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Thrombolysis is a method of dissolving the blood clot that is the cause of the majority of strokes in Australia. The first major trial to demonstrate benefit for this treatment was published some 11 years ago but treatment has not been widely implemented across Australia because of the difficulties in giving treatment within the very tight time window for which treatment is currently approved (patients must get to hospital, be scanned and start treatment within 3 hours of the onset of the stroke ....Thrombolysis is a method of dissolving the blood clot that is the cause of the majority of strokes in Australia. The first major trial to demonstrate benefit for this treatment was published some 11 years ago but treatment has not been widely implemented across Australia because of the difficulties in giving treatment within the very tight time window for which treatment is currently approved (patients must get to hospital, be scanned and start treatment within 3 hours of the onset of the stroke). Other factors which have limited implementation of treatment in Australia are continued debate over the trial data for this treatment as only one of the 5 major trials was positive. In addition, virtually no patients aged over 80 years old were included in the previous trials, and as this age group represents about a third of all stroke in Australia, new data in this age group is required. As a result of the difficulty in giving a treatment within such a tight time window and the ongoing debate about the trial data, few Australians are currently treated and thus the public health impact is negligible. In to change clinical practice, we need reliable data from a large convincing further trial of thrombolysis with the more realistic time window of 6 hours. The Third International Stroke Trial (IST-3) is a large international collaborative effort to determine whether thrombolysis treatment offered to a wider range of patients up to 6 hours from stroke onset results in an increase in long-term independent survival. Data from such a trial is most likely to change clinical practice and lead to an important public health benefit.Read moreRead less
Enhanced Control Of Hypertension And Thrombolysis In Stroke Study (STAY ENCHANTED)
Funder
National Health and Medical Research Council
Funding Amount
$2,437,384.00
Summary
"Clot busting" treatment is the only approved medical treatment for the commonest type of stroke, ischaemic stroke. However, uptake of treatment remains poor, mainly due to the known major risk of bleeding in the brain. STAY ENCHANTED is an international clinical trial to investigate whether "clot-busting" can be made safer using a lower dose and/or immediate blood pressure lowering. A safer more effective regime could have a major global health impact.
Optimizing Stroke Therapy - Advanced Brain Imaging And Reperfusion Therapies
Funder
National Health and Medical Research Council
Funding Amount
$419,180.00
Summary
Most stroke is due to a blocked blood vessel reducing blood flow to the brain. This research aims to optimize fast restoration of blood flow to the brain and improve patient outcomes. We will test potentially more effective clot-dissolving medication, examine potential benefits of redesigning pre-hospital ambulance transport systems and clarify the role of advanced brain imaging to maximize delivery of recently proven minimally invasive procedures to physically remove blood clots in the brain.
Imaging Of Acute Ischemic Stroke – Improving Patient Selection For Thrombolysis
Funder
National Health and Medical Research Council
Funding Amount
$367,946.00
Summary
Stroke is a major cause of death and disability in our community and is most often due to a blocked blood vessel. Powerful treatments are available to open blocked blood vessels but there are restrictions on eligibility and some risks. This research aims to improve doctors' understanding of stroke in the individual patient to aid treatment decisions by identifying those with potentially salvageable brain tissue and avoiding those with high risk of bleeding complications.
EXTEND-IA Randomized Trial Of Intra-arterial Clot Retrieval In Ischemic Stroke
Funder
National Health and Medical Research Council
Funding Amount
$764,534.00
Summary
Most strokes are caused by a blocked blood vessel in the brain. Current treatments to dissolve the blockage improve recovery for many patients but often fail to unblock larger brain arteries. The EXTEND-IA trial will use advanced brain imaging to identify patients who have the most to gain if the blocked artery can be re-opened. The trial will test whether a new minimally invasive clot removal procedure performed after standard clot-dissolving treatment improves recovery after stroke.
Deep Brain Stimulation For Treatment Resistant Major Depression: Neural Correlates And Neuropsychological Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$257,561.00
Summary
Major depression is a prevalent and devastating mental illness. While there are numerous pharmacological and psychological antidepressant therapies available, many patients do not respond to these treatments. Deep Brain Stimulation (DBS) is emerging as a potential treatment option for individuals with chronic severe treatment resistant major depression. The current project will investigate the cognitive and neurobiological outcomes associated with the use of DBS to treat depression.
This Australian-led, investigator initiated and conducted study, is the first and only large scale clinical trial designed to assess the balance of potential benefits and risks of early rapid blood pressure lowering in intracerebral haemorrhage stroke, a disease in which there is still no convincing evidence of benefit from any medical treatment, where the role of surgery remains controversial, and from which the chances of surviving has failed to improve in recent decades.
Seizures And Carbon Dioxide – A Study Of Respiratory Acidosis As A Cause For Seizure Termination And Trial Of Carbogen As An Anti-epileptic
Funder
National Health and Medical Research Council
Funding Amount
$317,582.00
Summary
Although much is known about epilepsy, the reason a seizure stops is not clear. A rise in the acidity of the blood, mainly due to a rise in carbon dioxide from breathing less deeply, may well contribute. Currently the standard treatments given in hospital to stop seizures are sedatives. Although effective, this sedation can need Intensive Care treatment. We aim to develop a safe, rapid, non-sedating way to treat seizures using a small amount of carbon dioxide in oxygen.
‘Chemobrain’: Neuroimmunological Consequences Of Chemotherapy-induced Mucositis And Opioid Palliation In Development Of The Condition
Funder
National Health and Medical Research Council
Funding Amount
$318,768.00
Summary
Approximately 46% of cancer patients receiving chemotherapy will experience cognitive impairment. The development of this condition may be linked to another common gut side-effect of chemotherapy- mucositis. The treatment of mucositis pain by potent painkillers called opioids may also increase the risk of cognitive change. This project will determine the nervous system changes occurring in mucositis to identify targets for drug intervention to prevent development of cognitive decline.
Cannabidiol (CBD): A Novel Therapeutic For Alzheimer's Disease.
Funder
National Health and Medical Research Council
Funding Amount
$775,005.00
Summary
Current drugs do not stop or reverse the progression of Alzheimer’s disease (AD). Also, brains of AD patients show a number of biological changes and effective drugs should target those together. Cannabidiol (CBD) has such abilities when tested in AD cell models. We found that CBD can also prevent and reverse memory deficits in AD mice. We propose to provide convincing preclinical evidence for the benefits of CBD for human AD therapy and to define mechanisms involved.