Enhancing the alignment of the preclinical and clinical stroke recovery research pipeline: Consensus-based core recommendations from the Stroke Recovery and Rehabilitation Roundtable translational working group

So they are saying stroke recovery research is difficult. Well that seems to be news to our fucking failures of stroke associations. World stroke day last year had a meme of 'stroke is treatable' . I snorted coffee thru my nose on that bald-faced lie. And these three guys I consider to be among the best stroke researchers out there. 8 posts on Dr. Corbett. 7 posts on Dr. Carmichael.
1 post on Dr. Murphy although he has numerous articles in Sage  Journals.

http://journals.sagepub.com/doi/full/10.1177/1747493017711814

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Dale Corbett, S Thomas Carmichael, Timothy H Murphy, ...

First Published July 12, 2017 Research Article

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Abstract

Stroke recovery research involves distinct biological and clinical targets compared to the study of acute stroke. Guidelines are proposed for the pre-clinical modeling of stroke recovery and for the alignment of pre-clinical studies to clinical trials in stroke recovery.

Keywords Rehabilitation, stroke recovery, translational medicine, stroke, consensus, neurorehabilitation, neurorecovery

Introduction

Moving treatments from the preclinical to the clinical realms is notoriously difficult. For all diseases, only 10% of agents that enter phase 1 trials result in a clinically used drug.^1,2 The success rate in stroke and traumatic brain injury is also low and well-documented.^3–5 The translational failure in stroke has been attributed to the narrow therapeutic window and to mistakes such as very broad inclusion criteria, and imprecise, global outcome measures.^3–5 On the preclinical side, depth and rigor of study design, analysis and interpretation have received special focus.
Stroke recovery involves distinct biological principles and a very different time window compared to stroke neuroprotection.^6–8 Unlike acute stroke, post-stroke behavioral activity shapes recovery and can be manipulated to promote recovery, or to negatively interact with recovery.^6,9 In addition, stroke recovery involves a unique biology of altered synaptic signaling, enhanced synaptic plasticity and changes in neuronal circuits that provide novel drug and cellular targets but also raise special considerations in clinical translation. The special considerations include: the animal stroke models, the tissue and behavioral outcome measures, imaging biomarkers and conceptual management of the full translational pipeline.
Recent conceptual and technological developments in neuroscience are bringing promising physical, pharmacological and cellular therapies to the field of neurorehabilitation and brain repair. This paper outlines a series of guidelines and recommendations specifically tailored to enhance the quality and rigor of preclinical stroke recovery research.
The task of the translational working group of the Stroke Recovery and Rehabilitation Roundtable (SRRR)¹⁰ was to develop a set of guidelines and recommendations appropriate for preclinical stroke recovery research. Existing preclinical stroke research recommendation papers (e.g. STAIR, STEPS) focus chiefly on acute stroke.^11,12 Although cognitive impairments and depression are common after stroke,¹³ the SRRR working groups concluded that these topics require a subsequent roundtable discussion so the emphasis here is on preclinical sensorimotor recovery. The ultimate goal of the translational group was to align preclinical to clinical stroke recovery studies so as to avoid past mistakes and maximize clinical translation.

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