Researchers have identified a potential cause for a type of stroke that affects 35,000 people in the UK every year. This discovery could explain why existing treatments often fail and pave the way for new therapies. Lacunar strokes, which result from damage to tiny blood vessels deep within the brain, can lead to severe problems with thinking, memory, movement, and ultimately dementia.
Study Reveals Key Findings
Unlike ischaemic strokes, which are caused by blocked arteries, experts at the University of Edinburgh and the UK Dementia Research Institute suggest that lacunar strokes may stem from the widening of arteries deep within the brain. Their study involved 229 individuals who had experienced either lacunar or mild non-lacunar strokes. Over the course of a year, the researchers tracked brain changes and cognitive function.
The analysis found no link between lacunar strokes and arterial narrowing. Instead, patients with widened arteries were four times more likely to suffer this type of stroke. This pivotal finding could be crucial for developing future treatments.
Why Current Treatments Fail
This discovery may explain why conventional treatments, such as anti-platelet drugs that prevent blood clots from forming in the arteries, are ineffective for lacunar strokes. The researchers noted that widened arteries were also associated with a higher risk of so-called silent strokes, which occur without obvious symptoms. More than one in four patients experienced silent strokes during the study, despite receiving treatment to prevent further strokes.
The British Heart Foundation estimates that lacunar strokes account for about a fifth of all strokes in the UK, or roughly 35,000 each year. Experts are now calling for new treatments that target the underlying damage to the small blood vessels in the brain.
Expert Commentary
Joanna Wardlaw, professor of applied neuroimaging at the University of Edinburgh’s Institute for Neuroscience and Cardiovascular Disease and group leader at the UK Dementia Research Institute, said: “This study provides strong evidence that lacunar stroke is not caused by fatty blockage of larger arteries, but by disease of the small vessels within the brain itself. Recognising this distinction is crucial, because it explains why conventional treatments like anti-platelet drugs are not as effective for this type of stroke and highlights the urgent need to develop new therapies that target the underlying microvascular damage.”
The findings, published in the journal Circulation, are already being used in studies exploring lacunar stroke treatments, including the LACunar Intervention Trial 3 (LACI-3), which is testing whether existing drugs can be effective against the condition.
Reacting to the study, Maeva May, director of policy at the Stroke Association, said: “Stroke research is chronically underfunded, with less than 1% of total UK research funding spent on the condition. Yet these findings illustrate the value of research and the potential it has to change the lives of stroke patients. This study – and more of its kind – need to be a national priority across the NHS, government and the wider research community with clear pathways to carry breakthrough discoveries from laboratory to patients.”
