Thursday, February 10, 2011

breakthrough in chronic stroke research

This was one of the more fascinating articles I've read mainly because it is for chronic rather than acute survivors. And it it would be one of those magical fixes. Like Peter Levines' stroke eliminator.
Inflammation Identified as New Therapeutic Target Years After Stroke
To view the multimedia assets associated with this release, please click http://www.prnewswire.com/news-releases/inflammation-identified-as-new-therapeutic-target-years-after-stroke-115025854.html
The study utilized a new method of delivery of etanercept, a potent biotechnology anti-inflammatory therapeutic. Etanercept has been a breakthrough for rheumatoid arthritis and other inflammatory disorders. It works by neutralizing tumor necrosis factor (TNF), a cytokine that initiates and amplifies inflammation. The therapeutic potential of etanercept in Alzheimer's disease, traumatic brain injury, spinal cord injury, sciatica, and other neuroinflammatory disorders has attracted increasing attention(1).

Ask your doctor if you might be an off-label use for this. If s/he knows about this, you have a good up-to-date doctor. Looking at the paper for this I really doubt the ability of this. No proof that TNF was measured either before or afterward, and no rigorous therapist documentation, just mainly spousal comments.
I do wonder how many years after a stroke the tumor necrosis factor (TNF) is still around in the brain.
I'll add that to my question for stroke researchers

6 comments:

  1. Dean,

    First of all, it's taken me about 15 minutes to write this just because every time I'm about to write something my interest in one of your entries makes me bounce around the Internet for another few minutes. I have one, two, three, four pages open that I have to get back to after writing this. Thanks for the homework.

    I am dubious about the purported results of etanercept on chronic stroke. Of course, I would love to be proven wrong. But certainly the video makes me skeptical. We have nothing but the spouse providing data. Am I missing something? What were the outcome measures? I see this a lot -- between a spouse, the survivor, and the clinicians there is a "group think of happiness".

    Consider this statement from the abstract: "Onset of clinical response was evident within 10 minutes of perispinal injection in all patients. Improvements in hemiparesis, gait, hand function, hemi-sensory deficits, spatial perception, speech, cognition and behaviour were noted among the patients treated."

    Within 10 minutes they showed improvements in all these areas, right? I do a lot of outcome measures. Assuming they did all the same outcome measures pretreatment, it would take at least two or three hours to do all these tests. What they may have done was say, "Yet, he looks better."

    I hope I'm wrong.

    best, -pete

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  2. Pete, I have to hope that magical recovery like this exists, for others mainly and because then I might finally get some rest.

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  3. My mother went for treatment yesterday. I would characterize myself as a skeptical, rational person. When I came home from work, she was bubbling with excitement, no sign of speech aphasia, and her right hand and arm were more flexible than I've ever seen. This is not snake oil. This is the stuff that Nobel prizes are made of.

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  4. Anonymous, Please describe what the treatment consisted of, dosage, how applied, How long after the stroke this treatment was applied. We need facts in order to determine the applicability to others.

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  5. I will ask my mother about dosage, which I'm not certain of. But they gave her the shot in the back of the neck, with head facing down. She is 81 and had her stroke 10 years ago. She is able to move her arm, lift it to above her head, which she couldn't yesterday morning. She isn't feeling as marked an improvement in her leg yet but is hopeful. Her speech is improved incredibly, as are her typing skills. The treatment isn't recommended for hemorrhagic stroke sufferers. The dr recommended another shot next week. They are 3-4k per shot, 400 for the consultation. The best way to determine if this is applicable is a phone call (free) - to get a sense directly from the doctor. I will keep you posted as the days progress.

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  6. From what I can tell it is well within the realm of possibility that the responses seen are in keeping with a strong placebo effect. The recently published study has significant flaws and severe limitations. The ONLY objsctive way to know if this treatment is truly effective is to have an INDEPENDENT clinical trial featuring the gold standard double-blind placebo control design. Until that is done we will not know if any of these results are more than would be expected by the intense heightened expectations of all involved in the treatments - the clinicians, the patients' family members and the patients themselves.

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