Drs. Savita Khanna and Cameron Rink, both assistant professors of surgery in the College of Medicine at The Ohio State University Medical Center are part of a research team that has been working for more than a decade to identify ways to reduce brain injury during stroke. Two key pieces of their research have recently revealed that the future of stroke treatment may lie in the form of supplementation - either with prophylactic use of a form of vitamin E, or administration of oxygen during a stroke.
"There are about 800,000 strokes each year, and strokes are the third leading cause of death in the US," says Khanna. "We've focused this research on identifying simple therapeutic strategies that could easily translate into clinical practice at little to no additional cost."
In 2008, Khanna was awarded a pilot grant from The Ohio State Center for Clinical and Translational Science (CCTS) for her research involving the role of glutamate in brain injury. Khanna discovered that oxygen supplementation during a stroke chemically converts glutamate - normally toxic to neurons - into a neuroprotective. Additionally the team determined that the timing of oxygen supplementation was critical; the protective benefit occurred only when oxygen was introduced before the use of clot-busting drugs. These findings were published in the Journal of Cerebral Blood Flow and Metabolism (February 2010).
Rink, also supported by CCTS funding, discovered that the preventive use of a form of vitamin E called tocotrienol reduces stroke-induced brain damage in multiple ways. Tocotrienol appears to enhance the body's natural ability to use other blood vessels in the brain to bypass a clot, reducing the amount of cell damage around the area of blockage. Further, it may reduce the chances of a repeat stroke, which happens in about one-fourth of all stroke victims. The research was published online in June 2011 and is scheduled for future print publication in the Journal of Cerebral Blood Flow & Metabolism.
"This is one of the first studies to provide evidence that a safe nutrient - a vitamin - can alter microRNA biology to produce a favorable disease outcome," says Rink.
The team has been working in partnership with the Ohio Supercomputer Center to create detailed images of brain activity during a stroke, providing researchers with an extraordinary window into the pathophysiology of ischemia - and real time impact of treatments.
With these data, both scientists are moving forward with their research, with the ultimate goal of testing the therapeutic strategies in humans. For now, experts at the Ohio State Stroke Center offer these tips on recognizing common stroke symptoms. When treatment is initiated during the first six hours of a stroke's onset, it can save lives, improve the outcome of stroke, and a patient's quality of life afterward. Symptoms may be sudden and include:
•weakness or numbness of the face, arm, or leg, especially on one side of the body
•confusion or difficulty speaking or understanding
•problems with vision such as dimness or loss of vision in one or both eyes
•dizziness or problems with balance or coordination
•problems with movement or walking
•severe headaches with no other known cause
It's important to note that not all strokes will have these symptoms, but to never ignore these signs even if they go away.
Exploring the current use and future of alternatives to traditional informed consent in acute stroke trials