# Predicting Stroke Risk in Intracranial Atherosclerotic Disease with Novel High Resolution,Functional and Molecular MRI Techniques - Resubmission - 1

> **NIH NIH R01** · UNIVERSITY OF CHICAGO · 2022 · $560,871

## Abstract

Project Summary/Abstract
The long-term goal of this work is to reduce the incident of stroke by identifying the most vulnerable patients
using MRI scans. Currently roughly 1 of every 8 patient who have had an initial stroke from intracranial
atherosclerosis disease (ICAD) will suffer a second stroke within a year. Patients who are likely to fail medical
management have loss of cerebrovascular reserve, poor collateral arterial blood supply, and/or plaque that is
vulnerable to rupture from active macrophage infiltration. Our goal is to identify vulnerable patients to inform the
selection for new medical management protocols, stenting or stent-less angioplasty. We will develop a suite of
new MRI scans and evaluate them in the intended patient population, comparing to reference standard CO2
Challenge CVR, HMPAO SPECT or direct imaging of active macrophages.
Significance: ICAD is one of the most common causes of stroke worldwide and carries an extremely a high risk
of recurrent stroke. ICAD patients with severe stenosis (70 to 99%) are at particularly high risk for recurrent
stroke in the vascular territory of the stenosis (~12 to 20% within 12 months) despite treatment with aspirin,
Plavix and management of risk factors (hypertension, smoking etc). The use of new, preventative treatment
including angioplasty, new anti-platelet medication would benefit if the most vulnerable patient can be identified.
Our imaging biomarkers will improve risk stratification for the of stroke in a vulnerable, high risk
population.
Innovation: We have developed time resolve MRI scans that are targeted to risk factor of stroke in ICAD:
 (1) Cardiac Gated “Snapshot” images of transient changes in the cerebral vasculature in response to arterial
 pressure changes induced by the cardiac cycle. These changes are muted by a loss of cerebrovascular
 reserve a risk fact of stroke.
 (2) A new mathematical deconvolution algorithm based on linear time-invariant system theory to quantify
 perfusion supplied to a vascular bed through collateral arterial blood supply distal to a stenosis.
 (3) First ever high-resolution permeability of the intracranial arterial walls to identify macrophage infiltration.
Scientific Rigor: The geometry of the human head and topology of the vasculature are unique, and we therefore
perform all our studies in the intended patient population: humans with ICAD. To ensure scientific rigor, we will
compare directly to reference standard values of CO2 cerebrovascular reserve, collateral arterial supply, and
macrophage infiltration in plaques.
Probability of Success: We have built a strong, multi-disciplinary team with a long track record of successful,
collaborative neurovascular research. We believe this high probability of successful completion of the aims and
high likelihood of clinical translation.

## Key facts

- **NIH application ID:** 10472015
- **Project number:** 5R01NS114632-03
- **Recipient organization:** UNIVERSITY OF CHICAGO
- **Principal Investigator:** Sameer A Ansari
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $560,871
- **Award type:** 5
- **Project period:** 2020-09-01 → 2025-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10472015

## Citation

> US National Institutes of Health, RePORTER application 10472015, Predicting Stroke Risk in Intracranial Atherosclerotic Disease with Novel High Resolution,Functional and Molecular MRI Techniques - Resubmission - 1 (5R01NS114632-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10472015. Licensed CC0.

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