PhD: The role of type 2 diabetes, retinal vasculopathy and inflammation in post-stroke cognitive decline

VIDA (Vascular and Immune contributions to DementiA) is a new multi-institutional partnership between four world-leading research sites: the University of Manchester, University of Edinburgh, Imperial, and St George’s University of London. With projects focussing on the Vascular and Immune contributions to DementiA, VIDA PhD students will become the next generation of much-needed dementia researchers, contributing to breakthroughs in dementia diagnosis, treatment, and care.

VIDA students will embark upon a four-year fully-funded PhD project at one of the institutions above, with access to the state-of-the-art research facilities and interdisciplinary training available at all sites. Students at each site will come together as a cohort at several points during the programme, most importantly for an induction week at the beginning of the programme, followed by annual conferences, and residential workshop retreats. Students will also participate in engagement schemes with the Alzheimer’s Society and beyond, sharing the impact of their research in the community. The programme also benefits from built-in opportunities for placements with leading industrial partners, and bespoke training plans including schemes to develop teaching, mentoring, and grant writing skills.

Project description

Most dementia has a vascular component. The prevalence of dementia is brought forward by 25 years in those with stroke compared with those without. Type II diabetes is an independent risk factor for stroke, especially ischemic stroke. Diabetes is associated with an increased risk of post-stroke dementia, independent of the stroke severity.

Pre-clinical and clinical data have shown that inflammation plays a key role in both the acute and chronic phases of ischemic stroke, including the development of dementia. In patients with type II diabetes, chronic hyperglycaemia causes chronic low-grade inflammation. This disrupts the balance of pro- and anti-inflammatory responses, resulting in more severe acute ischemic brain damage. Inflammation after a stroke can last for months or even years, resulting in neurodegeneration. Diabetic retinopathy is an early diabetes complication, driven by inflammation. Individuals with diabetic retinopathy have 34 % higher risk of incident dementia.

Despite promising results of anti-inflammation treatments in preclinical studies, studies of functional clinical outcome after stroke have been inconclusive. There are few studies on the role of inflammation in post-stroke cognitive dysfunction/dementia, and very few in high-risk diabetic stroke patients.

The aims of this PhD project are i) to examine pro- and anti-inflammation blood biomarkers during the course of clinical ischaemic stroke in patients with or without type II diabetes, ii) to explore the temporal patterns of inflammation in acute ischemic stroke and post-stroke cognitive decline, iii) to correlate these inflammation markers with clinical imaging findings and retinopathy biomarkers. Focusing on diabetic patients, this study will provide evidence of type II diabetes related inflammation in post stroke cognitive decline, identify strategies for early screening and intervention to prevent dementia.

St George’s University Hospital is a major comprehensive stroke centre in southwest London with high ethnic diversity of patient population, especially Asian patients of high prevalence in type II diabetes. St George’s University Hospital has an established and experience clinical stroke research team. University of Manchester has an international reputation in vascular inflammation and translational neuroscience. The studentship will link these two expert centres and provide training in setting up clinical study, lab skills, vascular and neuroimaging, cognitive assessment, data-analytics, statistics, with a potential of long-term clinical / academic development.

Supervised by Dr Liqun Zhang, Prof Craig Smith, Dr Philip Benjamin, Prof Alicja Rudnicka

Skills acquisition

The studentship will link these two expert centres and provide training in setting up clinical study, lab skills, vascular and neuroimaging, cognitive assessment, data-analytics, statistics, with a potential of long-term clinical / academic development.

The programme also benefits from built in opportunities for placements with leading industrial partners, and bespoke training plans including schemes to develop teaching, mentoring, and grant writing skills.

Entry requirements

Applicants are expected to hold (or about to obtain) a minimum upper second class undergraduate honours degree (or equivalent) in a biomedical science or medicine. Experience in neuroscience and/or immunology is desirable.

Application process

The following documents should be submitted to stgeorgesphd@sgul.ac.uk no later than Friday 20 December 2024, 23.59 GMT:

• Personal statement about your reasons for applying for this studentship (maximum one page)
• Curriculum Vitae (maximum two pages)
• Two references. Applicants should arrange for two relevant referees to submit letters of reference via email before the deadline. 

Interested candidates must first make contact with the Primary Supervisor Dr Liqun Zhang prior to submitting a formal application, to discuss their interest and suitability for the project. Informal enquiries can be sent via email to liqun.zhang@stgeorges.nhs.uk

Interviews will likely take place in March 2025. Candidates will be asked to give an eight-minute presentation on a previous/on-going research project that showcases skills and knowledge, followed by questions on the presentation and the application.