We propose a Specialized Program of Translational Research in Acute Stroke (SPOTRIAS) at the University of California, San Diego, Stroke Center (UCSD). The Core facilities and projects will meet SPOTRIAS target goals, increasing the number of thrombolytic-treated patients, particularly those treated within 2 hours following stroke. To achieve this, we offer 4 inter-related projects. 1) To find a simple, serum marker of acute stroke, we will characterize the free fatty acid (FFA) response in acute stroke patients, including the time course. We will determine whether FFA levels correlate with various stroke outcomes, and attempt to distinguish ischemia from common mimics. We will characterize the FFA response associated with effective thrombolysis. 2) To use hypotherrnia to prolong the time window for thrombolysis in a Phase 1 trial, by studying thrombolysis beginning 3 to 6 hours following stroke onset, combined with 24 hours of intravascular cooling. We hypothesize that hypothermia will be safe in such patients. We will proceed to a Phase 2 trial to show that hypothermia reduces hemorrhage rates and improves outcomes in 3 to 6 hour thrombolysis patients. 3) To use a non-invasive, bedside test---contrast enhanced transcranial ultrasoundmto identify vascular occlusion and perfusion defects before and after thrombolysis. We will test whether ultrasound may separate stroke from mimics, and identify potential treatment candidates from among patients with mild or fluctuating deficits presenting within 2 hours. 4) To determine whether novel broadband wireless Internet technology will allow UCSD Stroke Team faculty to direct thrombolysis at remote hospitals by placing audio/video consultation capability at remote Emergency Departments in San Diego. Acute consults may increase the number of 2-hour thrombolytic treatments. These projects are built on the core facilities of the UCSD Stroke Center, which include a nationally recognized stroke team, a training program, a data collection and statistical analysis unit, and a specimen collection and storage facility. All of the needed teams, collaborations, and facilities are in place. The SPOTRIAS program will allow us to enhance and initiate translational research that ultimately will benefit stroke patients by treating more patients under 2 hours, and finding ways to treat additional patients later.

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
Specialized Center (P50)
Project #
5P50NS044148-04
Application #
7111667
Study Section
Special Emphasis Panel (ZNS1-SRB-K (03))
Program Officer
Janis, Scott
Project Start
2003-05-19
Project End
2008-04-30
Budget Start
2006-05-01
Budget End
2007-04-30
Support Year
4
Fiscal Year
2006
Total Cost
$1,309,707
Indirect Cost
Name
University of California San Diego
Department
Neurosciences
Type
Schools of Medicine
DUNS #
804355790
City
La Jolla
State
CA
Country
United States
Zip Code
92093
Chen, P M; Nguyen, D T; Ho, J P et al. (2018) Factors Influencing Acute Stroke Thrombolytic Treatments in Hispanics In the San Diego Region. Austin J Cerebrovasc Dis Stroke 5:
Lyden, Patrick; Hemmen, Thomas; Grotta, James et al. (2016) Results of the ICTuS 2 Trial (Intravascular Cooling in the Treatment of Stroke 2). Stroke 47:2888-2895
Spokoyny, Ilana; Raman, Rema; Ernstrom, Karin et al. (2015) Defining mild stroke: outcomes analysis of treated and untreated mild stroke patients. J Stroke Cerebrovasc Dis 24:1276-81
Spokoyny, Ilana; Raman, Rema; Ernstrom, Karin et al. (2015) Accuracy of First Recorded ""Last Known Normal"" Times of Stroke Code Patients. J Stroke Cerebrovasc Dis 24:2467-73
Coffman, Clarity R; Raman, Rema; Ernstrom, Karin et al. (2015) The ""DeyeCOM Sign"": Predictive Value in Acute Stroke Code Evaluations. J Stroke Cerebrovasc Dis 24:1299-304
Guluma, Kama Z; Liebeskind, David S; Raman, Rema et al. (2015) Feasibility and Safety of Using External Counterpulsation to Augment Cerebral Blood Flow in Acute Ischemic Stroke-The Counterpulsation to Upgrade Forward Flow in Stroke (CUFFS) Trial. J Stroke Cerebrovasc Dis 24:2596-604
Neil, William P; Raman, Rema; Hemmen, Thomas M et al. (2015) Association of Hispanic ethnicity with acute ischemic stroke care processes and outcomes. Ethn Dis 25:19-23
Schlick, Konrad H; Hemmen, Thomas M; Lyden, Patrick D (2015) Seizures and Meperidine: Overstated and Underutilized. Ther Hypothermia Temp Manag 5:223-7
Lyden, Patrick D; Hemmen, Thomas M; Grotta, James et al. (2014) Endovascular therapeutic hypothermia for acute ischemic stroke: ICTuS 2/3 protocol. Int J Stroke 9:117-25
Spokoyny, Ilana; Raman, Rema; Ernstrom, Karin et al. (2014) Imaging negative stroke: diagnoses and outcomes in intravenous tissue plasminogen activator-treated patients. J Stroke Cerebrovasc Dis 23:1046-50

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