Tag: post-stroke prognosis

New Compound Restores Lost Brain Function in Mice after Stroke

Photo by Kanashi ZD on Unsplash

An international study published recently in the journal Brain has reported promising results in restoring function lost in mice and rat models of stroke. Researchers were able to restore lost brain function using small molecules that in the future could potentially be developed into a stroke recovery therapy.

“Communication between nerve cells in large parts of the brain changes after a stroke and we show that it can be partially restored with the treatment,” says Tadeusz Wieloch, senior professor of neurobiology at Lund University in Sweden.

“Concomitantly, the rodents regain lost somatosensory functions, something that around 60 per cent of all stroke patients experience today. The most remarkable result is that the treatment began several days after a stroke,” Wieloch continues.

In an ischaemic stroke, lack of blood flow to affected parts of the brain lead to loss of function such as paralysis, sensorimotor impairment and vision and speech difficulties, but also to pain and depression.

There are currently no approved drugs that improve or restore the functions after a stroke, apart from clot-dissolving treatment in the acute phase (within 4.5 hours of the stroke). Some spontaneous improvements occur, but many stroke patients suffer chronic loss of function.

For example, about 60% of stroke sufferers, experience lost somatosensory functions such as touch and position sense.

The new study shows that rats that were treated with a class of substances that inhibit the metabotropic glutamate receptor (mGluR5), a receptor that regulates communication in the brain’s nerve cell network.

“Rodents treated with the GluR5 inhibitor regained their somatosensory functions,” says Tadeusz Wieloch, who led the study.

Two days after the stroke, ie when the damage had developed and function impairment was most prominent, the researchers started treating the rodents that exhibited the greatest impaired function.

“A temporary treatment effect was seen after just 30 minutes, but treatment for several weeks is needed to achieve a permanent recovery effect. Some function improvement was observed even when the treatment started 10 days after a stroke,” says Tadeusz Wieloch.

Importantly, sensorimotor functions improved, even though the extent of the brain damage was not diminished.

This, explains Tadeusz Wieloch, is due to the intricate network of nerve cells in the brain, known as the connectome – the way brain areas are inter connected and communicate form the basis for various brain functions.

“Impaired function after a stroke is due to cell loss, but also because of reduced activity in large parts of the connectome in the undamaged brain. The receptor mGluR5 is apparently an important factor in the reduced activity in the connectome, which is prevented by the inhibitor which therefore restores the lost brain function,” says Tadeusz Wieloch.

The results also showed that sensorimotor function was further improved if treatment with the mGluR5 inhibitor is combined with somatosensory training by housing several rodents in cages enriched with toys, chains, grids, and plastic tubes.

The researchers hope that in the future their results could lead to a clinical treatment that could be initiated a few days after an ischaemic stroke.

“Combined with rehabilitation training, it could eventually be a new promising treatment. However, more studies are needed. The study was conducted on mice and rats, and of course needs to be repeated in humans. This should be possible since several mGluR5 inhibitors have been studied in humans for the treatment of neurological diseases other than stroke, and shown to be tolerated by humans,” says Tadeusz Wieloch.

Source: Lund University

Having Better Conversations about Post-stroke Prognosis

Photo by cottonbro from Pexels

Though conversations with stroke survivors and their loved ones about possible lasting impairment can be traumatic, they might also be therapeutic, according to research from The University of Queensland, published in the American Journal of Speech-Language Pathology.

PhD candidate Bonnie Cheng from UQ’s School of Health and Rehabilitation Sciences said that prognosis conversations can trigger mixed emotions of hope and grief, so knowing  how people would prefer for them to happen is important.

“When stroke is encountered for the first time, it’s hard to know what’s important and relevant to ask about, especially during that time of crisis immediately after such a serious health event,” Ms Cheng said.

“During this time, there’s also an immense sense of gratitude for the survival of their loved one that seems to stop significant others from asking for more information.

“Conversations about prognosis and lasting impairments, like speech difficulties, need to be an ongoing dialogue between health professionals, the patient, and their support network.

“It’s important for these conversations to be based on a mutual understanding of what improvements are personally meaningful to the patient and their significant others.”

Aphasia is a common condition after a stroke, diagnosed in one-in-three people after a stroke.

The researchers interviewed people who identified as a significant other of someone with aphasia between three and 12 months after stroke, including spouses, close friends, adult children and parents of someone with aphasia.

“In the interviews, we talked in-depth about their experience of finding out about the prognosis for aphasia, the impact these experiences had on them, and how they would want to get information about prognosis in a perfect world,” Ms Cheng said.

“What we found was significant others need to be included in prognosis conversations so that they too can be informed and supported, alongside the patient.

“The prognosis of aphasia is a sensitive issue to address because it often involves having to adjust to long-term difficulties and changes.

“Recovery needs to be looked at holistically in terms of everyday activities that affect the individual, rather than just scores on a language impairment test.

“Even though we can’t yet ‘cure’ aphasia, this research brings us one step closer to talking about recovery in a way that’s as informative and as compassionate as possible, so that people living with aphasia can be supported to live successfully with the condition.”

Source: University of Queensland