LONG TERM FUNCTIONAL ABILITY AND COSTS OF STROKE SUBTYPES.
Funder
National Health and Medical Research Council
Funding Amount
$270,604.00
Summary
Stroke is the third most common cause of death in Australia, and is more common in the older age groups. Because the population most at risk of developing stroke is growing faster than the rest of the population, it is likely that there will be a large increase in the number of strokes occurring in coming years. At 1 year after stroke about one-third of patients have died, a third remain severely disabled and a third recover with minimal disability. In Australia, there is little information on o ....Stroke is the third most common cause of death in Australia, and is more common in the older age groups. Because the population most at risk of developing stroke is growing faster than the rest of the population, it is likely that there will be a large increase in the number of strokes occurring in coming years. At 1 year after stroke about one-third of patients have died, a third remain severely disabled and a third recover with minimal disability. In Australia, there is little information on outcome beyond 1 year. It is thought that at 5 years after stroke about 55% of patients will die, and a further 10% will have another nonfatal stroke. Stroke is estimated to cost the community in excess of $1 billion a year. Little is known about the long-term costs of stroke to survivors and their relatives. These costs are likely to be substantial, and are likely to include costs related to hospitalisations, outpatient visits, general practitioner visits, medications, aids and community services. It is also likely that substantial informal care is provided by relatives and friends (e.g. assistance with shopping and personal care). The aim of this study is to assess the long-term outcome of patients with stroke. These will include measures of survival, stroke recurrence, and ability to perform usual daily activities. In addition, we aim to determine the long-term use of health care and community resources and the costs incurred by patients, their carers, and the community. Information on survival patterns, stroke recurrence and disability will provide information of great value for health service planning. Such information will also be useful to patients, their families, and medical staff who treat these patients. Information on the costs of stroke will provide the only information about the patterns of long-term health care and community resource use among stroke patients in Australia. This information will be useful for health service planning.Read moreRead less
Pharmacological Modulation Of Microglial Responses After Transient Forebrain Ischaemia In Rats
Funder
National Health and Medical Research Council
Funding Amount
$170,906.00
Summary
A stroke is caused by an acute blockade of blood flow to a brain region and is normally caused by a clot in the artery that supplies blood to that region. Within minutes, the region of the brain that is receiving no blood flow, dies and so the functions controlled by that region cease. If this region controls key functions such as breathing then the patient dies and this occurs in about one third of patients. However, in the majority of patients, the blockage affects parts of the brain controlli ....A stroke is caused by an acute blockade of blood flow to a brain region and is normally caused by a clot in the artery that supplies blood to that region. Within minutes, the region of the brain that is receiving no blood flow, dies and so the functions controlled by that region cease. If this region controls key functions such as breathing then the patient dies and this occurs in about one third of patients. However, in the majority of patients, the blockage affects parts of the brain controlling movement of limbs or speech and so these patients suffer permanent disabilities. Not surprisingly, stroke is the most common life-threatening neurological disease and the major cause of disability in adults over 45. Apart from the profound effect stroke has on the patient and the family, the annual cost of disability to the Australian community is approx $ 1 billion. If the disability could be minimised by reducing institutionalization then the cost saving would be great. Research is being carried out to define how nerves die when they have insufficient blood supply and progress has been made in understanding the biochemical basis of this process. Such knowledge opens the way for the design of novel drugs to delay nerve death. Our laboratory has been successful in designing a novel drug, AM-36 that minimises nerve death in the forebrain of rats that have had the blood supply to the forebrain interrupted for 3 to 5 hours. A recent report has shown that a stroke in the forebrain can lead to nerve damage in the spinal cord and this could contribute to impaired walking in stroke patients. This is an unexpected finding and this project seeks to define how and when nerves in the spine die after a stroke in the forebrain. Such information should then lead to the rational design of drugs to minimise the death of nerves in the spinal cord as well as in the forebrain.Read moreRead less
The Role Of Interferon Signalling In The Regulation Of Stroke
Funder
National Health and Medical Research Council
Funding Amount
$620,381.00
Summary
This project focuses on the role that inflammation plays in the progression of the type of neural injury seen in stroke victims. This project targets a specific pathway that is thought to be involved in the regulation of general inflammation but has not been greatly investigated in terms of the neural injury seen in stroke. Understanding the actions of this pathway may lead to future therapies that can be used to prime the brain to react in a positive way to stroke.
Arachidonic Acid Modulation Of Glutamate Transporters
Funder
National Health and Medical Research Council
Funding Amount
$286,980.00
Summary
Neurotransmitter transporters play a key role in regulating the dynamics of neurotransmission and are also the targets for a number of very important drugs. Glutamate is the predominant neurotransmitter responsible for fast excitatory neurotransmission and glutamate transporters are responsible for controlling glutamate concentrations to maintain normal neurotransmission. The failure of glutamate transporters has been implicated as playing a key role in brain damage following a stoke and also fo ....Neurotransmitter transporters play a key role in regulating the dynamics of neurotransmission and are also the targets for a number of very important drugs. Glutamate is the predominant neurotransmitter responsible for fast excitatory neurotransmission and glutamate transporters are responsible for controlling glutamate concentrations to maintain normal neurotransmission. The failure of glutamate transporters has been implicated as playing a key role in brain damage following a stoke and also for long term neurological disorders such as Alzheimer's disease. In this project we shall investigate a novel mechanism for regulating the activity of glutamate transporters and explore the possibility of pharmacologically manipulating glutamate transporters. This work may lead to the development of novel compounds that improve transporter function and reduce the pathological consequences of impaired transporter function. Such compounds may have therapeutic potential as neuroprotectants in the treatment of neurological disorders such ischaemic brain damage or neurodegenerative disorders such Alzheimer's disease.Read moreRead less
Neural Mechanisms Of Language Facilitation In Aphasia Due To Transcranial Direct Current Stimulation.
Funder
National Health and Medical Research Council
Funding Amount
$523,192.00
Summary
This project will assess the underlying neural mechanisms by which neurostimulation improves impaired language functions after stroke (aphasia). This will be accomplished by using a novel combination of functional magnetic resonance imaging and simultaneous transcranial direct current stimulation (tDCS) administered to different brain regions. These studies will provide crucial information necessary to optimise future clinical trials that combine tDCS with language therapy.
10-year Outcome After Stroke: Final Follow-up For Survival, Stroke Recurrence, Functional Ability And Costs
Funder
National Health and Medical Research Council
Funding Amount
$51,475.00
Summary
Stroke is common, occurring in approximately 50,000 Australians each year. About a third of people with stroke die within the first 12 months but we do not know how many survive or how well they manage in the longer term. We aim to interview 10-year survivors of stroke to assess how much help they need to undertake everyday activities, and how much the stroke is costing the Australian community. This information will help us in planning the health care needs for stroke patients in future years.
Long-term Outcome After Stroke: Survival, Stroke Recurrence, Functional Ability And Costs.
Funder
National Health and Medical Research Council
Funding Amount
$649,971.00
Summary
Stroke is the third most common cause of death in Australia, and is more common in the older age groups. Because the population most at risk of developing stroke is growing faster than the rest of the population, it is likely that there will be a large increase in the number of strokes occurring in coming years. At 1 year after stroke about one-third of patients have died, a third remain severely disabled and a third recover with minimal disability. In Australia, there is no information on outco ....Stroke is the third most common cause of death in Australia, and is more common in the older age groups. Because the population most at risk of developing stroke is growing faster than the rest of the population, it is likely that there will be a large increase in the number of strokes occurring in coming years. At 1 year after stroke about one-third of patients have died, a third remain severely disabled and a third recover with minimal disability. In Australia, there is no information on outcome beyond 5 years. It is thought that at 10 years after stroke about 70% of patients will have died, and a further 5-10% will have had another nonfatal stroke. The aim of this study is to assess the long-term outcome of patients with stroke. These will include measures of survival, stroke recurrence, and ability to perform usual daily activities. The use of health care and community resources and the associated costs of this will also be assessed. Information on survival patterns, stroke recurrence, disability and costs will be of great value for health service planning. Such information will also be useful to patients, their families, and medical staff who treat these patients.Read moreRead less
Brain Adaptation Associated With Spontaneous And Training-induced Recovery Of Touch Sensation Post-stroke.
Funder
National Health and Medical Research Council
Funding Amount
$339,950.00
Summary
Brain networks may reorganize to optimise stroke recovery. However, little is known about brain mechanisms underlying natural and training-induced recovery after stroke, particularly following loss of body sensations. Knowledge of the experiences that may facilitate brain reorganisation is a prerequisite for the development and evaluation of optimal stroke rehabilitation strategies. We aim to provide novel information on the potential benefits of specific training in facilitating reorganisation ....Brain networks may reorganize to optimise stroke recovery. However, little is known about brain mechanisms underlying natural and training-induced recovery after stroke, particularly following loss of body sensations. Knowledge of the experiences that may facilitate brain reorganisation is a prerequisite for the development and evaluation of optimal stroke rehabilitation strategies. We aim to provide novel information on the potential benefits of specific training in facilitating reorganisation of the brain after stroke. Specifically we will: (i) locate areas of brain activity associated with natural and training-induced recovery of touch sensation following stroke and (ii) investigate the relationship between brain activation, sensory recovery and intervening experience. Site and extent of brain activation associated with recovery of touch sensation will be investigated over time using serial functional magnetic resonance imaging (fMRI), a controlled sensory task and clinical measures of recovery. Thirty stroke patients with impaired touch sensation of the upper limb will be studied at 2-6 weeks and 6 months post-stroke to investigate changes in brain activation associated with natural recovery (Study 1). Ten healthy controls will also be studied over 6 months. Those patients who still have sensory loss at 6 months will then receive specific sensory training or placebo intervention to study the effect of training-induced recovery on brain activity (Study 2). The whole brain will be studied and activation sites will be interpreted relative to individual and standard brain maps. We expect that the findings will advance our knowledge of the relationship between clinical recovery, training and neural plastic changes in the brain. This information will provide direction for the development of scientifically based treatments designed to maximise recovery and help identify patients who are likely to show natural recovery and-or benefit from training.Read moreRead less