A $1.57 million grant will allow University of Wisconsin researchers and neuroscientists to pursue a way to identify patients at risk for small strokes that often go unnoticed, dubbed “silent strokes.”
The study aims to further understand the causes and impacts of multiple strokes on a person’s brain in order to predict those at risk for stroke and start treatment early, said Robert Dempsey, professor and chairman of neurological surgery at UW School of Medicine and Public Health and lead investigator of the research.
To do so, a team of researchers will study characteristics of plaques that break off from artery walls, travel to the brain and cause silent strokes that result in loss of cognition, like memory loss, Dempsey said.
He said to predict patients at risk for stroke, the study will use non-invasive scans to identify characteristics of plaques and evidence of silent stroke in patients.
“We hopefully will understand much more about strokes, how often they occur, which patients are at risk and how they affect your thinking,” Dempsey said.
Unlike the classic major stroke, silent strokes may go unnoticed by the patient but still cause a decline in cognition, associate professor of neurosurgery Raghu Vemuganti said.
The grant from the National Institute of Neurological Disease and Stroke will allow the researchers to determine whether the structural stability of plaques has a connection to small strokes and loss of cognition, said Vemuganti.
Vemuganti said the study will also answer questions regarding whether a silent stroke always affects cognition and how much it affects it when it does.
Vemuganti, whose part of the research focuses on genes expressed in clogged arteries of patients, will look at differences between people who experience a stroke and those who do not to find whether a person is at a higher risk for stroke.
Using a variety of scientific techniques to screen the patient, including ultrasound, researchers will determine whether a patient has vulnerable plaques that are more likely to rupture and cause silent strokes, Tomy Varghese, associate professor of medical physics, said.
This will help identify those patients with higher risk of stroke and “absolutely” in need of surgery, Varghese said. He added that many older patients would have trouble with the difficult surgery, but the alternative, a stroke, would be even harder on the patient.
“If we can come up with a modality to tell patients ahead of time if they need to undergo surgery or not, it would be a really good outcome,” he said.
This would also help reduce costs for the patient, as the surgeries are relatively expensive, he added.
Plaque results from cholesterol, among a number of other factors, Varghese said. As people grow, people progressively add small layers of plaque to blood vessels that accumulate and may cause a vessel to become too narrow and restrict blood flow to the brain.
People accumulate different amounts of plaque, with some experiencing silent strokes at an older age, Varghese said.
“Sometimes it depends on how lucky you are,” he said.