Stroke remains one of the major causes of death and long-term disability worldwide. Currently, the only approved therapy for the acute treatment of this disease is thrombolysis, a strategy that can only be applied to a small percentage of patients due to its narrow therapeutic window. Unfortunately, during the last years numerous promising drugs that showed neuroprotection in the experimental setting failed to translate into the clinic because of their toxicity or lack of efficacy.
Researchers in the field now face the crucial need to develop effective stroke therapies and successfully translate novel strategies into the clinical setting. Rational Basis for Clinical Translation in Stroke Therapy presents the most recent promising preclinical approaches and the most updated clinical evidence for treating stroke patients. By bringing together the experience of accomplished stroke researchers and clinicians, the book is a useful tool for improving the treatment and management of stroke patients.
The book describes current approaches for the management of stroke patients including thrombolysis and mechanical recanalization procedures as well as other clinically relevant topics such as diagnosis, imaging, risk factors, and prevention. Also described are emerging interventions based on the use of stem cells, botulinum toxin, and antidepressants which complement emergency stroke treatment and conventional rehabilitation procedures.
Clinical approaches are integrated with the most promising therapeutic opportunities based on targeting the immune system, hypothermia, and postconditioning. The book also covers issues related to the improvement of R&D strategies in stroke therapeutics, aimed at the implementation of preclinical approaches with stroke model guidelines and at the optimization of clinical trial design. This volume is a reference for all those interested in the rational development of novel stroke therapeutics.
Table of Contents
Stroke Units, Regional Systems of Emergency Stroke Care, and Telestroke Networks; Anna Cavallini, Elisa Candeloro, Alessandra Persico, Isabella Canavero, and Giuseppe Micieli
Overview of Endovascular Treatment and Revascularization Strategies in Acute Ischemic Stroke; Salvatore Mangiafico and Arturo Consoli
Benefits and Harms of Pharmacological Thrombolysis; Svetlana Lorenzano and Danilo Toni
Mechanical Revascularization Strategies for Stroke Treatment; Erasmia Broussalis and Monika Killer
Risk Factors and Restroke Prevention; Vida Demarin, Sandra Morovic, and Tatjana Rundek
Genomics for the Advancement of Clinical Translation in Stroke; Steven D. Brooks, Reyna Van Gilder, Jefferson C. Frisbee, and Taura L. Barr
Acute Stroke Imaging and Beyond; Nicoletta Anzalone, Corrado Santarosa, and Costantino De Filippis
Imaging the Penumbra: CTP or Perfusion–Diffusion MRI Mismatch?; Alessandro Bozzao, Alessandro Boellis, and Andrea Romano
Predictors of Hemorrhagic Transformation of Ischemic Stroke after Thrombolysis; Domenico Inzitari, Francesco Arba, Benedetta Piccardi, and Anna Poggesi
Imaging Approaches to Map the Penumbra in Preclinical Stroke Models; Phillip Zhe Sun, Yu Wang, Xunming Ji, and Eng H. Lo
Trial Design and Reporting Standards for Acute Intravascular Cerebral Thrombolysis; Gregory J. del Zoppo and Alfonso Ciccone
Analysis and Interpretation of Outcome Measures in Stroke Clinical Trials; Stefano Ricci
Evaluation of Interventions in Stroke: The Cochrane Stroke Group Experience; Peter Langhorne
Neuroprotective Therapy: Failure and Future for Clinical Application; Taizen Nakase
Stroke Model Guidelines and STAIR Recommendations for Preclinical Stroke Studies; Shimin Liu
Animal Models of t-PA-Induced Hemorrhagic Transformation; Isaac García-Yébenes, Victor G. Romera, Macarena Hernández-Jiménez, Guadalupe Camarero, Tamara Atanes, Ignacio Lizasoain, and María A. Moro
Assessment of Sensorimotor Symptoms in Rodents after Experimental Brain Ischemia; Juan G. Zarruk, Jesús M. Pradillo, María J. Alfaro, Roberto Cañadas, María A. Moro, and Ignacio Lizasoain Section
Glutamate and Stroke: From NMDA to mGlu Receptors and Beyond; Tania Scartabelli, Elisa Landucci, Elisabetta Gerace, and Domenico E. Pellegrini-Giampietro
Therapeutic Hypothermia for Acute Stroke; Serena Candela, Michele Cavallari, and Francesco Orzi
Drug-Induced Hypothermia in Stroke: Current Status and New Therapeutic Approaches; Mirko Muzzi and Alberto Chiarugi
Immune Response in Cerebral Ischemia: Role of TLRs; Jesús M. Pradillo, Ana Moraga, Alicia Garcia-Culebras, Sara Palma-Tortosa, Marta Oses, Diana Amantea, María A. Moro, and Ignacio Lizasoain
Polarization of Macrophages/Microglia toward an M2 Phenotype as a Therapeutic Strategy for Stroke Treatment; Iván Ballesteros, María I. Cuartero, Juan de la Parra, Alberto Pérez-Ruiz, Olivia Hurtado, Ignacio Lizasoain, and María A. Moro
Minocycline Repurposing for Acute Cerebral Hemorrhage; Jeffrey A. Switzer, Andrea N. Sikora, David C. Hess, and Susan C. Fagan
NCX as a Key Player in the Neuroprotection Exerted by Ischemic Preconditioning and Postconditioning; Giuseppe Pignataro, Ornella Cuomo, Antonio Vinciguerra, Pierpaolo Cerullo, Gianfranco Di Renzo, and Lucio Annunziato
Cell-Based Therapies for Stroke; Paul M. George and Gary K. Steinberg
Contribution of Neuroplasticity to Recovery after Stroke; Nikhil Sharma
Stroke Rehabilitation Care: Management and Procedures; Michelangelo Bartolo, Chiara Zucchella, and Giorgio Sandrini
Focal Treatment of Stroke-Related Spasticity in the Rehabilitation Setting: Clinical Exploitation of Botulinum Toxin; Sheila Catani and Alessandro Clemenzi
Use of Antidepressants as Adjunctive Therapy to Improve Recovery after Ischemic Stroke; Harold P. Adams, Jr.
Giuseppe Micieli is director of the Department of Emergency Neurology at the IRCCS "C. Mondino" Foundation in Pavia, Italy, as well as adjunct professor at the University of Pavia. He received his degree in medicine and surgery from the University of Pavia and holds specialization degrees in neurology and clinical pharmacology. He is former director of the Laboratory of Vegetative Physiopathology, the Headache Centre, and the Sub-intensive Unit of Cerebrovascular Diseases at the IRCCS "C. Mondino" Foundation. He is also the former leader of the Emergency Neurology and Stroke Unit of the Humanitas Clinical Institute in Rozzano, Milan. Dr. Micieli has published more than 170 peer-reviewed articles and held numerous leadership positions including coordinating roles for the Stroke Unit Network and the Italian Stroke Forum.
Diana Amantea is aggregate professor of pharmacology in the Department of Pharmacy, Health Sciences and Nutrition at the University of Calabria, Italy. She also leads the Stroke Research Unit at the Center of Preclinical and Translational Pharmacology located in the University of Calabria. Dr. Amantea received her PharmD from the University of Calabria and her PhD in pharmacology from the University of Birmingham. Her research focuses on understanding the inflammatory mechanisms occurring during ischemic brain injury in order to identify novel pharmacological targets for stroke therapy.