A lot of the attention in stroke research is paid to the acute phase. How can we treat a stroke in the ER? What can we do so it doesn't get worse? How can we prevent strokes from happening? What can we do in inpatient rehab to help folks get better?
Those are all important things, and the stunning innovations happening around us are amazing, newsworthy, and truly impacting people's lives in a meaningful way.
But there's not as much attention given to chronic stroke. Sure, there's some. There are people working really hard to help stroke survivors recover even years after stroke. But not as much makes it into the news.
That's one reason I was interested in Dr. Jesse Dawson's work at the University of Glasgow. The recently published a study in the Lancet about using Vagus Nerve Stimulation to drive recovery in patients years after stroke. And their procedure looks promising.
Bio
Dr. Jesse Dawson is a Professor of Stroke Medicine and Consultant Physician in the Queen Elizabeth University Hospital. His research portfolio includes prevention and rehabilitation clinical trials in stroke survivors. His main interest is in improving the long-term outcome after stroke. Dr. Dawson holds a BHF/Stroke Association programme grant, HTA NIHR funding and NIH funding and runs a large outcomes adjudication system for multi-national stroke trials. He is the NHS Research Scotland lead for stroke research and sits on the editorial board of Stroke.
Dr. Dawson is currently researching the role of xanthine oxidase inhibition as a novel preventative treatment after stroke. This is the focus of a UK wide clinical trial, funded by a programme grant from the BHF/Stroke Association.
He is also studying novel treatments for upper limb weakness after stroke, including vagus nerve stimulation and robotic therapy. These studies included a large NIHR funded study, funding from Chest Heart Stroke Scotland and a collaboration with industry.
Dr. Dawson is the Medical Outcomes Manager for the endpoint committee of the large NIH funded CLEAR III trial, the NIH funded MISTIE III study, the European Union FP-7 funded EuroHYP study and the international SITSOPEN collaboration. This involves review of all trial endpoints and co-ordination of the endpoint adjudication process for these large phase III studies.
He supervises several PhD and MD students, including students with competitive government and charitable funded fellowships. He co-directs a large MSc programme in Clinical Pharmacology and is Director of the Vertical Theme for Clinical Pharmacology and Therapeutics for the MBChB programme. He is a regular MRCP PACES examiner and external higher degree examiner for several UK univeristies.
The Research
This is a fascinating study because even though they are stimulating the Vagus nerve, they are not actually treating it. Instead they are using it as a messenger to the brain to say, "Wake up! It's time to learn something." Essentially, it's trying to get the brains attention so traditional Occupational and Physical Therapy can work. And it seems to be working. It will be interesting to see if in future studies they can get similar results with Speech Therapy.
The other important take away here is that this work with chronic stroke survivors -- folks who had strokes years ago -- even in the control group. Granted the experimental group that got the Vagus Nerve Stimulation got better results.
The point is, though, that intense physical and occupational therapy gets results even years after as stroke, demonstrating once again that the 6 or 12 month caps on recovery are complete and utter nonsense.
Hack of the Week
Pick a small thing to focus on. Perhaps it’s a small task. Or part of a small task. Or maybe it's a new goal you haven't done before but it seems within reach. Do that. Focus on that. Achieve that. The look for more small challenges. Lots of wins on small challenges adds up to big success in the long run.
Links
Where do we go from here?
- Lear more about this study here.
- Share this episode with someone you know by giving them the link http://Strokecast.com/VNS
- Subscribe to the free, monthly Strokecast newsletter at http://Strokecast.com/News
- Don't get best…get better.
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