Study reveals why lacunar stroke not as responsive to medication

Researchers say the cause of lacunar stroke may explain why some standard medicines are less effective.

Lacunar strokes affect about 35,000 people in the UK each year and account for around a quarter of all strokes.

They had previously been linked to arteries in the brain becoming blocked by fatty deposits. New findings suggest they may instead be caused by enlargement and widening of arteries in the brain.

Maeva May, director of policy at the Stroke Association, said the findings “illustrate the value of research and the potential it has to change the lives of stroke patients.”

“There is still so much we don’t know about stroke despite it being the leading cause of complex adult disability and the fourth leading cause of death in the UK,” May said.

“Answering these questions and developing effective treatments is crucial to help ensure a good recovery for the 240 people who survive stroke every day in the UK.

“Stroke research is chronically underfunded, with less than 1 per cent of total UK research funding spent on the condition.

“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.”

Ischaemic stroke happens when blood supply to part of the brain is blocked.

The research, carried out by academics at the University of Edinburgh and the UK Dementia Research Institute, analysed 229 patients who had experienced either a lacunar stroke or a mild non-lacunar stroke.

The study found that narrowing of larger arteries was more commonly seen in other types of stroke.

Widening arteries, by contrast, showed strong links to lacunar disease, with affected patients more than four times more likely to have had a lacunar stroke.

The findings may help explain why aspirin and other blood-thinning medicines, often used to reduce the risk of ischaemic stroke, are not as effective in preventing lacunar stroke.

Joanna Wardlaw, professor of applied neuroimaging at the University of Edinburgh 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.”