A stroke results in sudden loss of neurological function due to perturbed blood supply to the brain or less frequently to the spinal cord. More than 85% of the strokes are caused by ischemia (blockage to blood flow) via thrombosis or embolism (two forms of blood clots in the vessels), and a smaller proportion is a result of hemorrhage. Significant efforts have been put on stroke prevention by reducing risk factors, such as high blood pressure, diabetes, high cholesterol levels, smoking, irregular heart beat (atrial fibrillation) and by reducing blood clotting or clearing up the narrowing of diseased arteries. However, one to two out of 1000 people still suffer strokes a year, and it is still one of the leading causes of deaths worldwide. It results in disabilities such as visual disturbances, inability to speak or swallow, and difficulties in moving one or more limbs.
The John van Geest Centre for Brain Repair accommodates both clinician scientists and basic researchers, covering two main areas of research relevant to stroke treatment or rehabilitation. Firstly, investigations by clinician scientists help improve treatment strategies that are aimed at limiting the damage by restoring the blood supply to areas around irreversible injury, called the penumbra. This is normally carried out by dissolving the blood clot (thrombolysis) or by removing it from the cerebral arteries (intravascular thrombectomy) in an emergency setting. Secondly, another area of research is related to inducing the brain’s ability to repair itself. This is an adaptive process, called plasticity, leading to the re-arrangement of connections on healthy nerve cells that could take over the lost function. To a limited extent this can be enhanced during clinical rehabilitation. However, a particular focus of several basic research groups in the BRC is to make plasticity even more efficient following brain damage.