Stroke incidence and cognitive outcomes of intracranial atherosclerotic stenosis: study protocol for a multicenter,...

Area of Science:

• Neurology
• Vascular Medicine
• Cognitive Science

Background:

• Intracranial atherosclerotic stenosis (ICAS) is a major cause of stroke, yet current diagnostics and treatments are insufficient for plaque vulnerability and stroke recurrence.
• Asymptomatic ICAS poses a significant risk for cognitive impairment, with its underlying pathogenesis remaining largely unknown.
• Understanding the complex interplay of factors contributing to stroke and cognitive decline in ICAS is crucial for effective management.

Purpose of the Study:

• To elucidate the pathophysiology of stroke and cognitive impairment in patients with ICAS.
• To comprehensively evaluate interactions between life-course exposures, genetic variations, vascular risk factors, cerebrovascular burden, and neurodegeneration in the ICAS population.
• To establish a large prospective cohort for advancing ICAS research.

Main Methods:

• A multicenter, prospective, observational cohort study involving 3,000 patients with symptomatic or asymptomatic ICAS (>50% stenosis or occlusion).
• Participants will undergo detailed assessments including magnetic resonance imaging, blood biomarkers, and cognitive function tests.
• Follow-up includes 6-month clinical visits and 3-month telephone interviews for at least 12 months.

Main Results:

• The study aims to identify novel biomarkers for vulnerable intracranial plaques.
• It seeks to identify individuals at high risk for incident ischemic stroke or cognitive impairment.
• Primary outcome is the incidence of ischemic stroke or cognitive impairment within 12 months.

Conclusions:

• The SICO-ICAS study will establish a valuable prospective cohort for ICAS research.
• Findings are expected to lead to the discovery of new biomarkers and risk stratification tools.
• The ultimate goal is to inform precise diagnostic and treatment strategies for the ICAS population.