The SHIVA project, coordinated by Professor Stéphanie Debette (BPH, VINTAGE team) and co-coordinated by Prof. Thierry Couffinhal (Inserm U1034), awarded 8.2M€, is one of the winners of the “Hospital-University Research in Health”-call of the French government “Investments for the Future” program to support innovative and large-scale research projects in the field of health.
Supported by the University of Bordeaux, SHIVA « Stopping cognitive decline and dementia by fighting covert cerebral small vessel disease » focuses on the disease of small brain vessel disease, a leading cause of stroke, cognitive decline, stroke and dementia in the general population.
The project aims to better understand the determinants and consequences of small brain vessel disease through innovative approaches, to develop new personalized diagnostic and preventive approaches and to accelerate the discovery of new therapeutic targets.
This project brings together complementary research teams from the University of Bordeaux (including 6 teams from BPH! VINTAGE, LEHA, BIOSTAT, EPICENE, HEALTHY, Psycho, SISTM, as well as the Inserm U1034 teams and CNRS U5293); clinical departments of the Bordeaux University Hospital, APHP-Broca and the National Ophthalmology Hospital in Paris and 3 French SMEs (Fealinx, Qynapse and Imagine-Eyes), to meet this major public health challenge.
Stroke and dementia are the most common age-related sources of neurological disability, representing a huge burden for society. Vascular brain injury, which includes stroke and (most often) covert vascular brain injury, detectable on brain images in stroke-free persons, contributes considerably to the occurrence of dementia. Its most frequent substrate is cerebral small vessel disease (cSVD). Covert cSVD is very common in older community persons and is a powerful predictor of stroke and dementia risk. Better detection and management of covert cSVD would have a major impact on preventing disability and costs related to stroke and dementia. Our research program aims at developing personalized management of cSVD, preventing its complications, and deriving novel biological targets for cSVD treatment.
We will leverage extensive data from complementary cohort studies spanning across the clinical spectrum of cSVD to:
-Improve diagnosis and characterization of cSVD by developing novel integrative methods for quantification of cutting-edge imaging biomarkers in brain and retina (a window on microvessels), using a dedicated IT infrastructure (SHIVA platform) and leading to novel software / medical devices
-Discover novel blood biomarkers for cSVD, and derive a cSVD biomarker-signature using high-throughput technologies (genomics and multiple other “omics” modalities) to improve detection of high-risk individuals and understanding of disease pathways
-Identify and explore novel biological targets, through bioinformatics and experimental approaches (in vitro and in mice), to help accelerate the development of novel cSVD treatments
-Optimize personalized risk prediction of cSVD complications (stroke, cognitive decline, dementia) using innovative analytical approaches, including machine learning, and include best performing algorithms into the SHIVA platform and medical device software
-Propose pragmatic, evidence and expert-panel based recommendations for cSVD management, accounting for ethical aspects, and suggest priorities for a cSVD trial design