Stroke research

02 November 2015

A stroke is a sudden interruption of blood flow to part of the brain causing it to stop working and eventually damaging brain cells. The effects can be devastating and may last a lifetime. A stroke is also known as a cerebrovascular accident (CVA). 

Stroke is the 3rd largest killer in New Zealand (about 2,500 people die every year). Around 10% of stroke deaths occur in people under 65 and every day about 24 New Zealanders have a stroke. (Source: Stroke Foundation of New Zealand

Stroke is largely preventable and the early detection and control of stroke risk factors can greatly reduce the possibility of stroke. The number of people suffering stroke would be more than halved if all recommended risk reduction strategies were taken in the community.

Brain Research New Zealand - Rangahau Roro Aotearoa have dozens of stroke clinicians, neurologists and neuroscientists working on stroke prevention, rehabilitation and treatement. Here are some of our latest research developments. 

BRNZ_Andrew Clarkson otago
Dr Andrew Clarkson speaks about stroke at a local event

Engaging the brain to restore stroke function - Smart Ideas Project - $1 million over three years

“Stroke is the leading cause of lasting impairment and can affect anyone at any time. Until recently the brain was thought not to recover following a stroke. However, we have previously shown that if the right treatment is given at the right time following a stroke, significant improvements in motor and cognitive function can be achieved.


This three year Smart Idea project, under the leadership of stroke biologist at the University of Otago and Brain Research New Zealand Principal Investigator Dr Andrew Clarkson brings together leading experts in chemistry from the Ferrier Research Institute (Victoria University of Wellington) and KODE Biotech (Auckland University of Technology), and biomaterials experts at the University of Otago (Christchurch).

Their common goal is to develop novel treatments to improve function following brain injury. This research builds on our team's ability to greatly simplify the synthesis of novel compounds capable of targeting any part of the brain extracellular matrix; the glue that holds all brain cells in place, vital to brain health.

The team will use an iterative, smart design approach to develop and test a range of potential drugs to help patients recover from stroke.

Such novel compounds have wide-ranging potential as they have the ability to modulate many biological and physiological processes in the brain. So beyond holding great promise for treatment of stroke, in the future they may aid in improving outcomes for numerous other neurological conditions.”

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What does stroke have to do with air pollution? 

It turns out air pollution has been an under-appreciated factor in strokes, along with other surprising risks.

That was revealed by a global study spearheaded by internationally renowned stroke researcher Professor Valery Feigin, based at the Auckland University of Technology.

In developing countries, air pollution in the form of fine particulate matter accounted for about a third of the stroke burden, prompting Feigin and colleagues to argue cutting smog should be a big priority in these countries.

But in developed countries a noticeably higher burden of stroke was associated with behavioural and medical risk factors.

In these countries, the researchers revealed, it was more reasonable to focus on the reduction of behavioural risks - in particular, diet, physical inactivity and obesity - and the management of associated medical conditions.

Addressing these could improve health outcomes, reduce health-care costs and could arguably slash an individual's risk of stroke by about 80 per cent - and overall incidence by about 50 per cent.

"Our findings are important for helping national governments and international agencies to develop and prioritise public health programmes and policies," Feigin said.

"Governments have the power and responsibility to influence these risk factors through legislation and taxation of tobacco, alcohol, salt, sugar or saturated fat content, while health service providers have the responsibility to check and treat risk factors such as high blood pressure."

Originally published in the NZ Herald 'Brain Detectives: 10 Amazing Kiwi Insights'.  

Reference 

Prevention of stroke: a strategic global imperative. Valery L. Feigin, Bo Norrving, Mary G. George, Jennifer L. Foltz, Gregory A. Roth, & George A. Mensah

Cathy Stineaer

Associate Professor Cathy Stinear

Assoc Prof Cathy Stinear is a BRNZ Principal Investigator and Clinical Neuroscientist in the Department of Medicine at the University of Auckland.

Her research focuses on translating discoveries in neuroscience into clinical practice.

She is an expert in movement neuroscience, and uses a range of neurophysiological and imaging techniques to study how the brain controls movement in both health and disease.

Assoc Prof Stinear studies the neural mechanisms of stroke, and how thebrain adapts to, or compensates for, the structural and functional disruptions caused by stroke. Her team has been able to identify opportunities to enhance the recovery process.

She is currently investigating a range of techniques for promoting neural plasticity, which is a change in the number or strength of connections between brain cells.

Neural plasticity is thought to be responsible for much of the recovery of movement, communication and other functions after stroke.

Assoc Prof Stinear’s current studies are testing whether non-invasive brain stimulation, drug treatments, and coordinated movement patterns can promote plasticity in healthy adults, and recovery of function in people who have experienced stroke.

She is also developing clinical methods so these techniques can be optimised for individual patients. This work has been published in Lancet Neurology, and has generated a great deal of media interest.

Associate Professor Stinear is the Chair of the Neurological Foundation’s Scientific Advisory Committee, and a member of the Foundation’s National Council.

Prof Winston Byblow (left) with Dr Nick Gant
Prof Winston Byblow (left) with Dr Nick Gant

Professor Winston Byblow

Professor Winston Byblow is a BRNZ member and Director of the Movement Neuroscience Laboratory at The University of Auckland where he mentors postgraduate students, postdoctoral fellows and emerging academics. His research specialisation is in neuromodulation and neural plasticity, neurorehabilitation, neurophysiology and human brain imaging relevant to recovery of motor function after brain injury such as stroke, cerebral palsy and for those with movement disorders. He has presented at international conferences across North America, Europe, and Australasia and has co-authored over 140 peer-reviewed publications, mostly journal articles. 

 

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Professor Valery Feigin  - The Stroke Riskometer app

Stroke Neuroepidemiologist and BRNZ PI Professor Valery Feigin, based at the AUT campus in Auckland.

Valery saw that current strategies just weren’t good enough at preventing stroke and heart disease. “Mobile has enormous outreach and is the future of personal medicine. Non-communicable diseases constitute about 75% of the burden associated with all health conditions," said Prof Feigin. 

“People need access to information,” he explains, “stroke causes 10% of all deaths. The only solution to this global problem is prevention on a global scale; this app is going to make a significant change in the world.”

The app is free to download for iOS and Android devices and uses ground-breaking mobile health technologies, that allow people to assess their risk of a stroke in the next 5-10 years.

The RIBURST study commenced soon after the app’s launch in June this year, with input from healthcare experts across 30 countries and a large number of expected participants, the study is heralded as the largest international health collaboration project ever undertaken.

The global study is estimated to significantly contribute to the reduction of the global stroke epidemic, saving millions of lives and billions of dollars in the process.

The Stroke Riskometer™ app involves a simple interactive quiz that covers topics as broad as medical risk factors, diet, physical inactivity, alcohol and stress. This information is analysed to calculate a percentage likelihood of stroke within a five to ten year period. Results are then compared to those of an individual of the same age who expresses no risk factors.

A recent update to the app allows users to submit their data to the study anonymously into a global database. From the global data, risk factors specific to geographic regions and other demographic factors will become evident.

Features:

- Endorsed by the World Stroke Organization, the world’s leading organization in the fight against stroke, the World Federation of Neurology and the International Association of Neurology and Epidemiology.

- Quickly assess your risk of stroke over the next 5 to 10 years.

- Assess quarterly, half yearly or yearly to monitor your risk of stroke.

- For people who what to manage their health, at-risk individuals and for post-stroke individuals.

- For ages 20 to 90+ years old.

- Learn about four key signs of stroke – F.A.S.T.

- Join RiBURST study

Try the app on Apple Store: https://appsto.re/i6Lm3z5 and Google Play: https://goo.gl/vnXwt0