24 Feb 22. Dr Una Clancy gains PhD

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Dr Una Clancy has successfully defended her PhD thesis, entitled “Nonfocal symptoms of cerebral small vessel disease”.

Una was funded by a Chief Scientist Office Clinical Academic Fellowship and Stroke Association Princess Margaret Research Development Fellowship.

Supervised by Professor Joanna Wardlaw and Dr Fergus Doubal in the SVD Research Group, Una’s thesis aimed to advance understanding of the diverse clinical features of cerebral small vessel disease and to determine whether a potential clinical ‘SVD syndrome’ exists beyond stroke and dementia.

In a systematic review and meta-analysis, small but important associations were found between SVD severity and apathy, fatigue, and delirium. Analyses of data from the ongoing Mild Stroke Study 3 explored dynamic symptom-lesion associations, confirming that specific nonfocal gait and mood symptoms may herald SVD progression. An analysis of Mild Stroke Study 2 data explored how cognition, function, and WMH volumes are interrelated at different timeframes after stroke.

Finally, in non-stroke populations, neuropsychiatric symptoms were found to be associated with WMH progression in the Sunnybrook Dementia Study population, completed during a research visit to Toronto funded by SINAPSE PECRE and as part of the Fondation Leducq Transatlantic Network of Excellence for the Study of Perivascular Spaces in Small Vessel Disease collaboration. In the Lothian Birth Cohort 1936, apathy at age 79 was independently associated with preceding longitudinal WMH progression.

Overall, Una’s thesis findings show that SVD is dynamic and highlights the existence of a potential clinical syndrome for identifying future SVD progression in high-risk patients.

Since completing her thesis, Una has returned to Geriatric Medicine/General Internal Medicine training in South East Scotland and has recently been awarded a Scottish Clinical Research Excellence Development Scheme (SCREDS) clinical lectureship which will commence in August 2022.

We asked Una how she felt about gaining her PhD.

“I’m delighted to be awarded the PhD which would not have happened without patients who gave up their valuable time to take part in the MSS3, MSS2, LBC1936, and Sunnybrook Dementia Studies, my excellent supervisors Prof Joanna Wardlaw and Dr Fergus Doubal, everyone working in the SVD Research Group at the University of Edinburgh, Edinburgh Imaging, the Cerebrovascular Research Group, Edinburgh Neuroscience, the CCBS, my funders, examiners, and my colleagues who contributed their time to help with data collection, image analysis, statistical advice, and the systematic review.”