Hypothermia to Rescue Stroke Victims. Brain cooling could help recovery patients

Scientists have called for funding for a Europe-wide trial for a new way of treating stroke victims. A consortium of medics have said inducing hypothermia in people suffering from strokes can prevent death or disability. The treatment could help about 40,000 stroke victims a year, according to the researchers. Cooling the brain is already used as a way of reducing brain injuries following cardiac arrest and birth injuries. It acts by stimulating a kind of hibernation in the brain, reducing the need for oxygen and preventing further damage. It also gives doctors longer to treat blocked or burst blood vessels.The research is being led by Dr Malcolm Macleod, head of experimental neuroscience at the Centre for Clinical Brain Sciences at the University of Edinburgh. He said: “Every day 1000 Europeans die from stroke – that’s one every 90 seconds – and about twice that number survive but are disabled. Our estimates are that hypothermia might improve the outcome for more than 40,000 Europeans every year.”  Dr Malcolm Macleod Research overview;  1. Systematic review and meta-analysis of animal models of neurological disease 2. Hypothermia and mineralocorticoid receptor induced neuroprotection

3. Clinical trials in acute ischaemic stroke.  Research direction;    My group has led the development and application of systematic review and meta-analysis of animal studies modelling stroke. This work allows a very precise estimate of efficacy in animals; the identification of limits to efficacy (e.g. at later time points) in animal models which helps to inform the design of clinical trials; and the identification of aspects of design and conduct which bias the results of animal experiments. Current work is seeking to generalise this approach to models of multiple sclerosis, Alzheimer’s disease, Parkinson’s disease and Huntington’s disease. The CAMARADES dataset now includes information from over 2,500 publications, 5,000 individual experiments describing outcome in over 60,000 experimental animals, and has allowed important secondary analyses of for instance publication bias and journal citation patterns.We have explored the protective effects of hypothermia following acute neuronal injury. Using pharmacological and genetic approaches we have shown that mineralocorticoid expression is increased in cell culture, in animals and in humans following neuronal injury, and that this conveys neuroprotective benefits. Our current work seeks to recapitulate these benefits in a clinical context.I am Chief Investigator of HAIST, a pilot study of therapeutic hypothermia in acute ischaemic stroke; lead clinician for the South East Scotland Stroke Research Network; and local PI in Stirling for CLOTS, TARDIS, ENOS, AVERT, ROCKET AF, TRA-2P and ENGAGE. I am Honorary Principal Research Fellow at the Florey Neurosciences Institute, Melbourne, Australia and Treasurer of the European Stroke Research Network for Hypothermia.  The Centre for

Clinical Brain Sciences CCBS was established in 2004. Its mission is “to promote excellence in research and training of an internationally competitive standing in brain disorders”. The Centre seeks to achieve this by providing: training opportunities; a research career structure; communications and networking; facilities for clinical and imaging research; sharing of resources; the opportunity to participate in internationally recognised research programmes; a raised profile for the research of its members and associated members. The Centre is operates as a ‘virtual’ centre at present, though the longer term aim is to consolidate the majority of our activity onto a single site.The main areas of clinical research focus on stroke, major affective disorders, and multiple sclerosis. Imaging research underpins a great deal of this work. Other cross-cutting interdisciplinary work is underway in genetics, symptoms research and on translating laboratory research into benefits for patients (at present, the latter focuses on stroke and multiple sclerosis). The centre has expertise in a wide range of clinical research designs: disease registers, population surveys, observational cohort studies, case-control studies, randomised trials, systematic reviews, and evaluation of diagnostic test performance.The main constituent elements of the Centre are housed within the Division of Psychiatry, the Division of Clinical Neurosciences and the SFC Brain Imaging Research Centre. News from:  University of Edinburgh, Centre for Clinical Brain Sciences

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