Stroke continues to represent the leading cause of long-term disability in Americans. Rehabilitation therapy is provided as standard of care following stroke, as strong evidence supports that it can improve patient outcomes. However, patients show a great deal of variability in their response to post-stroke rehabilitation therapy. While a number of factors have been identified that provide insight into the basis for these inter-subject differences, overall knowledge remains limited. The proposed studies will examine how genetic polymorphisms interact with rehabilitation therapy and with stress to affect treatment-induced recovery after stroke. In this research we build on our prior work and take a unique approach to understanding therapeutic response in stroke survivors. Dr. Holman has addressed the important impact that stress and genetic susceptibilities to stress may have on well-being and health outcomes following trauma. Dr. Cramer has studied stroke recovery and its genetic influences. In collaboration with geneticists in the Center for Human Genetic Research at Massachusetts General Hospital, the team will study how stress and specific genetic factors are related to the response to rehabilitation therapy, and the maintenance of these gains over time. Variability in therapy-induced recovery after stroke is wide. The current studies may provide insight into biological factors underlying this phenomenon, and so may help individualize rehabilitation care.

Public Health Relevance

Stroke is a major cause of human disability, but rehabilitation treatment can reduce this post-stroke disability. The proposed studies will examine how stress and genetic makeup are related to responses to rehabilitation treatments following stroke. By providing insight into biological and stress-related processes underlying response to rehabilitation therapies, this research will contribute to development of personalized treatment plans for stroke survivors.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Research Project (R01)
Project #
1R01NR015591-01
Application #
8877907
Study Section
Special Emphasis Panel (ZRG1-BBBP-T (59))
Program Officer
Tully, Lois
Project Start
2015-06-17
Project End
2020-03-31
Budget Start
2015-06-17
Budget End
2016-03-31
Support Year
1
Fiscal Year
2015
Total Cost
$554,520
Indirect Cost
$169,614
Name
University of California Irvine
Department
Type
Schools of Nursing
DUNS #
046705849
City
Irvine
State
CA
Country
United States
Zip Code
92697
Juth, Vanessa; Chan, Michelle K; Cramer, Steven C et al. (2018) Assessing acute psychological distress in the immediate aftermath of stroke. Eur J Cardiovasc Nurs 17:186-189
Juth, Vanessa; Holman, E Alison; Chan, Michelle K et al. (2016) Genetics as a molecular window into recovery, its treatment, and stress responses after stroke. J Investig Med 64:983-8