Professor Bruce Brew from St Vincent’s Hospital was successful in the 2020 round of Theme and CAG collaborative research seed funding project for ‘Improving and translating the diagnostic capacity of Cerebral Small Vessel Disease with advance cardiac and brain MRI'.
Can you please tell us about the project and what you are hoping to achieve?
Cerebral Small Vessel Disease (CSVD) is a common feature of aging and is a risk factor for stroke and dementia. Yet, CSVD burden has been underestimated. Previous studies have overwhelmingly included multi-comorbid older patients (65+), therefore only capturing the severe end of the disease. Further, the standard diagnosis of CSVD relies on the evaluation of gross brain structural features using magnetic resonance imaging (MRI), which cannot reliably detect smaller vessel damage typical of CSVD. Indeed, one MRI-related clue with present technology is the presence of white matter hyperintensities but these are non-specific. However, recently there has been significant progress in the development of fast and more accurate imaging techniques, reducing MRI scanning time by up to 50%. Our study will use these MRI techniques to detect CSVD. We will compare 45-65 year old patients with moderate arteriosclerosis in the carotid arteries and at risk of early CSVD to a healthy matched control group. In addition, we will include advanced cardiac MRI to help understand how heart health may be associated with CSVD, given that the two conditions seem to occur together though it is not known how often or to what extent. Our capacity to couple brain and cardiac MRI is unique. Further, we will investigate a relevant panel of immune markers – another area of expertise - as this aspect of CSVD has been neglected.
What impact do you imagine the project will have?
We hope to identify CSVD with these newer MRI techniques and determine the relationship to carotid as well as cardiac disease. Further, we will be able to determine the significance of white matter hyperintensities to help guide the clinician as to whether further cerebrovascular and cardiac assessment is required.
How will the project support new collaborations between the theme and SPHERE partners?
This project will facilitate cross disciplinary collaborations among neurology, cardiology, radiology, and immunology within their respective SPHERE themes.
Is there any call to action or collaboration needs you would like to highlight?
The project is based on a long-term collaboration with my close collaborator Dr. Lucette Cysique from UNSW Psychology. It extends our NeuroHIV research with aging HIV individuals who are more prone to vascular brain injury to the general population. This funding also solidifies collaborative links between my research group and Professor Lindy Rae, mid-career researcher in cardiovascular diseases dementia risk factor research, Dr. Ruth Peters, as well as early career in brain imaging research Dr. Lauriane Jugé at NeuRA/UNSW Medicine.
About Professor Bruce Brew
Position/s: Bruce James Brew AM
MBBS (Hons) DMedSci (Syd Uni) DSc (UNSW) FRACP FAAN
Consultant Physician and Neurologist
Professor of Medicine (Neurology)
University of New South Wales, Sydney
Professor of Medicine
University of Notre Dame Sydney
Head Neurosciences Program and Peter Duncan Neurosciences Unit
St Vincent’s Centre for Applied Medical Research,
President of the International Society for Neurovirology 2019-