Current status of neuroprotection for cerebral ischemia: synoptic overview.

Abstract:

:Abundant preclinical studies have identified multiple mechanisms of ischemic brain injury and have provided proof of principle that strategies designed to counter these mechanisms can protect the ischemic brain. This review article emphasizes the translation of these strategies from the laboratory to clinical trials. It is a disappointing fact that many agents have been brought to clinical trial despite only modest or inconsistent preclinical evidence of neuroprotective efficacy. Preclinical investigations require rigorous attention to a variety of variables that may influence outcome. The widely touted STAIR criteria represent constructive guidelines for preclinical testing but, as experience has shown, do not increase the likelihood of translational success. Of the approximately 160 clinical trials of neuroprotection for ischemic stroke conducted as of late 2007, only approximately 40 represent larger-phase completed trials, and fully one half of the latter utilized a window to treatment of >6 hours, despite strong preclinical evidence that this delay exceeds the likely therapeutic window of efficacy in acute stroke. Other shortcomings of these trials include the use of agents lacking robust, consistent preclinical efficacy; inability to achieve adequate dosing in humans; and suboptimal clinical and statistical design features. Taken together, these factors identify areas of needed improvement for future trials.

journal_name

Stroke

journal_title

Stroke

authors

Ginsberg MD

doi

10.1161/STROKEAHA.108.528877

subject

Has Abstract

pub_date

2009-03-01 00:00:00

pages

S111-4

issue

3 Suppl

eissn

0039-2499

issn

1524-4628

pii

STROKEAHA.108.528877

journal_volume

40

pub_type

杂志文章,评审

相关文献

STROKE文献大全
  • Cerebral venous thrombosis in the absence of headache.

    abstract:BACKGROUND AND PURPOSE:Although headache is the most common symptom in cerebral venous thrombosis, 5% to 30% of patients do not report headache at baseline. Characteristics of these patients have not been investigated. METHODS:In post hoc analysis of the International Study on Cerebral Vein and Dural Sinus Thrombosis ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.114.007584

    authors: Coutinho JM,Stam J,Canhão P,Barinagarrementeria F,Bousser MG,Ferro JM,ISCVT Investigators.

    更新日期:2015-01-01 00:00:00

  • Key role of CD36 in Toll-like receptor 2 signaling in cerebral ischemia.

    abstract:BACKGROUND AND PURPOSE:Toll-like receptors (TLRs) and the scavenger receptor CD36 are key molecular sensors for the innate immune response to invading pathogens. However, these receptors may also recognize endogenous "danger signals" generated during brain injury, such as cerebral ischemia, and trigger a maladaptive in...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.109.572552

    authors: Abe T,Shimamura M,Jackman K,Kurinami H,Anrather J,Zhou P,Iadecola C

    更新日期:2010-05-01 00:00:00

  • Ultrasonographic evaluation of vertebral artery to detect vertebrobasilar axis occlusion.

    abstract:BACKGROUND AND PURPOSE:We performed the present study to determine whether the site of occlusion in the vertebrobasilar circulation could be identified by the measurement of blood flow velocity in the bilateral vertebral arteries. METHODS:Using color-coded duplex carotid ultrasonography, we measured the time-averaged ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.25.5.1006

    authors: Kimura K,Yasaka M,Moriyasu H,Tsuchiya T,Yamaguchi T

    更新日期:1994-05-01 00:00:00

  • Risk assessment of symptomatic intracerebral hemorrhage after thrombolysis using DWI-ASPECTS.

    abstract:BACKGROUND AND PURPOSE:Pretreatment lesion size on diffusion-weighted imaging (DWI) is a risk factor for symptomatic intracerebral hemorrhage (sICH) associated with thrombolytic treatment. Here, we investigated whether the Alberta Stroke Programme Early CT Score (ASPECTS) applied to DWI images (DWI-ASPECTS) predicts sI...

    journal_title:Stroke

    pub_type: 杂志文章,多中心研究

    doi:10.1161/STROKEAHA.109.550111

    authors: Singer OC,Kurre W,Humpich MC,Lorenz MW,Kastrup A,Liebeskind DS,Thomalla G,Fiehler J,Berkefeld J,Neumann-Haefelin T,MR Stroke Study Group Investigators.

    更新日期:2009-08-01 00:00:00

  • Disparities in Antihypertensive Prescribing After Stroke: Linked Data From the Australian Stroke Clinical Registry.

    abstract::Background and Purpose- Despite evidence to support the prescription of antihypertensive medications before hospital discharge to promote medication adherence and prevent recurrent events, many patients with stroke miss out on these medications at discharge. We aimed to examine patient, clinical, and system-level diff...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.119.026823

    authors: Dalli LL,Kim J,Thrift AG,Andrew NE,Lannin NA,Anderson CS,Grimley R,Katzenellenbogen JM,Boyd J,Lindley RI,Pollack M,Jude M,Durairaj R,Shah D,Cadilhac DA,Kilkenny MF

    更新日期:2019-12-01 00:00:00

  • Antegrade flow across incomplete vessel occlusions can be distinguished from retrograde collateral flow using 4-dimensional computed tomographic angiography.

    abstract:BACKGROUND AND PURPOSE:In acute stroke patients with intracranial vessel occlusion, angiographic demonstration of antegrade contrast opacification distal to the occlusion site (termed the "clot outline sign") has been associated with higher rates of vessel recanalization. We sought to determine whether antegrade flow c...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.112.668889

    authors: Frölich AM,Psychogios MN,Klotz E,Schramm R,Knauth M,Schramm P

    更新日期:2012-11-01 00:00:00

  • Infarct volume is a major determiner of post-stroke immune cell function and susceptibility to infection.

    abstract:BACKGROUND AND PURPOSE:Acute ischemic stroke in humans is associated with profound alterations in the immune system. Hallmarks of this stroke-induced immunodepression syndrome are: lymphocytopenia, impairment of T helper cell and monocyte function. We studied which stroke-specific factors predict these immunologic alte...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.109.557967

    authors: Hug A,Dalpke A,Wieczorek N,Giese T,Lorenz A,Auffarth G,Liesz A,Veltkamp R

    更新日期:2009-10-01 00:00:00

  • Are hypertension or cardiac embolism likely causes of lacunar infarction?

    abstract::We tested the hypothesis that hypertension is more common and cardiac embolism less common in patients with lacunar infarction than in patients with other types of cerebral infarction. We studied risk factor profiles in a series of 102 consecutive patients with a lacunar infarct and 202 consecutive patients with a car...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.21.3.375

    authors: Lodder J,Bamford JM,Sandercock PA,Jones LN,Warlow CP

    更新日期:1990-03-01 00:00:00

  • CT cerebral blood flow maps optimally correlate with admission diffusion-weighted imaging in acute stroke but thresholds vary by postprocessing platform.

    abstract:BACKGROUND AND PURPOSE:Admission infarct core lesion size is an important determinant of management and outcome in acute (<9 hours) stroke. Our purposes were to: (1) determine the optimal CT perfusion parameter to define infarct core using various postprocessing platforms; and (2) establish the degree of variability in...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.110.610618

    authors: Kamalian S,Kamalian S,Maas MB,Goldmacher GV,Payabvash S,Akbar A,Schaefer PW,Furie KL,Gonzalez RG,Lev MH

    更新日期:2011-07-01 00:00:00

  • Importance of intracranial atherosclerotic disease in patients with symptomatic stenosis of the internal carotid artery. The North American Symptomatic Carotid Endarterectomy Trail.

    abstract:BACKGROUND AND PURPOSE:The estimated prevalence of intracranial atherosclerotic disease (IAD) in patients with stenosis of the extracranial internal carotid artery (ICA) varies between 20% and 50%. The benefits of carotid endarterectomy (CE) in patients with both IAD and symptomatic extracranial ICA stenosis are uncert...

    journal_title:Stroke

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1161/01.str.30.2.282

    authors: Kappelle LJ,Eliasziw M,Fox AJ,Sharpe BL,Barnett HJ

    更新日期:1999-02-01 00:00:00

  • Classification of Covert Brain Infarct Subtype and Risk of Death and Vascular Events.

    abstract::Background and Purpose- To test the hypothesis that covert brain infarcts (CBIs) are more likely to be located in noneloquent brain areas compared with clinical strokes and that CBI etiological subtypes carry a differential risk of vascular events compared with people without CBI. Methods- We used brain magnetic reson...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.119.026068

    authors: Gutierrez J,Gil-Guevara A,Ramaswamy S,DeRosa J,Di Tullio MR,Cheung K,Rundek T,Sacco RL,Wright CB,Elkind MSV

    更新日期:2020-01-01 00:00:00

  • Extent of acute hydrocephalus after aneurysmal subarachnoid hemorrhage as a risk factor for delayed cerebral infarction.

    abstract:BACKGROUND AND PURPOSE:Delayed cerebral infarction (DCI) is an important cause of poor outcome after subarachnoid hemorrhage. Cerebral perfusion is a predictor for DCI. Because acute hydrocephalus may impair cerebral perfusion, we evaluated the predictive value of the extent of acute hydrocephalus on the development of...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.107.484220

    authors: Bakker AM,Dorhout Mees SM,Algra A,Rinkel GJ

    更新日期:2007-09-01 00:00:00

  • Early component changes in corticomotor evoked potentials following experimental stroke.

    abstract::Corticomotor evoked potentials have recently been used in experimental animals and patients as a measure of neurologic function after stroke. However, little is known about the fundamental electrophysiologic properties contributing to the formation of these potentials. To define some of these properties, corticomotor ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.18.6.1141

    authors: Simpson RK Jr,Baskin DS

    更新日期:1987-11-01 00:00:00

  • Role of insulin resistance associated with compensatory hyperinsulinemia in ischemic stroke.

    abstract:BACKGROUND AND PURPOSE:Although insulin resistance and hyperinsulinemia play a crucial role in the pathogenesis of atherosclerosis, little is known about their roles in ischemic stroke. The purpose of this study was to clarify whether insulin resistance and hyperinsulinemia are causative factors in the pathogenesis of ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.27.1.37

    authors: Shinozaki K,Naritomi H,Shimizu T,Suzuki M,Ikebuchi M,Sawada T,Harano Y

    更新日期:1996-01-01 00:00:00

  • Predictors of rehemorrhage after treatment of ruptured intracranial aneurysms: the Cerebral Aneurysm Rerupture After Treatment (CARAT) study.

    abstract:BACKGROUND AND PURPOSE:The primary purpose of intracranial aneurysm treatment is to prevent rupture. Risk factors for rupture after aneurysm treatment have not been clearly established, and the need to completely occlude aneurysms is debated. METHODS:The Cerebral Aneurysm Rerupture After Treatment (CARAT) study is an ...

    journal_title:Stroke

    pub_type: 杂志文章,多中心研究

    doi:10.1161/STROKEAHA.107.495747

    authors: Johnston SC,Dowd CF,Higashida RT,Lawton MT,Duckwiler GR,Gress DR,CARAT Investigators.

    更新日期:2008-01-01 00:00:00

  • Embolic stroke by compression maneuver during transcranial Doppler sonography.

    abstract:BACKGROUND AND PURPOSE:Embolic complications during ultrasound examinations are a rare cause of neurological deficits. The present case documents the occurrence of embolism by a nonobstructive compression maneuver during transcranial Doppler examination, resulting in a minor stroke. CASE DESCRIPTION:A 63-year-old man ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.25.5.1056

    authors: Khaffaf N,Karnik R,Winkler WB,Valentin A,Slany J

    更新日期:1994-05-01 00:00:00

  • B vitamin plasma levels and the risk of ischemic stroke and transient ischemic attack in a German cohort.

    abstract:BACKGROUND AND PURPOSE:Data from prospective studies on the associations between B vitamin plasma levels and the risk of stroke are limited. We investigated the individual and combined effects of plasma folate, vitamin B12, and pyridoxal 5-phosphate (PLP) levels on the risk of ischemic stroke and transient ischemic att...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.107.486068

    authors: Weikert C,Dierkes J,Hoffmann K,Berger K,Drogan D,Klipstein-Grobusch K,Spranger J,Möhlig M,Luley C,Boeing H

    更新日期:2007-11-01 00:00:00

  • Hemorrhage from cavernous malformations of the brain: definition and reporting standards. Angioma Alliance Scientific Advisory Board.

    abstract:BACKGROUND AND PURPOSE:Cavernous malformations of the brain (CMs) cause intracranial hemorrhage, but its reported frequency varies, partly attributable to study design. To improve the validity of future research, we aimed to develop a robust definition of CM hemorrhage. METHODS:We systematically reviewed the published...

    journal_title:Stroke

    pub_type: 共识发展会议,指南,杂志文章,评审

    doi:10.1161/STROKEAHA.108.515544

    authors: Al-Shahi Salman R,Berg MJ,Morrison L,Awad IA,Angioma Alliance Scientific Advisory Board.

    更新日期:2008-12-01 00:00:00

  • Risk Profile of Symptomatic Lacunar Stroke Versus Nonlobar Intracerebral Hemorrhage.

    abstract:BACKGROUND AND PURPOSE:Although lacunar stroke (LS) and deep intracerebral hemorrhage (dICH) represent acute manifestations of the same pathological process involving cerebral small vessels (small vessel disease), it remains unclear what factors predispose to one phenotype rather than the other at individual level. ME...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.116.013722

    authors: Morotti A,Paciaroni M,Zini A,Silvestrelli G,Del Zotto E,Caso V,Dell'Acqua ML,Simone AM,Lanari A,Costa P,Poli L,De Giuli V,Gamba M,Ciccone A,Ritelli M,Di Castelnuovo A,Iacoviello L,Colombi M,Agnelli G,Grassi M,de G

    更新日期:2016-08-01 00:00:00

  • Prevalence and time course of microembolic signals in patients with acute stroke. A prospective study.

    abstract:BACKGROUND AND PURPOSE:Cerebral emboli can be identified by the presence of typical microembolic signals (MES) in transcranial Doppler (TCD) spectral curves. The usefulness of this technique was studied by evaluating the prevalence and time course of MES in patients with acute stroke. In addition, we examined the influ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.28.2.358

    authors: Sliwka U,Lingnau A,Stohlmann WD,Schmidt P,Mull M,Diehl RR,Noth J

    更新日期:1997-02-01 00:00:00

  • Genetic Imbalance Is Associated With Functional Outcome After Ischemic Stroke.

    abstract::Background and Purpose- We sought to explore the effect of genetic imbalance on functional outcome after ischemic stroke (IS). Methods- Copy number variation was identified in high-density single-nucleotide polymorphism microarray data of IS patients from the CADISP (Cervical Artery Dissection and Ischemic Stroke Pati...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.118.021856

    authors: Pfeiffer D,Chen B,Schlicht K,Ginsbach P,Abboud S,Bersano A,Bevan S,Brandt T,Caso V,Debette S,Erhart P,Freitag-Wolf S,Giacalone G,Grau AJ,Hayani E,Jern C,Jiménez-Conde J,Kloss M,Krawczak M,Lee JM,Lemmens R,Leys D

    更新日期:2019-02-01 00:00:00

  • Symptomatic intracranial hemorrhage after stroke thrombolysis: comparison of prediction scores.

    abstract:BACKGROUND AND PURPOSE:Several prognostic scores have been developed to predict the risk of symptomatic intracranial hemorrhage (sICH) after ischemic stroke thrombolysis. We compared the performance of these scores in a multicenter cohort. METHODS:We merged prospectively collected data of patients with consecutive isc...

    journal_title:Stroke

    pub_type: 杂志文章,多中心研究

    doi:10.1161/STROKEAHA.113.003806

    authors: Strbian D,Michel P,Seiffge DJ,Saver JL,Numminen H,Meretoja A,Murao K,Weder B,Forss N,Parkkila AK,Eskandari A,Cordonnier C,Davis SM,Engelter ST,Tatlisumak T

    更新日期:2014-03-01 00:00:00

  • Predictors for Cerebral Edema in Acute Ischemic Stroke Treated With Intravenous Thrombolysis.

    abstract:BACKGROUND AND PURPOSE:Cerebral edema (CED) is a severe complication of acute ischemic stroke. There is uncertainty regarding the predictors for the development of CED after cerebral infarction. We aimed to determine which baseline clinical and radiological parameters predict development of CED in patients treated with...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.117.018223

    authors: Thorén M,Azevedo E,Dawson J,Egido JA,Falcou A,Ford GA,Holmin S,Mikulik R,Ollikainen J,Wahlgren N,Ahmed N

    更新日期:2017-09-01 00:00:00

  • Cerebral neutrophil recruitment, histology, and outcome in acute ischemic stroke: an imaging-based study.

    abstract:BACKGROUND AND PURPOSE:Evidence now exists for a pathogenic role for neutrophils in acute cerebral ischemia. We have studied the patterns and temporal profile of cerebral neutrophil recruitment to areas of acute ischemic stroke (IS) and have attempted to correlate this with neurological status and outcome. METHODS:Pat...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.STR.0000130592.71028.92

    authors: Price CJ,Menon DK,Peters AM,Ballinger JR,Barber RW,Balan KK,Lynch A,Xuereb JH,Fryer T,Guadagno JV,Warburton EA

    更新日期:2004-07-01 00:00:00

  • Incremental predictive value of carotid inflammation in acute ischemic stroke.

    abstract:BACKGROUND AND PURPOSE:Microwave Radiometry (MWR) allows in vivo noninvasive assessment of internal temperature of tissues. The aim of the present study was to evaluate in patients with ischemic stroke and bilateral carotid plaques (1) whether ipsilateral carotid arteries exhibit higher temperature differences (ΔT), as...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.114.007526

    authors: Toutouzas K,Benetos G,Drakopoulou M,Deligianni C,Spengos K,Stefanadis C,Siores E,Tousoulis D

    更新日期:2015-01-01 00:00:00

  • The beta-hCG+erythropoietin in acute stroke (BETAS) study: a 3-center, single-dose, open-label, noncontrolled, phase IIa safety trial.

    abstract:BACKGROUND AND PURPOSE:Animal data suggest the use of beta-human chorionic gonadotropin followed by erythropoietin to promote brain repair after stroke. The current study directly translated these results by evaluating safety of this sequential growth factor therapy through a 3-center, single-dose, open-label, noncontr...

    journal_title:Stroke

    pub_type: 杂志文章,多中心研究

    doi:10.1161/STROKEAHA.109.574343

    authors: Cramer SC,Fitzpatrick C,Warren M,Hill MD,Brown D,Whitaker L,Ryckborst KJ,Plon L

    更新日期:2010-05-01 00:00:00

  • Glucagon-Like Peptide-1 Receptor Agonists and Prevention of Stroke Systematic Review of Cardiovascular Outcome Trials With Meta-Analysis.

    abstract::Background and Purpose- The purpose of this study was to conduct a meta-analysis of CVOTs (cardiovascular outcome trials) to evaluate the effect of glucagon-like peptide-1 receptor agonists therapy in reducing the risk of stroke in patients with type 2 diabetes mellitus. Methods- PubMed and other electronic sources we...

    journal_title:Stroke

    pub_type: 临床试验,杂志文章

    doi:10.1161/STROKEAHA.119.027557

    authors: Bellastella G,Maiorino MI,Longo M,Scappaticcio L,Chiodini P,Esposito K,Giugliano D

    更新日期:2020-02-01 00:00:00

  • Sarpogrelate-Aspirin Comparative Clinical Study for Efficacy and Safety in Secondary Prevention of Cerebral Infarction (S-ACCESS): A randomized, double-blind, aspirin-controlled trial.

    abstract:BACKGROUND AND PURPOSE:The antiplatelet agent sarpogrelate is a selective inhibitor of 5-hydroxytryptamine receptors. The purpose of this study was to compare the efficacy and safety of sarpogrelate with those of aspirin in Japanese ischemic stroke patients. METHODS:In total, 1510 patients with recent cerebral infarct...

    journal_title:Stroke

    pub_type: 杂志文章,随机对照试验

    doi:10.1161/STROKEAHA.107.505131

    authors: Shinohara Y,Nishimaru K,Sawada T,Terashi A,Handa S,Hirai S,Hayashi K,Tohgi H,Fukuuchi Y,Uchiyama S,Yamaguchi T,Kobayashi S,Kondo K,Otomo E,Gotoh F,S-ACCESS Study Group.

    更新日期:2008-06-01 00:00:00

  • Effects of statins on endothelium and signaling mechanisms.

    abstract::Endothelium dysfunction may result from increased production of reactive oxygen species and decreased availability of nitric oxide. Inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase (ie, statins) exert cholesterol-independent vasoprotective effects that are mediated, in part, through the inhibiti...

    journal_title:Stroke

    pub_type: 杂志文章,评审

    doi:10.1161/01.STR.0000143319.73503.38

    authors: Endres M,Laufs U

    更新日期:2004-11-01 00:00:00

  • Newly Diagnosed Leptospirosis and Subsequent Hemorrhagic Stroke: A Nationwide Population-Based Cohort Study.

    abstract:BACKGROUND AND PURPOSE:Preceding infection as an important risk factor for ischemic stroke has been reported but neglected for hemorrhagic stroke, especially in young and middle-aged patients. This study investigates whether newly diagnosed leptospirosis is associated with an increased risk of stroke. METHODS:We ident...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.120.029998

    authors: Li KY,Chou MC,Wei JC,Lin MC,Hung YM,Chang R

    更新日期:2021-01-26 00:00:00