New British Heart Foundation clinical trial for lacunar stroke

Professor Joanna Wardlaw (Centre for Clinical Brain Sciences) is leading a new research trial funded by the British Heart Foundation focusing on whether existing drugs could be used to prevent cognitive decline and dementia after stroke. 

The Edinburgh team are collaborating with the University of Nottingham and a number of other research groups including those from hospitals in Derby, Fife, Glasgow, Leeds and London to test two existing treatments for heart and circulatory disease in people who have suffered a lacunar stroke. This type of stroke occurs in the smallest vessels of the brain and affects around 35,000 people in the UK each year. 

There are currently no proven treatments to prevent lacunar stroke, and researchers believe that small vessel damage (including lacunar stroke) could contribute to at least 40% of dementias, even when the main cause is Alzheimer’s. 

The first phase of the Lacunar Intervention Trial (LACI-1), funded by Alzheimer’s society, found that it was safe for people who have had a lacunar stroke to take cilostazol and isosorbide mononitrate. Cilostazol costs around 63 pence per tablet and is currently used to treat people with peripheral arterial disease. Isosorbide mononitrate costs around 7 pence per tablet and is currently used to treat people with conditions like angina.

Due to this essential groundwork, the second phase of the Lacunar Intervention Trial (LACI-2) can now be more quickly rolled out to include 400 people who have had lacunar strokes. Over three years this project hopes to establish what effect these drugs have on reducing the risk of more lacunar strokes, and the risk of developing cognitive decline.

Professor Joanna Wardlaw said: “Research into lacunar strokes has often fallen in to the ‘gap’ between stroke research and dementia research so it hasn’t always been easy to find funding. I’m thrilled to see two charities working together to fund our research so that we can bring benefits to people who have had a lacunar stroke, and are at risk of developing cognitive decline, as soon as possible.”