Underlying cause of brain injury in stroke

New research shows how the novel drug QNZ-46 can help to lessen the effects of excess release of glutamate in the brain — the main cause of brain injury in stroke.

Published in Nature Communications, the study shows how identifying the source of damaging glutamate in stroke leads to discovery of brain protection with QNZ-46, a novel form of preventative treatment with clinical potential.

Existing studies show that restricted blood supply promotes the excess release of glutamate. The glutamate binds to receptors, over-stimulating them and leading to the break-down of myelin — the protective sheath around the nerve fibre (axon).

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Nervous system discovery could inform stroke, pain therapies

New research published in the journal Nature for the first time reveals the atomic structure of a key molecular component of the nervous system.

Scientists at OHSU used advanced imaging techniques to ascertain the resting state of an acid-sensing ion channel. “They are really important ion channels that are spread throughout the body,” said senior author Eric Gouaux, Ph.D., senior scientist with the OHSU Vollum Institute and an investigator with the Howard Hughes Medical Institute. “People have pursued them as targets for stroke therapies, and they clearly have important roles in pain transduction.”

Ion channels create tiny openings in the membrane of cells throughout the body, allowing the transmission of signals in the nervous system. Acid-sensing ion channels are believed to play a role in pain sensation as well as psychiatric disorders. OHSU scientists expect the basic science research will spur new research and development into therapeutic agents targeting the channel.

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Aspirin lowers risk of early death for patients with diabetes, heart failure

For people living with both Type 2 diabetes and heart failure, taking an aspirin each day appears to lower the risk of dying or being hospitalized for heart failure, according to research being presented at the American College of Cardiology’s 67th Annual Scientific Session. But the data also reveal aspirin use may increase the risk of nonfatal heart attack or stroke, a somewhat contradictory finding that surprised researchers.

The study is the first to assess aspirin as a preventive measure for patients who have both diabetes and heart failure. Aspirin, a blood thinner, is strongly recommended for patients who have previously had a heart attack or stroke, but guidelines are unclear regarding its use as a preventive measure for patients who have cardiovascular risk factors but no history of heart attack or stroke. Previous studies in people who have not had those types of health events have shown conflicting evidence of aspirin’s potential benefits in the general population. In patients with heart failure, some studies suggest a daily aspirin may even be harmful.

About 27 million people in the U.S. have Type 2 diabetes and about 6.5 million U.S. adults have heart failure, a condition in which the heart becomes too weak to pump enough blood to meet the body’s needs. Each condition is associated with an elevated risk of cardiac events, including heart attack and stroke. This study sheds new light on the potential risks and benefits of aspirin for people with both conditions.

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Eye could provide ‘window to the brain’ after stroke

Research into curious bright spots in the eyes on stroke patients’ brain images could one day alter the way these individuals are assessed and treated. A team of scientists at the National Institutes of Health found that a chemical routinely given to stroke patients undergoing brain scans can leak into their eyes, highlighting those areas and potentially providing insight into their strokes. The study was published in Neurology.

“We were kind of astounded by this — it’s a very unrecognized phenomenon,” said Richard Leigh, M.D., an assistant clinical investigator at the NIH’s National Institute of Neurological Disorders and Stroke (NINDS) and the paper’s senior author. “It raises the question of whether there is something we can observe in the eye that would help clinicians evaluate the severity of a stroke and guide us on how best to help patients.”

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Discovery paves way for treatment to prevent blood vessel damage

The discovery of a previously unknown interaction between proteins could provide a breakthrough in the prevention of damage to healthy blood vessels. Led by the University of Bradford, the research shows how the two proteins combine to protect blood vessels from inflammation and damage and could pave the way for treatments to reduce the risk of coronary heart disease and stroke.

The new study, published in Nature Communications, found that when a protein called SOCS3 binds directly with another protein called Cavin-1, small cell surface regions of blood vessels called caveolae are stabilised, preventing damage. This mechanism, previously unknown, is important for maintaining healthy vascular function. This process happens naturally in healthy cells but can be compromised when damage occurs, through natural processes such as ageing or as a result of lifestyle.

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Arm exercise improves walking ability after stroke

A new study shows that arm exercises may improve walking ability months and even years after having a stroke. The study, the first to test the influence of arm training on post-stroke leg function, is published ahead of print in the Journal of Neurophysiology. It was chosen as an APS select article for February.

Researchers from the University of Victoria in British Columbia, Canada, worked with a group of older adults who had had a stroke between 7 months and 17 years prior to the study. The volunteers participated in three 30-minute, moderate-intensity arm cycling training sessions each week for five weeks. The research team measured the volunteers’ physical abilities before and after arm training using several standardized scales and tests of physical function, including:

  • Six Minute Walk, which measures how far a person can walk in six minutes;
  • Timed 10 Meter Walk, which measures how quickly a person can walk 10 meters; and the
  • Timed Up and Go, which measures the time it takes to stand up from a seated position, walk 10 feet, turn around, walk back and sit down again.

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Migraine linked to increased risk of cardiovascular problems

Migraine is associated with increased risks of cardiovascular problems (conditions affecting the heart and blood vessels) including heart attacks, stroke, blood clots and an irregular heart rate, say researchers in a study published by The BMJ today.

Although the absolute risks were low, the findings suggest that “migraine should be considered a potent and persistent risk factor for most cardiovascular diseases in both men and women,” say the authors.

Around one billion people worldwide are affected by migraine. It has considerable impact on quality of life and imposes a substantial burden on society.

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MIND diet may slow cognitive decline in stroke survivors

A diet created by researchers at Rush University Medical Center may help substantially slow cognitive decline in stroke survivors, according to preliminary research presented on Jan. 25 at the American Stroke Association’s International Stroke Conference 2018 in Los Angeles. The findings are significant because stroke survivors are twice as likely to develop dementia compared to the general population.

The diet, known as the MIND diet, is short for Mediterranean-DASH Diet Intervention for Neurodegenerative Delay. The diet is a hybrid of the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets. Both have been found to reduce the risk of cardiovascular conditions such as hypertension, heart attack and stroke.

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Starting periods before age of 12 linked to heightened risk of heart disease and stroke

Starting periods early — before the age of 12 — is linked to a heightened risk of heart disease and stroke in later life, suggests an analysis of data from the UK Biobank study, published online in the journal Heart.

It is one of several reproductive risk factors, including early menopause, complications of pregnancy, and hysterectomy, that seem to be associated with subsequent cardiovascular disease, the findings show.

Previous research has suggested that certain reproductive risk factors may be linked to an increased risk of heart disease or stroke, but the findings have been somewhat mixed.

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PCSK9 Inhibitor improves outcomes for patients with peripheral artery disease

Patients with peripheral artery disease (PAD) are at high risk of heart attack, stroke and cardiovascular death. In addition, PAD patients can suffer major adverse limb events, such as acute limb ischemia — the equivalent of a heart attack in the leg — that can lead to limb loss. Managing PAD is challenging for patients and physicians alike — despite best available treatment including high-intensity statins, risk of cardiovascular and limb events remains high. With few clinical trials focused on patients with PAD, physicians must often extrapolate from studies in broader populations with atherosclerosis about the best treatment approach for these patients. Unfortunately, few of these studies have characterized limb risk and fewer have demonstrated benefits of preventive therapies in reducing this risk. A new sub-analysis of the FOURIER clinical trial, however, now offers information on the safety and effectiveness of giving the PCSK9 inhibitor evolocumab on top of statin therapy to this high-risk population. At the 2017 American Heart Association Scientific Sessions, Marc Bonaca, MD, MPH, investigator at the TIMI Study Group and director of the Aortic Disease Center at Brigham and Women’s Hospital, presented results from the sub-analysis, which are published simultaneously in Circulation.

“Whenever trials like FOURIER demonstrate benefit of a therapy in a broad population, we then want to understand the efficacy and safety in subpopulations to help clinicians understand which patients are going to derive the greatest absolute benefit. We’ve found that several sub-groups of patients respond well to evolocumab, but it’s especially encouraging to see these results for patients with PAD since this is a population at heightened cardiovascular risk and there are few therapies that modify limb risk,” said Bonaca. “We see that adding evolocumab can make a big difference for these patients.”

Full story at Science Daily