Blood biomarkers offer new clues to stroke and dementia risk

SVD is a common disorder affecting the tiny blood vessels in the brain and is a major cause of both strokes and dementia, contributing to around 45% of dementia cases worldwide. Because the brain relies on a rich network of small vessels to function, damage to these vessels can lead to memory problems, difficulty walking, and other serious issues. However, SVD can be difficult to predict or track because it often progresses “silently” until it causes major injury.

The research team explored whether blood tests could offer early warning signs of SVD progression. They studied 181 people from the Lothian Stroke Service who had experienced mild strokes and showed signs of SVD, measuring 13 different blood biomarkers linked to blood vessel health. Study participants also underwent detailed brain scans and cognitive tests over the course of a year.

Their findings, published recently in Alzheimer’s & Dementia: the Journal of the Alzheimer’s Association, highlight how certain biomarkers are closely tied to the health of the brain’s small vessels. Firstly, higher levels of vascular endothelial growth factor (VEGF) were associated with new brain lesions appearing on scans after one year, suggesting it could predict ongoing brain injury.

Additionally, higher levels of intercellular adhesion molecule-1 (ICAM-1) were linked to poorer blood flow regulation in the brain, a sign of reduced vascular health. Platelet-derived growth factor-subunit B and endothelin-1 also appeared to be linked to better vascular responses. Platelet-selectin, another blood marker, was associated with the development of mild cognitive impairment over the year.

The results build on and contribute to growing evidence that dysfunction of the cells lining blood vessels (the endothelium) and supporting cells (pericytes) plays a critical role in how SVD damages the brain.

Lead author Daniela Jaime Garcia, Postdoctoral Researcher in Translational Neuroscience at the Row Fogo Centre said:  “Our research uncovers key blood biomarkers associated with the progression of small vessel disease in the brain, providing critical insights into vascular dysfunction as a core mechanism driving cognitive decline and stroke risk. Blood biomarker research has the potential to reshape how we approach both the diagnosis and management of SVD, ultimately improving outcomes for individuals at risk of stroke, cognitive impairment or rapid-progression SVD.”

Thus far, there have been no reliable blood tests to monitor disease progression or predict who might suffer from worsening SVD. Previous research has been obstructed by inconsistent findings and differences in study design, but the comprehensive approach in this study; namely, combining brain imaging, cognitive testing, and a wide range of biomarkers, strengthens the case for blood test use in future clinical care.

To learn more about Cerebral Small Vessel Disease (SVD), click here.

Click here to read the full paper: https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.70152 

Full citation:

Jaime Garcia, D., Clancy, U., Arteaga, C., Valdés-Hernandez, M. C., Chappell, F. M., Jochems, A. C. C., Cheng, Y., Zhang, J., Thrippleton, M. J., Stringer, M. S., Sleight, E., Backhouse, E. V., Wiseman, S., Brown, R., Doubal, F. N., Montagne, A., Wardlaw, J. M., & MSS3 Study Group (2025). Blood biomarkers of vascular dysfunction in small vessel disease progression: Insights from a longitudinal neuroimaging study. Alzheimer’s & dementia: the journal of the Alzheimer’s Association, 21(4), e70152. https://doi.org/10.1002/alz.70152