Advanced rehabilitation in ischaemic stroke research

FYI.

 Advanced rehabilitation in ischaemic stroke research

Jixian Wang ,1 Yongfang Li,1 Lin Qi,2 Muyassar Mamtilahun,2 Chang Liu,2
Ze Liu,2 Rubing Shi,2 Shengju Wu,2 Guo- Yuan Yang 2
1
Department of Rehabilitation

ABSTRACT
At present, due to the rapid progress of treatment
technology in the acute phase of ischaemic stroke,(Where? I SEE NOTHING!)
the mortality of patients has been greatly reduced
but the number of disabled survivors is increasing,
and most of them are elderly patients. Physicians and
rehabilitation therapists pay attention to develop all
kinds of therapist techniques including physical therapy
techniques, robot-assisted technology and artificial
intelligence technology, and study the molecular, cellular
or synergistic mechanisms of rehabilitation therapies
to promote the effect of rehabilitation therapy. Here,
we discussed different animal and in vitro models of
ischaemic stroke for rehabilitation studies; the compound
concept and technology of neurological rehabilitation; all
kinds of biological mechanisms of physical therapy; the
significance, assessment and efficacy of neurological
rehabilitation; the application of brain–computer interface,
rehabilitation robotic and non-invasive brain stimulation
technology in stroke rehabilitation.

The priorities for future stroke research

You can look at their top 10 priorities and they are all wrong, focusing on secondary issues, NOT THE PRIMARY ISSUE OF 100% RECOVERY!  My God, the stupidity involved in what passes for stroke leadership.

If we had any leadership at all in stroke we could accomplish so much. But no, we have shit for brains instead. 

Oops, I'm not playing by the polite rules of Dale Carnegie,  'How to Win Friends and Influence People'. 

Telling stroke medical persons they know nothing about stroke is a no-no even if it is true. 

Politeness will never solve anything in stroke. Yes, I'm a bomb thrower and proud of it. Someday a stroke 'leader' will try to ream me out for making them look bad by being truthful , I look forward to that day.

The priorities for future stroke research

Richard Francis, Head of Research at the Stroke Association, identifies the priority areas for research investment that will make the greatest difference to stroke survivors

Stroke is a leading cause of adult disability and the fourth biggest killer in the UK (1). Whilst stroke mortality (age-standardised) has almost halved, the incidence and prevalence of stroke is rising. There are 1.3 million stroke survivors in the UK (2), and this figure is set to increase to over 2 million, by 2035 (3). The reduced mortality rate for stroke is worth celebrating – there are hundreds of thousands of people in the UK who wouldn’t be here today if it weren’t for the leaps and bounds in our understanding of acute treatment for stroke.

The Stroke Association is an example of an organisation that has played a crucial role in supporting stroke research in the UK and has been involved with major breakthroughs in treatment and care. This includes thrombolysis and thrombectomy which radically improve outcomes for ischaemic stroke.

However, the improvements that we have seen in acute stroke treatment have not been replicated in rehabilitation and community care. With more stroke survivors surviving and living with the long-term effects of stroke – almost two-thirds of stroke survivors leave hospital with a disability (2), two-thirds of stroke survivors have problems with their speech and communication and four in ten experience depression and/or anxiety (4), we need to ensure that equivalent advances are seen across the stroke pathway.

Despite the huge impact of stroke, the picture we see now for research is bleak, just 1.2% of UK public and charity health research spend is on stroke (5). Given the urgent need for innovation in stroke care and the lack of funds for stroke research, our charity is calling for an increase in stroke research funding and for these limited funds to be invested in the areas that will most change stroke survivors’ lives. We need to be in a position where we can support the growing numbers of stroke survivors, who are living with the life-changing effects of stroke.

Our charity, the Stroke Association has announced the areas future research must focus on to improve stroke care. The announcement of these research priorities, which have been set by stroke survivors, carers and professionals, marks the first UK-wide project spanning the entire stroke care pathway. The findings are being shared in the charity’s new report “Shaping stroke research to rebuild lives: The Stroke Priority Setting Partnership results for investment.”(Check out how bad this is.)

The priorities were established in the Stroke Priority Setting Partnership (Stroke PSP) using the well-established James Lind Alliance process to ensure credible, patient-centric outputs (6).(Well then you don't know what patient centric is then, do you? 100% recovery is the only patient centric goal and you missed that. But you'd rather use the tyranny of low expectations to not make yourself look totally incompetent) The findings provide a road map to direct the activities of funding bodies, researchers and decision-makers investing in stroke research.

The Stroke PSP produced two priority lists of 10 uncertainties, ranked in order of importance – the first on prevention, pre-hospital and hospital care, the second in rehabilitation and long-term care. These lists reflect the diverse and complex field of stroke and the opportunities for innovation in research. The number one priorities are primary prevention of stroke, and diagnosis, prevention and treatment of the psychological impacts of stroke.

Establishing these research priorities is a huge first step, however, challenges lie ahead. The COVID-19 pandemic has reduced the already limited funds for stroke research and has delayed progress for some ongoing trials (7). Furthermore, in the UK, we now have increased pressure on our already over-stretched health and social care system, with a workforce who must also cope with significant disruption (8-9).

We’re calling for significantly increased investment in stroke research to close the gaps in treatment and care for stroke survivors and their carers. Investing in the priority research areas established by the Stroke PSP will ensure that research makes the biggest difference to the lives of people affected by stroke and reduce the cost of stroke to society.

It’s projected that investing £10 million into stroke cognitive rehabilitation research, a top priority identified in the Stroke PSP, will save over 71 times the amount invested over 20 years (10). Stroke costs the NHS and social care services £8.6 billion per year (11) so significant investment in stroke research and resulting interventions will save both lives and money.

Our thanks go to everyone who has contributed to the Stroke PSP, in particular, to the 1,400 stroke survivors, carers and professionals who shared their views. We are committed to making sure that the current underfunding of stroke research is addressed as part of our vision for there to be fewer strokes, and for people affected by stroke to get the help they need to live the best life they can.

References
(1) GBD 2016 Stroke Collaborators. Global, regional, and national burden of stroke, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Volume 18, Issue 5, P439-458, MAY 01, 2019. DOI: https://doi.org/10.1016/S1474-4422(19)30034-1

(2) Stroke Association, Stroke Statistics. https://www.stroke.org.uk/what-is-stroke/stroke-statistics

(3) King, D., Wittenberg, R., Patel, A., et al. The future incidence, Prevalence and costs of stroke in the UK. Age and Ageing 2020; 1-6 (Online first 19 January 2020) https://doi.org/10.1093/ageing/afz163

(4) Stroke Association, Lived Experience of Stroke. (2018) https://www.stroke.org.uk/lived-experience-of-stroke-report

(5) UK Clinical Research Collaboration, UK Health Research Analysis 2018. 2020 https://hrcsonline.net/reports/analysis-reports/uk-health-research-analysis-2018/

(6)James Lind Alliance. JLA Guidebook. March 2021. https://www.jla.nihr.ac.uk/jla-guidebook/

(7) Association of Medical Research Charities. Covid-19: The risk to AMRC charities. https://www.amrc.org.uk/covid-19-the-risk-to-amrc-charities

(8) Stroke Association. What we think about: The stroke workforce. 2019. stroke.org.uk/sites/default/files/new_pdfs_2019/our_policy_position/psp_stroke_workforce.pdf

(9) Markus, H., Brainin, M. COVID-19 and stroke – A global World Stroke Organisation perspective, April 2020. https://doi.org/10.1177/1747493020923472

(10) Patel et al., Current, future and avoidable costs of stroke in the UK, 2019 stroke.org.uk/sites/default/files/economic_impact_of_stroke_report_final_feb_2020_0.pdf

(11) Patel et al., Estimated societal costs of stroke in the UK based on a discrete event simulation, 2020 https://academic.oup.com/ageing/article/49/2/270/5679684

 

Head-to-Head Comparison of Social Network Assessments in Stroke Survivors

How the fuck is anything here going to get survivors better recovered?  That is the only lens stroke research should be looking through.

Head-to-Head Comparison of Social Network Assessments in Stroke Survivors

Show all authors

Morgan Prust, MD, Abby Halm, BA, Simona Nedelcu, MD, PhD, ...

First Published August 13, 2020 Research Article 

https://doi.org/10.1177/1941874420945889

Article information

Abstract

Background and Purpose:

Social networks influence human health and disease through direct biological and indirect psychosocial mechanisms. They have particular importance in neurologic disease because of support, information, and healthy behavior adoption that circulate in networks. Investigations into social networks as determinants of disease risk and health outcomes have historically relied on summary indices of social support, such as the Lubben Social Network Scale–Revised (LSNS-R) or the Stroke Social Network Scale (SSNS). We compared these 2 survey tools to personal network (PERSNET) mapping tool, a novel social network survey that facilitates detailed mapping of social network structure, extraction of quantitative network structural parameters, and characterization of the demographic and health parameters of each network member.

Methods:

In a cohort of inpatient and outpatient stroke survivors, we administered LSNS-R, SSNS, and PERSNET in a randomized order to each patient. We used logistic regression to generate correlation matrices between LSNS-R scores, SSNS scores, and PERSNET’s network structure (eg, size and density) and composition metrics (eg, percent kin in network). We also examined the relationship between LSNS-R-derived risk of social isolation with PERSNET-derived network size.

Results:

We analyzed survey responses for 67 participants and found a significant correlation between LSNS-R, SSNS, and PERSNET-derived indices of network structure. We found no correlation between LSNS-R, SSNS, and PERSNET-derived metrics of network composition. Personal network mapping tool structural and compositional variables were also internally correlated. Social isolation defined by LSNS-R corresponded to a network size of <5.

Conclusions:

Personal network mapping tool is a valid index of social network structure, with a significant correlation to validated indices of perceived social support. Personal network mapping tool also captures a novel range of health behavioral data that have not been well characterized by previous network surveys. Therefore, PERSNET offers a comprehensive social network assessment with visualization capabilities that quantifies the social environment in a valid and unique manner.

Keywords stroke, cerebrovascular disorders, social networks, social determinants of health, stroke recovery, network mapping

Access Options

 

Rehabilitation After Stroke: Current State of the Science - 2010

Instead of 7 pages I could do it in one sentence. 'With no effective rehab protocols you have a 10% chance of getting fully recovered, you're screwed and your stroke hospital is doing nothing to get better at stroke recovery.'  10 years later and I wouldn't have to change that sentence at all.  10 years of stroke research and I see NOTHING better. I look forward to rebuttals with objectively proven results.

Rehabilitation After Stroke: Current State of the Science - 2010

 Abstract

 Stroke rehabilitation is evolving into a clinical field based on the neuroscience of recovery and restoration.There has been substantial growth in the number and quality of clinical trials performed. Much effort now is directed toward motor restoration and is being led by trials of constraint induced movement therapy. Although the results do not necessarily support that constraint induced movement therapy is superior to other training methods,this treatment has become an important vehicle for developing clinical trial methods and studying the physiology underlying activity-based rehabilitation strategies.Other promising interventions include robotic therapy delivery, magnetic and electrical cortical stimulation,visualization, and constraint-driven aphasia therapies.Amphetamine has not been demonstrated to be effective,and studies of other pharmacologic agents are still preliminary. Future studies will incorporate refinements in clinical trial methods and improved activity and technology based interventions.

Introduction

In the past two decades, stroke rehabilitation has evolved from a field dominated by expert opinion and clinical tradition to one focused on exploiting recent advances in the neuroscience of development, physiology, imaging, and cognition. Many laboratory findings have progressed to preliminary and small-scale studies testing the relevance and utility of these interventions in the clinical setting. Now large scale phase 2 studies are commonplace, and the first cohort of phase 3 rehabilitation trials is entering the literature.See Table 1 for a list of some of the largest clinical trials that are ongoing at the time of this writing.By far, the strongest focus in rehabilitation research has been on motor restoration of hemiplegic limbs, perhaps the most obvious and disabling consequence of stroke and one particularly accessible to imaging and physiologic investigation. However, substantial work in aphasia remediation, hemispatial neglect, pharmacotherapy, and biomechanics alsohas been done. In this article, we critically review important findings from this area and place these findings in the context of current clinical practice and future research directions.

Is all stroke research a complete waste of time?

With no one creating and distributing protocols from research, nothing ever gets to useful recovery interventions for survivors. We may as well stop all stroke research until we have a strategy to translate research into interventions. And that will require survivors to be in charge. Existing stroke leaders have failed for decades to put anything in place that even remotely got survivors closer to 100% recovery.  I look forward to getting flamed by all stroke medical personnel, all will be published and responded to.  Yes this is a BHAG(Big Hairy Audacious Goal)

But leaders tackle such goals, they don't 

RUN AWAY!

using the excuse; 'All strokes are different, all stroke recoveries are different.'

Spatial Neglect in Stroke: Identification, Disease Process and Association with Outcome During Inpatient Rehabilitation

So you fuckingly lazily described a problem, but offered NO SOLUTION.  Good to know we can expect nothing from our stroke researchers.

Spatial Neglect in Stroke: Identification, Disease Process and Association with Outcome During Inpatient Rehabilitation

Ulrike Hammerbeck 1 , Matthew Gittins 2, Andy Vail 2, Lizz Paley 3 , Sarah F Tyson 4 and Audrey Bowen 1,* on behalf of the SSNAPIEST Team 1 Division of Neuroscience and Experimental Psychology, Faculty of Biology, Medicine and Health, University of Manchester, MAHSC, Manchester M13 9PL, UK; ulrike.hammerbeck@manchester.ac.uk 2 Centre for Biostatistics, Faculty of Biology, Medicine and Health, University of Manchester, MAHSC, Manchester M13 9PL, UK; Matthew.Gittins@manchester.ac.uk (M.G.); Andy.Vail@manchester.ac.uk (A.V.) 3 School of Population Health and Environmental Sciences, Kings College London, London SE1 1UL, UK; Lizz.Paley@phe.gov.uk 4 Division of Nursing, Midwifery and Social Work, University of Manchester, MAHSC, Manchester M13 9PL, UK; sarah.tyson@manchester.ac.uk * Correspondence: audrey.bowen@manchester.ac.uk; Tel.:+44-161-275-1235
Received: 30 October 2019; Accepted: 11 December 2019; Published: 13 December 2019

Abstract: 

We established spatial neglect prevalence, disease profile and amount of therapy that inpatient stroke survivors received, and outcomes at discharge using Sentinel Stroke National Audit Programme (SSNAP) data. We used data from 88,664 National Health Service (NHS) admissions in England, Wales and Northern Ireland (July 2013–July 2015), for stroke survivors still in hospital after 3 days with a completed baseline neglect National Institute for Health Stroke Scale (NIHSS) score. Thirty percent had neglect (NIHSS item 11≥1) and they were slightly older (78 years) than those without neglect (75 years). Neglect was observed more commonly in women (33 vs. 27%) and in individuals with a premorbid dependency (37 vs. 28%). Survivors of mild stroke were far less likely to present with neglect than those with severe stroke (4% vs. 84%). Those with neglect had a greatly increased length of stay (27 vs. 10 days). They received a comparable amount of average daily occupational and physiotherapy during their longer inpatient stay but on discharge a greater percentage of individuals with neglect were dependent on the modified Rankin scale (76 vs. 57%). Spatial neglect is common and associated with worse clinical outcomes. These results add to our understanding of neglect to inform clinical guidelines, service provision and priorities for future research.

Promising Use of Big Data to Increase the Efficiency and Comprehensiveness of Stroke Outcomes Research

I can't see enough of this to see if it is promising. 

Promising Use of Big Data to Increase the Efficiency and Comprehensiveness of Stroke Outcomes Research

Re-imagining Stroke Environments with Virtual Reality (RiSE-VR) – research - Australian request for research guinea pigs

Join if you can. 

Re-imagining Stroke Environments with Virtual Reality (RiSE-VR) – research

Florey Institute of Neuroscience and Mental Health, 30 Royal Parade, Parkfille, VIC, 3052

0 comments

• 
  

This project is examining how responses and behaviours of stroke survivors can be influenced by hospital ward physical environment. There is limited scientific knowledge informing the design of hospital environments for people who have had a stroke. You are eligible for this study if you have had a stroke and are discharged from hospital at least 1 month.
Researchers from The Florey Institute and Swinburne University are exploring the responses of stroke survivors to a novel patient room design immersive virtual reality experience (VR).
Participation involves completing 2 VR sessions lasting 60 minutes each, and answering some questionnaires. This will be followed by a single interview with you to gather further details from you about the VR experience.
Researchers will measure your responses using preference and emotional ratings while using the VR experience. Your physical responses will also be tracked using a pulse and blood pressure probe, and a wearable motion sensor. This study will run for 2 years at The Florey Institute, Melbourne.
Contact:
Michelle Shannon
mshannon1@student.unimelb.edu.au

Stress in Stroke Study

The two sentence reason for all the stress stroke survivors have is: 

1.  There are no stroke rehab protocols to get you to 100% recovery.  

2.  You find out your doctor knows absolutely nothing about getting you completely recovered, not compensated, RECOVERED.  

You wouldn't need to work on this secondary problem if you solved the primary problem, 100% recovery.

Stress in Stroke Study

Researchers need to compare test results in people who have and haven’t had strokes to help them find out more about how stress affects a person’s recovery after stroke.
High stress levels change the brain’s chemistry, making healing after stroke difficult.
This study will monitor stress levels in people who have had stroke at least 9 months ago. It will look at how their recovery is progressing and whether they are experiencing significant stress levels.
Researchers also need people who haven’t had strokes to make comparisons.

The study is being supported by a research grant from the John Hunter Hospital Charitable Trust Fund.

Who can participate in the research?

• People who have had a stroke at least 9 months ago.
• People who have never had a stroke

You will not be able to participate in this study if you have a history of pituitary and adrenal gland diseases.

Why is the research being done?

People recovering from stroke often report high and ongoing levels of psychological stress. High levels of stress hormones, most notably cortisol, are known to impair the brain repair and brain remodelling processes. High stress limits neuroplasticity and recovery.
Until recently, it has been difficult to monitor the levels of stress hormones in people over extended time periods.  We have now established a technology to measure cortisol from a simple hair sample at HMRI. This first study of people later after stroke is the first of its kind in Australia.
If this pilot trial is successful, it will inform future large-scale community-focused monitoring and the development of treatments for stress for people with stroke.

What would you be asked to do?

If you are happy to participate, you will be asked to come to HMRI for a once-only appointment of about 2 hours. The research team can organise and pay for a taxi for you if you can’t drive to us. You may be seen by one or more of the following researchers:

• Dr Prajwal Gyawali
• Wei Zhen (‘Adele’) Chow, PhD candidate
• Dr Lin Ong

During your appointment you will be asked to:

1. Complete surveys – 30min

Give information on your health and function, stress levels, how you are coping, thinking skills, fatigue, depression and anxiety.

2. Provide a blood sample

Provide a blood sample from a vein in your arm, about a teaspoon’s worth, to analyse stress markers such as cortisol.

3. Provide a hair sample

Provide a small sample of hair from your head which will be tested in a laboratory to analyse stress levels. The hair will be taken from the back of the skull (in the middle). About 50 strands of hair will be secured as close to the scalp as possible and cut with a pair of scissors.

Study participant Helene Rabbit said participating in this study was easy, interesting and left her with a sense of hope

Participant Information Statement

I have had a stroke - click here to download the Participant Information Statement
I have not had a stroke - click here to download the Participant Information Statement
Lead Researchers: Conjoint Associate Professor Michael Pollack, Professor Michael Nilsson, Associate Professor Rohan Walker, Dr Lin Kooi Ong
It builds on the work of A/Prof Rohan Walker’s team – which you can read more about here.

Register your interest

To find out more or to register your interest please contact Dr Prajwal Gyawali on 02 404 20759 or Prajwal.Gyawali@newcastle.edu.au

Hunter Stroke Research Register

This study is also inviting people from the Hunter Stroke Research Volunteer Register to participate. To be invited to participate in other studies in stroke rehabilitation and recovery, register here.

Upcoming Events

• Raffle Tickets Prize Draw
  21 March,2019

View all

View Research & Dis

Evaluating stroke research and stroke articles/books - Great stroke association responsibilities

How we should have stroke information evaluated for us. Individual stroke doctors and stroke hospitals are not doing any of this.  Having 10 million yearly stroke survivors  do this evaluation is the height of stupidity.

1. What in here could be used to update or create a stroke  protocol?
2. What research should we sponsor based on this to either recover from stroke or prevent  stroke?
3. What do we need to write on our website or put out as a press release? 
4. What needs to be pushed out to all stroke therapists, doctors or hospitals?
5. Every week the same questions would be asked on the research  that came out that week.

Are there opportunities for a closer collaboration on clinical stroke research in Europe?

Well there could be if you included the most important stakeholders, the survivors. But you won't because obviously they have no knowledge of stroke.

Are there opportunities for a closer collaboration on clinical stroke research in Europe? 

Show all authors

Eivind Berge, Gary A. Ford, Christian Stapf, ...

First Published December 11, 2017 Research Article

https://doi.org/10.1177/2396987317747456

Article information

Abstract

Introduction

One of the aims of the European Stroke Organisation (ESO) is to facilitate academic, multinational clinical stroke research. However, despite examples of successful regional and national stroke research networks and collaborative groups, there is no organisational structure at a European level that can facilitate multinational clinical stroke research.

Materials and methods

In a project including a survey and a workshop and involving stroke researchers in the ESO, we sought to identify the challenges faced by existing clinical stroke research networks, to define the purpose and roles of any future European stroke research collaboration, and to propose an organisational structure.

Results

The survey and workshop gave strong support for an alliance model with independent network members, with the purpose of facilitating clinical stroke research through improved coordination and communication, provision of support, education, and advocacy and communication with other stakeholders. The focus of a proposed European clinical stroke research alliance should be multinational randomised-controlled trials in acute care, prevention and rehabilitation, but the alliance could also support other forms of multi-national clinical stroke research.

Conclusion

There is an interest for increased collaboration on multinational clinical stroke research in Europe, in the form of an alliance of independent research networks and collaborative groups. The ESO Trials Network Committee will continue consultation with existing stroke research networks and collaborative groups, and other key stakeholders, to assess the feasibility and support for development of an ESO Trials Alliance.

40 Years of Alzheimer's Research Failure: Now What?

Compare to stroke. In the last 40 years of stroke research has there been any successes? tPA is a failure at 12% full recovery. Survivors could run this much much better that all these Drs. and PhDs.

40 Years of Alzheimer's Research Failure: Now What?

What is the backlist in stroke?

With hundreds/thousands of stroke research each year it is almost impossible to keep up. But do we even know what needs to be solved from past research? I'd have to say NO, there is absolutely NO strategy in stroke anyplace. Because we don't even know what problem we are solving, ALL stroke research is just spinning its wheels, pretty much totally worthless.
Seth Godin discusses backlist here:

A good day for the backlist 

“What’s new?”
That’s a fine approach to staying up to date on a situation or field where you are well-informed.(That's the first problem in stroke, NO ONE seems to be well informed. See all the cases where previous research was obviously not known about and not discussed as to how new research refuted old research.)After all, if you notice what’s new and incorporate it with what you know, you’ll remain well informed. This is the thesis behind Slack and even email.
The small town police chief has been to every house, met every resident. Hearing about the changes in town are enough for her to stay on top of her job.
The deluge of information being created in every corner of the world, though, means that it’s really unlikely that we’re actually well-informed. Knowing what’s new isn’t sufficient to keep us informed.
It’s possible that you’ve heard every single recorded performance of the Grateful Dead, or read all of Isaac Asimov or understand the nuances in the tax code. But it’s unlikely. And so, if you’re busy checking to see what’s new on the last Sunday of summer in the northern hemisphere, perhaps it makes sense to set the breaking news aside and take a look at the backlist instead.

Prof Julie Bernhardt - Stroke Research at the Florey

You can listen to the 43 minutes yourself.
https://www.youtube.com/watch?v=JfKn8JKJgQQ

American Stroke Association honors 10 for outstanding stroke research

You can make your own determination of appropriateness.
https://www.eurekalert.org/pub_releases/2018-01/aha-asa012418.php

American Heart Association Meeting Report

American Heart Association

Share

 Print  E-Mail

LOS ANGELES, Jan. 24, 2018 - Scientists who've devoted their careers to stroke research, as well as authors of notable new research will be honored for their work by the American Stroke Association during the International Stroke Conference 2018.
The honorees are:
Joanna M. Wardlaw, M.D., CBE, University of Edinburgh, Edinburgh, Scotland, who will be honored with the William M. Feinberg Award for Excellence in Clinical Stroke. (5 posts in my blog)
Walter J. Koroshetz, M.D., National Institute of Neurologic Disorders and Stroke, who will receive the David G. Sherman Lecture Award for outstanding lifetime contributions in basic or clinical stroke science.(10 posts in my blog)
Jun Chen, M.D., P.D., University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, who will be awarded the Thomas Willis Lecture Award for significant contributions to clinical stroke research.(no posts in my blog)
Dawn Kleindorfer, M.D., University of Cincinnati, who will receive the Outstanding Stroke Research Mentoring Award.(7 posts in my blog)
Brittany M. Bogle, Ph.D., MPH, University of North Carolina at Chapel Hill, recipient of the Stroke Care in Emergency Medicine Award.(no posts in my blog)
Steven Warach, M.D., Ph.D., Seton Dell Medical School Stroke Institute, Dell Medical School, University of Texas at Austin, who will be awarded the Stroke Rehabilitation Award.(4 posts in my blog)
Edrich Rodrigues, M.D., a fellow at the Comprehensive Stroke Centre at the Royal Melbourne Hospital in Melbourne, Australia, who will receive the Mordecai Y.T. Globus Award.(no posts in my blog)
Eliza C. Miller, M.D., Neurological Institute of New York, Columbia University Medical Center, New York, NY, who is the Robert G. Siekert Award recipient.(1 post in my blog)
Ken Uekawa, M.D., Ph.D., Weill Cornell Medicine, New York, NY, who will receive the Vascular Cognitive Impairment Award.(no posts in my blog)
Han-Gil Jeong, M.D., Seoul National University Hospital, Seoul, South Korea, the recipient of the Stroke Basic Science Award.(2 posts in my blog)
Joanna M. Wardlaw, M.D., CBE, the 2018 winner of the Feinberg Award, is Professor of Neuroradiology at the University of Edinburgh and Director of the Brain Research Imaging Centre at Edinburgh Imaging, and Research Professor in the UK Dementia Research Institute.
The William M. Feinberg Award for Excellence in Clinical Stroke is named for a prominent stroke clinician-researcher and American Heart Association volunteer who contributed to a fuller understanding of the causes of stroke. The award recognizes significant contributions to the investigation and management of clinical research in stroke.
Wardlaw's research focuses on the diagnosis, prevention and treatment of cerebrovascular disease, starting in the early 1990s with one of the first randomized controlled trials of intra-arterial thrombolysis for stroke. She has served on steering committees for several thrombolysis trials, researching ways to improve cost-effective use of imaging for stroke diagnosis and prevention. Increasingly, she targets the determining mechanisms of small vessel disease, a common cause of stroke and dementia, with a view to improving prevention and treatment of all its manifestations.
Wardlaw will give the William M. Feinberg Lecture titled "Small Vessel Disease: A Big Problem, but Fixable" at 10:35 a.m. Pacific Time, Thursday, Jan. 25 in Hall K.
Walter J. Koroshetz, M.D., the 2018 winner of the Sherman Award, is the director of the National Institute of Neurologic Disorders and Stroke (NINDS), where he oversees research programs aimed at reducing the burden of illness due to neurological disorders and stroke.
The Sherman Award honors David G. Sherman, M.D., a prominent stroke physician and an internationally recognized leader and researcher in stroke prevention and treatment. The award recognizes lifetime contributions to the investigation, management, mentorship and community service in the stroke field.
Koroshetz's research has led to multiple scientific advances in the care of patients with subarachnoid hemorrhage, traumatic brain injury, intracerebral hemorrhage and ischemic stroke. Together with the investigators in the Martinos Center for Biomedical Imaging, he pioneered the study of diffusion and perfusion-weighted MRI imaging and then CT angiography and CT perfusion imaging in stroke patients. His team also collaborated with the interventional neurosurgery division to provide one of the first programs in intra-arterial reperfusion therapy for acute stroke patients.
Koroshetz will give the David G. Sherman Lecture "Stroke Science: Back to the Future" at 11:35 a.m. Pacific Time during the closing Main Event on Friday, Jan. 26 in Hall K.
Jun Chen, M.D., P.D., the 2018 winner of the Willis Award, is the Richard K. Mellon Professor and Director of Center of Cerebrovascular Disease Research and the University of Pittsburgh Medical Center's Endowed Chair Professor and Director of the Pittsburgh Institute of Brain Disorders & Recovery at the University of Pittsburgh.
The Thomas Willis Award honors the prominent British physician credited with providing the first detailed description of the brain stem, the cerebellum and the ventricles, with extensive hypothesis about the functions of these brain parts. The award recognizes contributions to the investigation and management of stroke basic science.
Chen also runs a second international research laboratory on brain injury and recovery at Fudan University in Shanghai. Last year, Chen was appointed Editor-in-Chief of the Journal of Cerebral Blood Flow and Metabolism. His laboratories focus on preclinical and translational neuroscience research, including the cellular and molecular mechanisms underlying neuronal degeneration in models of cerebral ischemia or traumatic brain injury; and the role of endogenous neuroprotection, among others.
Chen will give the Thomas Willis Lecture, "Mechanistic Research to Identify Novel Targets for Stroke Therapy: The Dawn of a New Era of Integrative Approaches," at 11 a.m. Pacific Time, Wednesday, Jan. 24 in Hall K.
Dawn O. Kleindorfer, M.D., the recipient of the Stroke Research Mentoring Award, is the Professor in the Department of Neurology and Rehabilitation Medicine, at the University of Cincinnati in Ohio.
The award recognizes outstanding achievements in mentoring future generations of stroke researchers.
Kleindorfer is also Associate Dean of Faculty Development and Women's Initiatives and Co-Director of the University of Cincinnati Stroke Team, where she has been principal investigator on numerous important clinical research studies. From 2004-2006, she was Associate Director of the Neurology Medical Student Clerkship as well as the Director and Founder of the "Neuroscience Specialized Educational Pathway" in which she was responsible for developing and directing a multi-disciplinary medical student program directed towards the neurosciences. Since 2013, she has served as Chair of the Education Core of the National Institutes of Health's StrokeNet - coordinating national fellowship/trainee educational activities for 200 hospitals and 25 academic regional stroke centers. In addition, she is principal investigator of an NIH project to train and support post-graduate trainees in neurology, emergency medicine and neurocritical care.
Brittany M. Bogle, Ph.D., MPH, the 2018 winner of the Emergency Medicine Award, is a postdoctoral fellow in Cardiovascular Disease Epidemiology at the University of North Carolina at Chapel Hill.
The Emergency Medicine Award is given for the highest scoring emergency medicine abstract and encourages investigators to undertake or continue research in the emergent phase of acute stroke treatment.
Bogle's research broadly focuses on applying operations research and data science methods to cardiovascular disease research, with a particular interest in pre-hospital emergency care. Her winning abstract is titled "Using Discrete Event Simulation to Assess the Regionally-Specific Impact of the Severity-Based Stroke Triage Algorithm for EMS on Patient Outcomes and Overtriage." (Presentation 93).
Steven Warach, M.D., Ph.D., the 2018 Stroke Rehabilitation Award winner, is a professor of Neurology and Executive Director of the Seton Dell Medical School Stroke Institute, Dell Medical School, University of Texas at Austin. The Stroke Rehabilitation Award encourages investigators to undertake or continue research and/or clinical work in the field of stroke rehabilitation. His abstract is titled "Validation of an Ordinal, 6-Item Functional Outcome Scale for Speech and Language Disability in Stroke: The Austin Speech Labs Communication Disability Scale." (Presentation 42)
The 2018 Globus Award winner Edrich Rodrigues, M.D., recently completed his Stroke Fellowship at the Comprehensive Stroke Centre at the Royal Melbourne Hospital in Melbourne, Australia. The Mordecai Y.T. Globus New Investigator Award recognizes Globus' major contributions to research in cerebrovascular disease, and his outstanding contributions to uncovering the role of neurotransmitters in ischemia and trauma; the interactions among multiple neurotransmitters; mechanisms of hypothermic neuroprotection; and the role of oxygen radical mechanisms and nitric oxide in brain injury.
Rodgrigues' abstract is titled "CT Perfusion Mismatch Identifies More Thrombectomy Patients than Clinical Core Mismatch." (Presentation 113)
This year's Siekert Award winner, Eliza C. Miller, M.D., is an assistant professor of Neurology in the Division of Stroke and Cerebrovascular Disease at Columbia University Medical Center. The Robert G Siekert New Investigator Award in Stroke is given in recognition of the founding chairman of the American Heart Association's International Conference on Stroke and Cerebral Circulation. The award encourages new investigators to undertake or continue stroke-related research. Miller's abstract is titled "Preeclampsia and Early Stroke Incidence in the California Teachers Study" (Presentation 174).

###

2018's Vascular Cognitive Impairment Award recipient, Ken Uekawa, M.D., Ph.D., is a visiting fellow in Neuroscience at the Feil Family Brain and Mind Research Institute (BMRI), Weill Cornell Medicine, New York. The Vascular Cognitive Impairment Award promotes understanding and prevention of cognitive impairment due to cerebrovascular disease, one of the highest priorities for patients and a key step to improving brain health. Uekawa's abstract is titled "CD36 in Perivascular Macrophages Contributes to Neurovascular and Cognitive Dysfunction and Amyloid Angiopathy in Mice Overexpressing the Alzheimer Aβ Peptide." (Presentation 149).
Han-Gil Jeong, M.D., was honored with the Stroke Basic Science Award, which recognizes basic or translational science that is laboratory based. His abstract is titled "Biocompatible, Aminocaproic Acid Stabilized Ceria Nanoparticles Rescue the Injured Brain After Subarachnoid Hemorrhage" (Presentation 40).

Effects of action observation therapy on hand dexterity and EEG-based cortical activation patterns in patients with post-stroke hemiparesis

How many fucking times does action observation need to be proven in research before someone writes up a fucking stroke protocol on it? NEVER I BET.
With 80 action observation posts back to May, 2011 it just shows the fucking incompetence in stroke. 
Ask your doctor what stroke research partner they are working with to determine the best interventions for stroke rehab. Your doctor can't be that lazy sit on your asses person, waiting for SOMEONE ELSE TO SOLVE THE PROBLEM. The solutions are out there we just need them translated into protocols. 

Effects of action observation therapy on hand dexterity and EEG-based cortical activation patterns in patients with post-stroke hemiparesis

Topics in Stroke Rehabilitation , Volume 23(5) , Pgs. 318-325.

NARIC Accession Number: J77365.  What's this?
ISSN: 1074-9357.
Author(s): Kuk, Eun-Ju; Kim, Jong-Man; Oh, Duck-Won; Hwang, Han-Jeong.
Publication Year: 2016.
Number of Pages: 8.
Abstract: Study examined the effects of action observation training (AOT) on hand dexterity and electroencephalography (EEG)-based cortical activation in patients with post-stroke hemiparesis. AOT is a training process that involves observing specific actions performed by others, and subsequently imitating these actions prior to physical training, with the benefits of repetitively practicing the observed actions. Twenty patients with post-stroke hemiparesis were randomly divided into either the experimental group (EG) or control group (CG), with 10 patients in each group. Prior to the execution of motor tasks (carrying wooden blocks from one box to another), subjects in the EG and CG observed a video clip displaying the execution of the same motor task and pictures showing landscapes, respectively. Outcome measures included the Box and Block Test (BBT) to evaluate hand dexterity and EEG-based brain mapping to detect changes in cortical activation. The BBT scores (EG: 20.50 at pre-test and 24.40 at post-test; CG: 20.20 at pre-test and 20.60 at post-test) revealed significant main effects for the time and group and significant time-by-group interactions. For the subjects in the EG, topographical representations obtained with the EEG-based brain mapping system were different in each session of the AOT and remarkable changes occurred from the second session of AOT. Furthermore, the middle frontal gyrus was less active at post-test than at pre-test. These findings suggest that AOT may be beneficial in altering cortical activation patterns and hand dexterity.
Descriptor Terms: BRAIN, DEXTERITY, ELECTROPHYSIOLOGY, HEMIPLEGIA, MOTOR SKILLS, PHYSICAL THERAPY, STROKE.


Can this document be ordered through NARIC's document delivery service*?: Y.

Citation: Kuk, Eun-Ju, Kim, Jong-Man, Oh, Duck-Won, Hwang, Han-Jeong. (2016). Effects of action observation therapy on hand dexterity and EEG-based cortical activation patterns in patients with post-stroke hemiparesis.  Topics in Stroke Rehabilitation , 23(5), Pgs. 318-325. Retrieved 1/14/2018, from REHABDATA database.

Immunity and stroke, the hurdles of stroke research translation

I despise these researchers that  work on limiting the pool of survivors that can benefit rather than solving for all survivors. I don't care how fucking hard it is to get everyone recovered. If you were any good at all you would tackle the hard problems rather than taking the lazy way out. You'll have to ask your doctor what immunomodulation can do for recovery. 
https://www.ncbi.nlm.nih.gov/pubmed/27784822#

Send to

Int J Stroke.

2017 Feb;12(2):123-131. doi: 10.1177/1747493016676622. Epub 2016 Oct 26.

Pagram H¹, Bivard A¹, Lincz LF², Levi C¹.

Abstract

Immunomodulatory therapies after stroke have the potential to provide clinical benefit to a subset of patients, but risk subverting the protective, healing aspects of the innate immune response. Neutrophils clear necrotic cerebral tissue and are important in immunomodulation, but can also contribute to tissue injury. Human trials for immunomodulatory stroke treatments in the sub-acute time frame have attempted to prevent peripheral neutrophil infiltration, but none have been successful and one trial demonstrated harm. These unselected trials had broad inclusion criteria and appear to not have had a specific treatment target. Unfortunately, due to the heterogeneous nature of brain ischemia in humans resulting in variation in clinical severity, the negative effect of thrombolytic drugs on the blood-brain barrier, and the heterogeneity of immune response, it may only be a subset of stroke patients who can realistically benefit from immunomodulation therapies. Translational research strategies require both an understanding of lab practices which create highly controlled environments in contrast to clinical practice where the diagnosis of stroke does not require the identification of a vessel occlusion. These differences between lab and clinical practices can be resolved through the integration of appropriate patient selection criteria and use of advanced imaging and ridged patient selection practices in clinical trials which will be an important part to the success of any future trials of translational research such as immunomodulation.