Implementation Of Quality Use Of Advanced CT Imaging In Acute Stroke
Funder
National Health and Medical Research Council
Funding Amount
$1,128,594.00
Summary
Many centres now use advanced CT scanning techniques to assess stroke patient suitability for clot-dissolving treatment. However, there is major variation across Australia in the clinical application of advanced CT scanning techniques, which is a barrier to the delivery of this treatment. This project addresses the variation in CT imaging techniques by developing, piloting and evaluating the implementation of a standardised advanced CT scanning strategy for acute stroke patients.
We are studying human amnion epithelial cells (AECs) as a new therapy for stroke. Here if we find the protective effects of AECs are unaffected by a 'clot-buster' drug,we will broaden our planned Phase II trial of AECs to include patients that have received clot lysis therapy. Further, as we suspect that AECs exert their effects via release of nanoparticles called 'exosomes', we will test whether exosomes given intravenously or intranasally are similarly protective.
Very Early Rehabilitation In SpEech: An RCT Of Aphasia Therapy After Stroke
Funder
National Health and Medical Research Council
Funding Amount
$742,000.00
Summary
Aphasia affects one in three stroke survivors. It interferes with talking, understanding speech, reading and writing. Aphasia is devastating. Research suggests that very early aphasia therapy improves recovery of talking and understanding. However, over 70% of people with aphasia do not get very early treatment. This study promotes a “use it” or “lose it” approach to brain recovery and aims to show that very early aphasia therapy is beneficial and cost effective.
New Therapies For Stroke – Preventing Stroke Progression And Enhancing Recovery
Funder
National Health and Medical Research Council
Funding Amount
$463,652.00
Summary
Stroke is a major cause of death and disability worldwide. Dr Spratt’s team have discovered a new mechanism causing pressure to rise in the skull after stroke. They will build on their discovery of a promising new therapy to prevent early worsening of stroke and improve patient outcomes. He also leads a team studying better stroke recovery by promoting activity by enriching the rehabilitation environment, and ways to improve fitness in stroke survivors.
Tenecteplase Versus Alteplase For Stroke Thrombolysis Evaluation (TASTE) Trial
Funder
National Health and Medical Research Council
Funding Amount
$4,180,030.00
Summary
Tenecteplase versus Alteplase for Stroke Thrombolysis Evaluation (TASTE) is an Australian-led international randomised trial designed to generate practice-changing evidence by translating the advanced imaging treatment selection approach used in our previous pilot studies. TASTE aims to confirm the superiority of the new-generation clot-dissolving agent, tenecteplase, over the standard agent, alteplase, in the broad group of stroke patients eligible for acute clot-dissolving treatment.
Acute Stroke: Imaging The Ischaemic Penumbra With Perfusion CT
Funder
National Health and Medical Research Council
Funding Amount
$243,000.00
Summary
The burden of stroke is large. Clot-dissolving medication (thrombolysis) may dramatically improve the outcome of many patients with severe stroke by unblocking the affected brain artery. However, very few patients receive this medication, as the current approval is restricted to treatment within 3 hours of stroke onset. The major aim of thrombolysis is to rescue brain tissue with reduced blood flow (the ischaemic penumbra) from becoming irreversibly damaged (infarcted). The penumbra progressivel ....The burden of stroke is large. Clot-dissolving medication (thrombolysis) may dramatically improve the outcome of many patients with severe stroke by unblocking the affected brain artery. However, very few patients receive this medication, as the current approval is restricted to treatment within 3 hours of stroke onset. The major aim of thrombolysis is to rescue brain tissue with reduced blood flow (the ischaemic penumbra) from becoming irreversibly damaged (infarcted). The penumbra progressively becomes infarcted over the next 48 hours if blood flow is not restored by the blood clot in the brain artery being dissolved. Penumbral brain tissue cannot be identified with clinical assessment or standard CT scanning. New generation CT scanners are capable of assessing brain blood flow. Perfusion CT imaging (CTP) is well tolerated and time-efficient, and can be integrated into the brain CT scanning process performed on all stroke patients. Preliminary evidence suggests that CTP can distinguish between tissue that represents the ischaemic penumbra, and tissue that is already permanently injured. This project aims to validate the use of CTP in imaging the ischaemic penumbra. This will be based on testing the accuracy of CTP tissue signatures of the penumbra in predicting clinical outcome and final stroke size. This is the only national collaborative study planned worldwide for this relatively new but increasingly accessible imaging technique. The ability to rapidly identify under-perfused but still viable brain with CTP would add new and exciting management options to the routine emergency assessment of stroke patients. The results of this unique study could have a significant impact on the management of acute stroke worldwide. If validated, it is anticipated that CTP would be widely used to improve patient selection for stroke thrombolysis, especially in safely extending the time window so that a greater number of patients can be treated with better outcomes.Read moreRead less
Low-Dose Tenecteplase Vs Standard-Dose Alteplase For Acute Ischaemic Stroke: An Imaging Based Safety And Efficacy Study
Funder
National Health and Medical Research Council
Funding Amount
$349,281.00
Summary
This study compares standard dose alteplase (a proven stroke thrombolytic) with a low dose of the new medication tenecteplase for stroke treatment. We propose that the clot-dissolving activity of low-dose tenecteplase will be superior to alteplase, with a lower risk of brain bleeding. MRI scanning is the most effective way of assessing outcomes and will be used to measure how well the medication restores blood flow, the amount of permanent brain damage, and whether any brain bleeding occurs.
Improving Stroke Outcomes: Attenuating Progression And Recurrence
Funder
National Health and Medical Research Council
Funding Amount
$9,331,996.00
Summary
Stroke is the second most common cause of death and major cause disability. There are few proven interventions, so we need to introduce new ones. We developed a bench to bedside program to introduce new stroke therapies and its early secondary prevention. Our general goal is to provide evidence for their effectiveness and safety. We will use animal stroke models, markers in the blood to help diagnose and predict stroke outcome and imaging to help select patients for several clinical trials.
Improving Early Recognition And Response To Symptoms In Acute Cardiovascular Events.
Funder
National Health and Medical Research Council
Funding Amount
$316,449.00
Summary
An important challenge facing cardiovascular public health is to improve access to treatment for acute events, like heart attacks and stroke, by improving public recognition and the initial response to symptoms. This research aims to extend the current understanding and to evaluate existing and test new interventions in this area. Outcomes from this research will inform the development of future campaigns and interventions aiming to improve symptom recognition and reduce delays in presenting to ....An important challenge facing cardiovascular public health is to improve access to treatment for acute events, like heart attacks and stroke, by improving public recognition and the initial response to symptoms. This research aims to extend the current understanding and to evaluate existing and test new interventions in this area. Outcomes from this research will inform the development of future campaigns and interventions aiming to improve symptom recognition and reduce delays in presenting to hospital for acute cardiovascular events.Read moreRead less