Stroke Recovery . . . Later

By Medical Discovery News

Nov. 10, 2012

Aubrey Plaza - "Safety Not Guaranteed" Greenroom Photo Op - 2012 SXSW Music, Film + Interactive Festival

Known for her snarky comments and deadpan delivery on NBC’s “Parks and Recreation,” 28-year-old actress Aubrey Plaza has a clear complexion, luminous brown eyes, and quick wit – the very picture of health. But eight years ago, she was talking with friends when she suddenly lost feeling in her right arm, then her whole right side. She tried to speak, but couldn’t form the words. She suffered a stroke, which she has now fully recovered from.

Stroke symptoms include sudden numbness or tingling, loss of movement, vision changes, difficulty speaking, confusion, loss of balance, and severe headache, although victims don’t necessarily show all the symptoms. And while most stroke patients are past midlife, even those in their 20s, like Plaza, can be at risk.

Stroke victims increase their chances of a full recovery if they can get treatment within three hours of the first symptoms. But for that to happen, a person must get to a hospital within the first hour to give doctors enough time to evaluate their condition and administer the right drugs. Stretching that window could buy a lot of time for more people.

In lab tests, a compound called dalfampridine, also known as Ampyra, can expand the treatment window not by mere hours, but by weeks. Today’s leading drug treatment is tissue plasminogen activator or t-PA. It’s used to treat the 80 percent of stroke victims who have ischemic strokes, caused by a blood clot blocking a blood vessel in the brain. T-PA dissolves the clot, but must be given within three hours.

By contrast, the new drug under study, Ampyra, improved motor function in rats that had suffered a stroke at least four weeks prior. All four limbs had better motor function, and rats given higher doses improved even more. A clinical trial is planned with a small number of human stroke patients who suffered a stroke at least 6 months earlier.  By then patients’ recoveries have usually hit a plateau, so improvements over the course of the study can be attributed to Ampyra.

The drug is already approved for helping multiple sclerosis patients walk. If it can do the same for stroke victims, it’ll be the first effective treatment other than physical therapy to restore motor function long after a devastating stroke.

Another drug researchers are studying is Gleevec. Like Ampyra, it can stretch the treatment window, but to give existing drug, t-PA, more time to work. One of the side effects of t-PA is cerebral bleeding. Researchers recently discovered Gleevec, a leukemia drug, is able to not only stem the bleeding, but stretch the treatment window beyond the three hours t-PA requires.

If both drugs prove effective, they could significantly improve the outcome for stroke patients who are unable to get immediate care.

The benefits of developing stroke therapies are obvious. Over 6 million Americans have had a stroke, and half a million new cases occur each year. More importantly, it’s the leading cause of serious, long-term disability in adults. That’s a heavy burden on the healthcare system and on family caretakers.

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