SNF Brain Stroke Samachar-439

[SN Foundation]

Stroke study searches for link with dementia
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Courtesy: The Age, Victoria, Australia
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Published: May 26, 2013
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In a world-first study, Melbourne researchers are investigating why
one in three stroke victims - even when they appear to make a good
recovery - slides into dementia.

It takes two or three years for symptoms to develop - and the reasons
for this have never been explained.

Lead researcher Amy Brodtmann said people had problems with thinking,
speech and memory immediately after a stroke ''but they usually
recover''.

''What's happening down the track is some people, not everyone, are
developing cognitive decline and some people are developing
dementia,'' she said.

The project involves studying the brains of 135 Melbourne people, who
are being recruited within a day or two of suffering a stroke. Over
three years, they will undergo four MRI scans - taken upon
recruitment, at three months, one year and three years - to measure
any changes in the brain, including shrinkage. The results are
correlated with evidence of memory and cognitive impairment.

Dr Brodtmann said understanding these changes could provide clues as
to why stroke patients travel more rapidly into dementia than others.

They may also show how to predict which patients will suffer cognitive
impairment and can be assisted by early intervention.

''We'll look at each subject and ask, why did they get worse and why
did someone else get better?'' she said.

''Was it some kind of medication or lifestyle or was it to do purely
with age?''

One aspect of brain degeneration being examined is ''white matter
hyperintensities''- lesions in the white matter of the brain that have
been strongly linked to a reduction in cognitive capacity.

''One of the things we will be looking for in our study is whether
these hyperintensities are more severe in patients with significant
cognitive problems,'' said Dr Brodtmann.

This could mean hyperintensities might either be causing the cognitive
decline or they may be used as an early detection marker for dementia.

People who present with pre-existing cognitive or memory loss - about
a third of stroke victims - are precluded from the project.

Fifty people have already been recruited, including a pilot group who
began their scans two years ago. Dr Brodtmann said these people seemed
to have undergone changes in the brain that are typical of patients
with Alzheimer's disease without the dementia. However, claiming a
causal relationship between strokes and dementia remains problematic,
largely because the risk factors that predispose a person to having a
stroke - smoking, late-onset diabetes, obesity, high cholesterol - can
also cause cognitive problems.

The longitudinal study is being assisted by the Victorian Life
Sciences Computation Initiative, funded by the Victorian government
and hosted at the University of Melbourne.
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