We investigate the role of small vessel dysfunction using advanced serial neuroimaging in a deeply phenotyped cohort to increase understanding of the natural history of small vessel disease, identify those at highest risk of early disease progression or regression & uncover novel targets for small vessel disease prevention & therapy. Keywords Blood–brain barrier Cerebral small vessel diseases Cerebrovascular circulation Cognitive dysfunction Dementia Lacunar stroke Longitudinal studies Magnetic resonance imaging Symptom assessment White matter hyperintensities Related links Link to paper on European Stroke Journal Professor Joanna Wardlaw Brain & nervous system Eyes / retinal Small vessel disease (SVD) Dementia Stroke Mild Stroke Study 3 What is a MR scan? Publication date 01 Jul, 2020
