# Early Detection of Vascular Dysfunction Using Biomarkers from Lagrangian Carotid

> **NIH NIH R01** · UNIVERSITY OF WISCONSIN-MADISON · 2022 · $359,853

## Abstract

Abstract
 Numerous studies have demonstrated the clinical significance of identifying not only presence of carotid
occlusive disease but also atherosclerotic plaques that are biochemically or functionally likely to produce
emboli for identifying at-risk subjects. We have previously demonstrated that our vascular biomarkers, namely
carotid strain indices enable detection of unstable plaque at risk for embolization and thereby mild cognitive
impairment (MCI) which could then rapidly progress to Alzheimer disease (AD) and Alzheimer related
dementias (ADRD). In this supplement we propose to obtain preliminary data to further evaluate vascular
relationships to AD/ADRD using our strain indices to identify unstable plaque and pre-clinical atherosclerosis
that may lead to MCI using carotid intima-media thickness (CIMT).
 In our first Aim, cognitive testing, transcranial Doppler (TCD), transcranial color-coded Doppler (TCCD)
and Lagrangian carotid strain imaging (LCSI) will be performed on both carotid endarterectomy (CEA) patients
and a control group of at-risk volunteers. These results will be validated and complimented by three-
dimensional (3D) carotid magnetic resonance imaging (MRI). In addition, we will also compare strain indices,
microemboli, cerebral hypoperfusion to the ground truth, namely 3D histopathology of the excised plaque. Our
prior results demonstrate that both asymptomatic and symptomatic CEA patients present with an inverse
relationship between strain indices and executive cognitive function. We hypothesize that this is due to silent
strokes and microemboli contributing to a decline in executive function. Symptomatic CEA patients also
demonstrate decline across other cognitive domains such as memory, visuospatial and language.
 Our second Aim, will focus on pre-clinical atherosclerosis, on the same group of high-risk volunteers
with controls being age and gender matched volunteers. We will correlate CIMT measurements to TCD, TCCD
and vascular strain indices on this cohort to cognitive testing for possible MCI. Baseline CIMT has been
demonstrated to be predictive for developing cognitive impairment and poor executive function in a prior study
which can then progress to AD. Our results will enable assessment of variations in plaque deposition and
vascular stiffness to determine deviations that could establish vascular aging criteria. Interventions to reverse
vascular aging for example lifestyle modifications and common medical therapies can then be prescribed.
 Validation of our results will foster use of real-time noninvasive ultrasound as a screening tool for
identifying human subjects susceptible to developing mild vascular cognitive impairment that could lead to AD.

## Key facts

- **NIH application ID:** 10490566
- **Project number:** 3R01HL147866-03S1
- **Recipient organization:** UNIVERSITY OF WISCONSIN-MADISON
- **Principal Investigator:** TOMY VARGHESE
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $359,853
- **Award type:** 3
- **Project period:** 2020-07-15 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10490566

## Citation

> US National Institutes of Health, RePORTER application 10490566, Early Detection of Vascular Dysfunction Using Biomarkers from Lagrangian Carotid (3R01HL147866-03S1). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10490566. Licensed CC0.

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