NIH Stroke Grant Progress Reported To Congressional Staff

Interdisciplinary Research Now in Fourth Year Explores Statin Use, Neuroimaging of Stroke Recovery, Prevention Education

SPOTRIAS: Specialized Programs of Translational Research in Acute Stroke NEW YORK (October 6, 2008) – Stroke researchers at Columbia University Medical Center (CUMC) and NewYork-Presbyterian Hospital (NYPH) reported progress to date today to U.S. House of Representatives staff on three major research efforts supported by a $12 million stroke center research grant from the National Institutes of Health. First awarded in Nov. 2004 and now in its fourth year, the Specialized Programs of Translational Research in Acute Stroke (SPOTRIAS) grant from the NIH’s National Institute of Neurological Disorders and Stroke has enabled researchers to learn more about three innovative approaches to stroke treatment, education and recovery. Attendees at the briefing included staffers from the office of U.S. Representative Joseph Crowley of the Seventh Congressional District of New York which includes the Bronx and Queens.

Extending over five years, the funding supports: one of the first clinical trials of high-dose statin medications as a potential acute stroke treatment; an imaging study of brain reorganization to predict recovery of function; and a novel stroke educational and behavior modification program. The three major research efforts draw on the expertise of clinician-scientists at Columbia’s College of Physicians and Surgeons, Columbia’s Mailman School of Public Health, and NewYork-Presbyterian Hospital/Columbia. Approximately 1,000 patients from Upper Manhattan are enrolled in clinical trials focused on treating stroke in its acute phases immediately after onset and about the same number are involved in a stroke education program.

Randolph S. Marshall, M.D., M.S. “As a major U.S. site for this nationally-funded, multi-center study, we are proud to be contributing to the knowledge base and development of new treatments that will hopefully arm clinicians and patients alike with the best strategies for combating stroke,” said Randolph S. Marshall, M.D., M.S., professor of neurology; director, Stroke Division, Department of Neurology, Columbia University Medical Center; and the principal investigator of the overall SPOTRIAS program.

“Initiated in 2001, SPOTRIAS has grown to a network of eight stroke centers across the country that conduct early phase clinical projects and share data,” said Scott Janis, Ph.D., M.S., clinical research project manager and SPOTRIAS program director, NINDS. “The goal is to improve acute stroke therapy by bridging basic research with clinical practice at medical centers with the capacity to evaluate and treat stroke patients very rapidly after the onset of their symptoms.”

“This important research makes clear that a robust funding stream for NIH grants is critical to advancing the treatment and prevention of stroke and providing innovative strategies for clinicians as they strive to improve quality of life for stroke patients,” said Dr. Richard Hodosh, president of the Board of Directors for the New York City Division of the American Heart Association and American Heart Association.

The three research efforts currently underway at Columbia/NewYork-Presbyterian include: • A safety study of high-dose statins – typically used to lower cholesterol – to protect the brain during the acute stroke period led by Mitchell S.V. Elkind, M.D., M.S., associate professor of neurology and associate attending neurologist. The study evolved from another Columbia study, the Northern Manhattan Stroke Study (NOMASS), which found that people already taking statins before having a stroke tended to have less severe strokes and a better recovery. Tests of high-dose statins as a stroke treatment in animal models have shown promise.

• An fMRI study, led by Dr. Marshall, to see if altered patterns of brain activity imaged within a few days of the onset of stroke can predict subsequent recovery of function. Dr. Marshall’s preliminary studies have demonstrated emergence of activity that correlates with recovery. If these early brain signals are validated as truly predictive of capacity to recover, the researchers will investigate whether treatment can mitigate the recovery-related fMRI signal.

• A Stroke Warning Information and Faster Treatment (SWIFT) study, led by Bernadette Boden-Albala, Dr.P.H., assistant professor of sociomedical sciences in neurology, that is investigating if a novel technique in behavioral change directed at stroke survivors will result in quicker patient response in getting to the hospital when a stroke occurs, and ease in navigation of the Emergency Department. (Stroke survivors are at increased risk of having additional strokes.) This study has offered interactive stroke education to groups of people in northern Manhattan to see if the information can help facilitate quicker treatment of stroke in this population. The SPOTRIAS grant also has four core organizational elements (resource cores) for patient access, biostatistics and data management, blood and tissue pathology, and career development to train future stroke researchers. - ### -

Columbia University Medical Center provides international leadership in basic, pre-clinical and clinical research, in medical and health sciences education, and in patient care. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, public health professionals, dentists, and nurses at the College of Physicians & Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Established in 1767, Columbia’s College of Physicians & Surgeons was the first institution in the country to grant the M.D. degree and is now among the most selective medical schools in the country. Columbia University Medical Center is home to the largest medical research enterprise in New York City and state and one of the largest in the United States. For more information, please visit www.cumc.columbia.edu.

NewYork-Presbyterian Hospital, based in New York City, is the nation’s largest not-for-profit, non-sectarian hospital, with 2,242 beds. The Hospital has nearly 2 million inpatient and outpatient visits in a year, including more than 230,000 visits to its emergency departments — more than any other area hospital. NewYork-Presbyterian provides state-of-the-art inpatient, ambulatory and preventive care in all areas of medicine at five major centers: NewYork-Presbyterian Hospital/Weill Cornell Medical Center, NewYork-Presbyterian Hospital/Columbia University Medical Center, Morgan Stanley Children’s Hospital of NewYork-Presbyterian, NewYork-Presbyterian Hospital/Allen Pavilion and NewYork-Presbyterian Hospital/Westchester Division. One of the largest and most comprehensive health-care institutions in the world, the Hospital is committed to excellence in patient care, research, education and community service. It ranks sixth in U.S.News & World Report’s guide to “America’s Best Hospitals,” ranks first on New York magazine’s “Best Hospitals” survey, has the greatest number of physicians listed in New York magazine’s “Best Doctors” issue, and is included among Solucient’s top 15 major teaching hospitals. The Hospital’s mortality rates are among the lowest for heart attack and heart failure in the country, according to a 2007 U.S. Department of Health and Human Services (HHS) report card. The Hospital has academic affiliations with two of the nation’s leading medical colleges: Weill Cornell Medical College and Columbia University College of Physicians and Surgeons. For more information, visit www.nyp.org.

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Mailman School, New York, New York City, SPOTRIAS