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International stroke research

Topics of the Winter School ranged from experimental to clinical research and health services research on stroke. For the first time, students from the Master's programme in Epidemiology and Biostatistics at the Catholic University of Health and Allied Science (CUHAS) Mwanza, Tanzania, also took part (virtually).

Prevention, treatment & experimental 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.

Secondary prevention & stroke aftercare

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"