Stroke Treatment Tomorrow

Despite numerous advances, the global prognosis for stroke is dire. By 2030, the percentage of deaths caused by stroke will increase to more than 10 percent worldwide, even as the percentage of deaths from cardiovascular disease drops. The burden will be especially heavy in countries with aging populations, such as the United States. But with continued funding for the National Institutes of Health and other organizations, researchers will be able to discover better ways to protect the brain from potential strokes, minimize the damage that occurs, and develop better ways to repair and reorganize the brain afterward.

Stroke prevalence is much higher in the senior years. As the U.S. population grows older, the need for improvements in stroke prevention, treatment, and rehabilitation is becoming more urgent. Annual costs are about $70 billion and will continue to grow if stroke is left unchecked.

Reproduced with permission, American Heart Association, © 2003.

Research Brings Hope for the Future

One promising therapy in testing, for instance, is induced hypothermia. Cooling the brain and body has already been shown to help with birth-related oxygen deprivation and cardiac arrest. Used soon after a stroke, it minimizes swelling, damage, and the risk of additional strokes. Scientists are now working to determine the ideal timing, temperature, and rate of cooling. Other treatments in development revolve around finding substances known as neuroprotectants that, like hypothermia, protect the brain from damage.

Stem cells offer another angle of attack. Neuroscientists are working to develop stem cells that become new brain cells or spur the formation of such cells in order to directly repair the damage suffered during a stroke. Human trials of such therapies have already begun. Researchers also are exploring growth factors and other chemicals that may reduce risk of stem-cell rejection and increase healing.

Other scientists are looking at ways to make rehabilitation faster and more effective. Drugs, electrical stimulation, or cell implants that increase brain plasticity, for instance, might make it easier to reroute or repair damaged brain circuits.

Preventative care is being expanded. Scientists have found several genetic changes that increase the risk for stroke, which may lead to more targeted and individualized treatments. Improvements in drugs for cardiovascular health — compounds that boost HDL, or “good cholesterol,” for instance — are in testing and also will ultimately reduce the number of strokes.

In the long term, experts expect more dramatic improvements in preventative care. These include small robots that scour clot-forming fat deposits out of blood vessels or repair weak vessels; drugs that induce the formation of new, alternative blood vessels; and gene therapies or drugs that minimize genetic vulnerabilities to stroke.

Hope for Other Diseases

It is impossible to separate stroke and heart disease. Ultimately, discoveries in treating stroke will help combat heart disease, the number one global killer.

But stroke research also may boost efforts to treat other brain disorders. Improvements in rehabilitation may help with several other diseases in which direct treatment is difficult or impossible, such as cerebral palsy, traumatic brain injury, and spinal cord injury. Neuroprotectants, meanwhile, may play a role in treating many brain disorders marked by the death of brain cells, including Parkinson’s, Alzheimer’s, and Huntington’s diseases.