The EMI's Vascular Health theme aims to evaluate cerebrovascular risk and dementia, taking a bench-bedside-population approach – from genes to 'big data'. The ultimate aim is to understand the vascular contribution to brain health and optimise interventional trials.
Vascular disease increases steeply with age and combines with neurodegenerative pathologies (notably, Alzheimer's disease) to accelerate cognitive decline. Recent trials and large cohorts (SPRINT-MIND, INFINITY, FINGER, Ontario Health Registry, ADNI) implicate cardiovascular risk factors in cognitive decline. As cardiovascular risk is modifiable, through lifestyle and medication, there is potential to slow or delay cognitive decline by focusing on cardiovascular health.
The most prevalent vascular cause of cognitive impairment is cerebral small vessel disease (SVD), a group of diseases affecting the smallest blood vessels in the brain. SVD is seen on brain scans as white matter hyperintensities (areas of increased brightness), lacunes (fluid-filled cavities), microbleeds, and enlarged perivascular spaces (fluid-filled areas surrounding blood vessels), and can present with a variety of clinical symptoms.
We are using large datasets from the DPUK Data Portal and also from the individual teams in the network. These datasets allow us to generate mechanistic hypotheses, to shortlist potential treatments, and to optimise the design of interventional studies. Researchers in the theme will conduct a multi-cohort, multimodal analysis to identify tractable targets for risk-stratified groups.
This programme will deliver evidence for stratifying vascular risk and identify pharmacologically tractable vascular targets related to dementia. Researchers will share novel imaging and genetic measures via the Data Portal, working alongside the Data Portal workstream. The work of the group will identify plausible cardiovascular drug targets for assessment in clinical trials.
The Vascular Health group benefits from multidisciplinary expertise and includes international leaders in neuroimaging, drug trials, neuropathology and translational biology. The group has representation from centres of excellence across the UK. We are keen to develop capacity and raise standards in vascular-brain research. To this end we hold workshops and publish best practice guidance.
Work with us
We actively encourage collaboration with industry partners. We are currently discussing projects with SloWave Therapeutics and Corvidane Bio. Previous partners include GlaxoSmithKline and Araclon Technologies.
Current work packages
1. Early vascular lesion MRI biomarkers and dementia risk (Professor Joanna Wardlaw, University of Edinburgh)
2. Identifying potential drug targets using Mendelian randomization (Professor Hugh Markus, University of Cambridge)
3. Identifying the most promising cardiovascular drugs for a cognitive endpoint trial (Dr Terry Quinn, University of Glasgow)
The EMI's Vascular Health theme is led by Dr Atticus Hainsworth (St George's, University of London).
Full list of team members:
Prof Stuart Allan (University of Manchester)
Prof Philip Bath (University of Nottingham)
Dr Tom Blackburn (TPBioventures)
Dr Zameel Cader (University of Oxford)
Prof Roxana Carare (University of Southampton)
Dr Atticus Hainsworth (St George's, University of London)
Prof Karen Horsburgh (University of Edinburgh)
Prof Raj Kalaria (Newcastle University)
Prof James Leiper (British Heart Foundation)
Prof Seth Love (University of Bristol)
Prof Clare Mackay (University of Oxford)
Prof Hugh Markus (University of Cambridge)
Dr Bernadette McGuinness (Queen's University Belfast)
Dr Richard Oakley (Alzheimer's Society)
Prof John O'Brien (University of Cambridge)
Dr Terry Quinn (University of Glasgow)
Prof Joanna Wardlaw (University of Edinburgh)
Prof David Werring (UCL)
Prof Steve Williams (King's College London)