International stroke research

The first day of the Win­ter School pro­vided an over­view of risk fac­tors and pre­ven­tion, treat­ment con­cepts and the cur­rent status of exper­imental stroke re­search on new thera­py con­cepts. Prof Karl Georg Häu­sler, Senior Con­sultant in Neu­rology at the Uni­versi­ty Hos­pital of Würzburg (UKWs), intro­duced the topic of strokes, high­light­ed risk fac­tors and dis­cuss­ed ap­proaches to prima­ry and sec­ondary pre­ven­tion as well as acute treat­ment for stroke pa­tients.

The acute care of is­chaemic stroke pa­tients in­cludes the time-critical appli­cation of treat­ment op­tions such as thromboly­sis and thrombectomy. Prof Mirko Pham, Direc­tor of the Insti­tute of Diag­nostic and Inter­ven­tional Neu­rora­diolo­gy at the UKW, pre­sent­ed these two treat­ment mile­stones in stroke care, focus­ing in par­ticular on the as­pects of safety and effi­cacy.

In his lec­ture, Prof Mi­chael Schuhmann, Head of the Clini­cal La­bora­tory of Neu­rology at the UKW and Pro­fessor of Ex­peri­men­tal Stroke Re­search, demonstrated the im­portance of col­la­bora­tion be­tween re­searchers in basic and clini­cal re­search. He ex­plained this using the ex­ample of thrombo­cytes, in­flam­mato­ry pro­cesses and their influ­ence on pro­gres­sive in­farct growth.

The inter­active even­ing event, organ­ised by Emily Har­vey and Harry Jen­kins, staff from Impe­rial Col­lege Lon­don, pro­vided a unique op­por­tunity for stu­dents, staff and pro­fes­sors to work to­gether in teams and deep­en their knowledge of atrial fibril­lation and in­trac­ere­bral bleed­ing using an ongo­ing clini­cal trial, the PRESTIGE-AF study. Ac­tive partic­ipa­tion in an es­cape room not only pro­moted un­der­stand­ing of the clini­cal pic­tures, but also ena­bled prac­tical appli­cation in iden­tify­ing suita­ble pa­tients for clini­cal trials.

The sec­ond day of the Win­ter School fo­cuss­ed on im­proved sec­ondary pre­ven­tion and after­care fol­low­ing a stroke. Prof Charles Wolfe from King's Col­lege Lon­don gave an im­pres­sive presentation on the rela­tion­ship be­tween socio­eco­nomic fac­tors and stroke risk and out­comes after a stroke. He shed light on the com­plex rela­tion­ship be­tween socio­eco­nomic fac­tors and the distri­bution of risk fac­tors.

Stu­dents from the Elite Grad­uate Pro­gram “Translational Medi­cine” pre­sent­ed topics cover­ing the treat­ment and pre­ven­tion of in­trac­ere­bral haemor­rhage, the treat­ment and pre­ven­tion of sub­arachnoid haemor­rhage and stroke care in de­velop­ing coun­tries.

Julia Schmidt and Anna-Lena Hof­mann from the Insti­tute of Clini­cal Epi­demi­ology and Bi­ometry (ICE-B) at the Uni­versi­ty of Würzburg and the Insti­tute of Medi­cal Data Sci­ence (ImDS) at the Uni­versi­ty Hos­pital then pre­sent­ed the CAEHR pro­ject, which aims to opti­mise healthcare for pa­tients with cardi­ovas­cular dis­eases by providing rele­vant health in­for­mation in a timely man­ner and intro­duc­ing intel­ligent data-driven ser­vices along the care path­way.

Anna-Lena Hof­mann and Mar­tha Schutzmei­er from ICE-B pre­sent­ed rele­vant results of the struc­tured, cross-sectoral after­care pro­gramme (SANO). By im­prov­ing pa­tient after­care, the SANO study was able to show posi­tive ef­fects with regard to the con­trol of cardi­ovas­cular risk fac­tors, such as smok­ing and hyper­lipi­dae­mia. Lena Schmidbau­er then pre­sent­ed the fol­low-up study SANO EX­TEND, which will inves­tigate the long-term ef­fects 5-6 years after the stroke.

Dr Chris­toph Schwarzbach, Senior Phy­sician at the Lud­wigs­hafen Clinic pre­sent­ed the chal­lenges of stroke after­care. It be­came clear that the play­ers in this field are com­plex and that after­care ex­tends far be­yond sec­ondary pre­ven­tion. Suc­cess­ful man­age­ment re­quires co-operation and mul­tidis­cipli­nary treat­ment.

An­other im­portant topic in stroke after­care is post-stroke fa­tigue. Prof Gilli­an Mead from the Uni­versi­ty of Edin­burgh pre­sent­ed stud­ies on this as­pect. Around half of stroke pa­tients suffer from post-stroke fa­tigue; in about a third of pa­tients, it im­proves with­out spe­cific treat­ment. Prof Mead pre­sent­ed stud­ies on phar­maco­logi­cal and non-pharma­colog­ical inter­ven­tions, which show some prom­ise. Con­sensus rec­om­men­da­tions from the Third Stroke Re­covery and Reha­bilita­tion Roundtable (2023) pro­vide ad­vice on clini­cal care and a roadmap for future re­search.

The sixth joint Win­ter School "Transla­tional Medi­cine and Clini­cal Sci­ence" was thus dedi­cated to a broad spec­trum of stroke top­ics, from exper­imental re­search to after­care and sec­ondary pre­ven­tion. For the first time, it in­clud­ed virtual partic­ipants from the CUHAS uni­versi­ty Mwanza, Tan­zania, and fea­tured con­tribu­tions from re­nowned ex­perts such as Prof Charles Wolfe from King's Col­lege Lon­don and Prof Gilli­an Mead from the Uni­versi­ty of Edin­burgh.

Text: Dr. Steffi Jírů -Hillmann, Elite Graduate Program "Translational Medicine"