Exploring the latest strategies in stroke prevention and neurorecovery from the 17th SSNN International Summer School of Neurology
A stroke doesn't end when the initial emergency is over. For millions of survivors worldwide, the event marks the beginning of a new, challenging journey to reclaim their lives, facing the persistent risk of another attack and the often-devastating aftermath of cognitive and physical decline.
In 2022, leading neurologists from across the globe gathered at the 17th SSNN International Summer School of Neurology to map out the latest strategies in this ongoing battle 1 . Their mission: to translate cutting-edge research into real-world practices for preventing secondary strokes and repairing the damaged brain.
This article delves into the fascinating science of neurorecovery, exploring how innovative therapies from dual antiplatelet regimens to electrical stimulation are offering new hope and a future for those living in the shadow of stroke 1 .
Leading experts from around the world gathered to share breakthrough research in stroke care and recovery.
The guiding principle in modern stroke care, as emphasized by Professor Natan Bornstein, is the powerful adage, "don't let stroke strike twice" 1 . This focus on tertiary prevention is critical because a first stroke significantly increases the risk of a second, which can lead to more severe disability or death.
A first stroke increases the risk of a second, more severe stroke.
One of the most significant advances in secondary prevention has been the refinement of Dual Antiplatelet Therapy (DAPT). This treatment, which involves using two different anti-clotting medications, has a research history spanning over 25 years 1 .
For patients who have suffered a mild ischemic stroke or a high-risk Transient Ischemic Attack (TIA), DAPT has proven highly effective in preventing the formation of new blood clots that could cause a second, potentially more devastating, stroke 1 .
Early research begins on dual antiplatelet approaches
First major clinical trials show promise
Refined protocols for specific patient groups
Current gold standard for secondary prevention
| Strategy | Description | Key Takeaway |
|---|---|---|
| Dual Antiplatelet Therapy (DAPT) | Using two antiplatelet medications to prevent blood clots 1 . | Most effective for patients with mild ischemic stroke or high-risk TIA 1 . |
| Arterial Revascularization | A procedure to reopen blocked arteries in the brain 1 . | The success of recanalization is a major predictor of patient outcomes 1 . |
| Multidimensional Approaches | Involving a team of specialists for comprehensive care 1 . | Crucial for addressing complex issues like post-stroke depression 1 . |
While prevention is paramount, the congress placed a strong emphasis on neurorehabilitation—the process of helping the brain recover and rewire itself after injury. Professor Dafin Muresanu, President of the European Federation of NeuroRehabilitation Societies (EFNR), outlined three crucial pillars for effective brain protection and recovery 1 :
Developing strong theories and validating them with basic research 1 .
Rigorously checking the effectiveness of new treatments 1 .
Using data-driven parameters to guide clinical practice 1 .
Central to this process are two powerful, interconnected biological sequences: neuroprotection (shielding brain cells from further death) and neurorecovery (actively building new connections) 1 . Researchers are now finding ways to enhance the brain's innate plasticity—its ability to adapt and change—to fuel these processes.
A key to recovery lies in understanding that damage from a stroke alters the brain's normal activity and connectivity 1 . To tackle this, scientists are exploring neuromodulation—the technique of altering neural activity by delivering targeted stimulation to specific sites in the nervous system 1 .
Professor Jesse Dawson from the University of Glasgow presented compelling research on using VNS after an ischemic stroke to improve upper limb motor function 1 .
The results from this and similar studies have been promising, showing that targeted neuromodulation can create task-specific plasticity, meaning the brain adapts in a very precise way to the skills being practiced 1 .
The progress in stroke research relies on a combination of advanced technologies and sophisticated biological agents.
| Tool / Substance | Function / Description |
|---|---|
| Vagus Nerve Stimulation (VNS) | A device that delivers electrical pulses to the vagus nerve to enhance brain plasticity during rehabilitation 1 . |
| Cerebrolysin | A neuroprotective drug that has been shown to inhibit endogenous inflammatory pathways and have positive effects on neuroplasticity 1 . |
| Brain-derived Neurotrophic Factor (BDNF) | A protein that acts as a key biomarker and growth factor for neuron health and synaptic plasticity; its levels can be enhanced through interventions like electrical stimulation 1 . |
| Exosomal microRNA | Tiny vesicles released by cells that can transfer genetic material; studied as biomarkers for monitoring treatment response in diseases like Multiple Sclerosis 1 . |
| Dual Antiplatelet Therapy (DAPT) | A combination of anti-clotting drugs used as a gold-standard pharmaceutical intervention for secondary stroke prevention 1 . |
The findings from the 17th SSNN International Summer School of Neurology paint a clear picture: the future of stroke care is integrative. There is no single magic bullet. Instead, the most significant gains for patients will come from combining the best available treatments—from time-tested DAPT regimens to innovative neuromodulation techniques and plasticity-enhancing drugs like Cerebrolysin 1 .
As Professor Muresanu concluded, the most effective way forward is for specialists to work together, breaking down the barriers between different disciplines to create a seamless continuum of care 1 . This collaborative spirit, backed by rigorous science and a deepening understanding of the brain's remarkable capacity to heal, is turning the tide against stroke, offering survivors not just longer lives, but lives lived with greater independence and quality.
Breaking down barriers between disciplines for better patient outcomes.
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