Most people have a family member who has suffered a stroke. This medical condition strikes about 800,000 people in the United States every year, and though they vary in strength, one of most important factors that affects the patient outcome is time.
When a person has a stroke, the event needs to be recognized and addressed swiftly in order to minimize the long-term damage. Certain lifestyle changes, such as avoiding loud, polluted urban environments and taking such steps as dietary changes to control your blood pressure, can reduce the risk of experiencing a stroke in the first place.
Seeking Innovative Interventions
Because of how common and devastating strokes can be, researchers have been hard at work finding new interventions, both for treating the underlying cause and rehabilitating patients during recovery. An early example of such an intervention is tPA, a clot-dissolving treatment first approved by the FDA in 1996.
Used to treat ischemic strokes, which are caused by a clot and represent 87% of all strokes, tPA can be used in the first few hours after a stroke commences. Unfortunately, many stroke patients don’t receive care within those first critical hours, so the drug often isn’t an option.
Treatment and Rehabilitation
One of the major areas of stroke research in recent years has focused on patient rehabilitation: Doctors hope to gain a better understanding of the potential length of the window for improvement for patients – because most appear to plateau over time – as well as what kind of repair is possible at the cellular level.
In order to get a closer look at the neuro-repair process, one area researchers are studying is how various proteins can help regulate gene expression and facilitate repairs. With support from a grant from the Brain Research Foundation, Dr. Agnieszka A. Ardelt has explored the use of the protein Hu antigen R as a messenger RNA stabilizer, beginning with a mouse model.
The goal is to achieve reduced scarring in the brain, which indicates improved repair as people recover. If such a protein is successful, then it could be administered to stroke patients with positive results.
Another direct approach to the repair process that’s currently being studied is the use of cell therapy. The approach essentially reprograms skin cells to become vascular tissue, and uses a technique known as nonviral tissue nanotransfection.
After deploying these altered cells in the brain, researchers have seen a recovery of 90% of motor function post-stroke in their mice model. The modified cells also support recovery of brain tissue by reinvigorating blood vessel development and circulation to the damaged area.
Identifying the Critical Moment
It’s obvious from observing past stroke patients that recovery is closely tied to elapsed time since the traumatic event. The faster patients receive help and the more recovery they achieve in the first weeks after their stroke, the more promising the outcomes.
How long does this peak recovery period last, though? Recent research indicates that the brain’s healing capacity is at its greatest for about two weeks after a stroke. While it’s understandable that providers try to avoid overtaxing the body shortly after a stroke, moving toward more aggressive rehabilitation early on may in fact be in the patient’s best interest.
The majority of strokes are preventable through lifestyle changes, medication, and careful medical monitoring. But because of factors such as inequitable access to healthcare, many patients will never have access to appropriate advice and care.
For these patients, then, innovative post-stroke interventions are the best available option. Though imperfect, our increased understanding of how and when the brain recovers has the ability to change lives for the better.
