A clinical trial of new treatments for lacunar stroke
LACunar Intervention (LACI) trial: assessment of safety and efficacy of cilostazol and isosorbide mononitrate to prevent recurrent lacunar stroke and progression of cerebral small vessel disease
Joanna Wardlaw (lead researcher)
Edinburgh, University of
Start date: (Duration 3 years)
Professor Joanna Wardlaw is leading a clinical trial to help find new treatments for people who have a lacunar, or small vessel, stroke.
In 2014 around 35,000 people in the UK had a lacunar stroke, which is caused by damage to one of the small vessels deep within the brain that affects the flow of blood. Lacunar stroke can lead to long-term disability, causing difficulty with thinking, memory, walking and ultimately dementia. Researchers think that lacunar stroke could be the underlying cause of nearly half of all dementias.
There is currently no proven treatment for lacunar stroke – existing treatments for stroke, like aspirin, may even be harmful. Scientists think drugs used to treat other diseases of the heart and brain’s blood vessels may help, but they have not yet been tested.
Professor Wardlaw at the University of Edinburgh will now run a clinical trial to test if two of these drugs, cilostazol and isosorbide mononitrate, could treat lacunar stroke and if they are safe. Cilostazol is currently used to treat people with peripheral arterial disease. And isosorbide mononitrate is used to treat conditions such as angina. In the trial, around 200 patients will be treated with either cilostazol, isosorbide mononitrate or both.
The researchers think that these drugs may help reduce the damage to the arteries in the brain that cause the stroke. They will perform MRI scans on people taking part in the trial to see what effects these drugs have on the small blood vessels within the brain.
If successful, this research could lead to a larger trial of these drugs to treat lacunar strokes and potentially prevent some cases of dementia.
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