Two different treatments for stroke victims- neither one immediate (one after 3 days, the other later on)- have been discussed  in the scientific arena

lately.  One therapy is based upon pharmacological changes, the other involves stem cell therapy.

Strokes (some $ 50 billion of our health care costs) describe the situation when the brain becomes oxygen deprived (due to a broken or blocked blood vessel).  Cells die off in this brain region (the infarct zone); they cannot be revived, but replacement via stem cells or perhaps rewiring the cells in the peri-infarct zone can reduce the long-term disability status of the brain.

A group of researchers under Dr. Carmichael of UCLA published data for their pharamacological treatment for strokes in Nature.  The peri-infarct zone has heightened neuroplasticity (which lets remapping functionality to occur); the presence of GABA (gamma aminobutyric acid) seems to mediate this activity.  GABA, which is an inhibitory neurotransmitter, shuts down brain functions where it accumulates.  In so doing it helps the brain to conserve energy and survive the traumatic oxygen deficit.  GABA may even put the brain into comatose state (dormancy).

Knowing that zolpidem (a “sleeping pill”) has been able to break the hold of GABA (it wakes UP the dormant brain, instead of serving the normal function of inducing sleep), the researchers tried to block the effects of GABA in mice.  This helped them recover mobility; since mice are normally less responsive to GABA, this finding means that humans should be even more affected by such therapy.

The normal treatment regimen is to provide thrombolytic drugs immediately after a stroke.  These clot-breaking drugs limit the size of the affected brain area.  This therapy would be attempted some three (3) days after a stroke ensued (sooner treatment worsens the damage).

Still later phase therapy could include stem cell therapy.  To advance that modality, the first of twelve patients was treated in Glasgow (Southern General Hospital) via fetal stem cell injection (ReNeuron Group PLC) into the affected area of the brain.  This first patient was provided a low dose of cells, in an attempt to assess the procedure’s safety.  The next patients will be subjected to increasing dosages of stem cells.  The additional patients will have their brain function assessed to determine efficacy.  All twelve of these patients are over the age of 60 and have demonstrated no improvement in their conditions for years; they will be monitored over the next two (2) years to determine the safety of the injections.  After adequate safety has been documented, other patients will be included in the study and efficacy will be the objective of that portion of the effort.

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