Ensuring the future of clinical and basic stroke research.

Abstract

The stroke field has seen tremendous progress regarding both clinical and basic research advances over the past several decades. Preclinical stroke research has identified the major components of the ischemic cascade that contribute to the death of ischemic brain tissue and the important interactions between neuronal, glial, and endothelial cells not only as they relate to acute ischemic injury but also to brain recovery.1 Recently, the interactions between the nervous system and other systems such as the immune and cardiovascular systems have become increasingly recognized as contributors to stroke pathophysiology.2,3 Another important basic science advance was the demonstration that processes may be deleterious at one stage after ischemic injury but recovery promoting at another phase.4 Many important clinical research and patient care advances have also occurred and the ones that I consider most important are provided in Table 1. A detailed report by National Institute of Neurological Disorders and Stroke’s (NINDS) Stroke Progress Review Group was presented recently.5 In this report, recent advances in areas including imaging, genetics, acute treatment, prevention, epidemiology, clinical trials, and health service implementation were summarized and recommendations for future research suggested. Another NINDS endeavor, a recent stroke research priorities meeting, led to a report suggesting 9 high-priority research areas outlined in Table 2 that were crosscutting along the spectrum of basic, translational, and clinical stroke research.6 The field of stroke has been energized by the contributions of many talented, dedicated, and innovative clinicians and basic scientists. Despite all of the successes, much work needs to be done to reduce the increasing incidence of stroke occurring in many countries, develop therapies to successfully treat ischemic and hemorrhagic stroke, and to enhance and amplify the endogenous recovery processes that occur after stroke. To meet these challenges, we will need …