Researchers have identified the underlying cause of a specific type of stroke affecting approximately 35,000 individuals in the UK annually, shedding light on why some treatments may fail to be effective.
Lacunar strokes, which represent about 25% of all strokes in the UK, have previously been attributed to arterial blockages in the brain resulting from the accumulation of fatty deposits. However, a recent study published on Wednesday challenges this notion, indicating that these strokes are actually due to the expansion and dilation of the brain’s arteries.
This discovery could clarify the limited effectiveness of aspirin and other anticoagulants, typically used to prevent ischaemic strokes, in the case of lacunar strokes.
The research, conducted by scholars at the University of Edinburgh and the UK Dementia Research Institute, examined 229 patients who had suffered either a lacunar stroke or a mild non-lacunar stroke.
Maeva May, the policy director for the Stroke Association, commented on the findings, emphasizing their significance in advancing stroke research and improving patient outcomes. She remarked, “These results demonstrate the importance of research and its potential to transform the lives of those affected by strokes.”
May further noted, “Despite being the leading cause of complex adult disability and the fourth leading cause of death in the UK, there remains a vast amount we still do not understand about strokes. Addressing these gaps and developing effective therapies is vital for the approximately 240 individuals who recover from strokes each day in the UK.”
She also highlighted the chronic underfunding of stroke research, which receives less than 1% of total UK research funding. May advocated for enhanced national prioritization of studies like this one within the NHS, the government, and the broader research community, stressing the importance of establishing clear pathways to translate laboratory findings into patient care.
The study specifically indicated that the narrowing of large arteries is more commonly associated with other stroke types, while the widening of arteries was significantly linked to lacunar disease. Patients exhibiting arterial widening were found to be over four times more likely to experience a lacunar stroke.
Joanna Wardlaw, a professor of applied neuroimaging at the University of Edinburgh and a group leader at the UK Dementia Research Institute, remarked, “This research offers compelling evidence that lacunar strokes are not a result of fatty blockages in larger arteries, but rather stem from disease affecting smaller vessels within the brain.”
She stressed the importance of recognizing this distinction, as it explains the limited efficacy of conventional treatments such as anti-platelet medications for this type of stroke, and underscores the pressing need for the development of new therapies that address the fundamental microvascular damage.
