Improvement in stroke and trauma patients

A study conducted at the Institute of Neurological Recovery in the US has revealed significant improvement in stroke  patients receiving the anti-inflammatory drug etanercept – even years after the original traumatic event.  The study will be published in the journal CNS Drugs.  

Dr Edward Tobinick, lead author of the report, has devised a novel way of administering etanercept, a compound which selectively binds inflammatory molecules  that are present up to years after a stroke has occurred.  The study was conducted over two years, using 629 patients.  617 patients  were treated on average 42 months after their stroke –  the remaining 12 had suffered traumatic brain injury (TBI)  some 115 months previously.  Hence the various improvements noted were a surprise; conventional wisdom suggests it is impossible for significant improvement to occur after such an extended period.  Nevertheless, statistically significant changes in patients were noted, including decreases in motor impairment and increased cognition.

It is true that a battery of drug treatments exists that are designed to tackle the effects of stroke, prevent complications and help prevent a further stroke occurring.  These may include anticoagulants, anti-hypertensives and anti-inflammatories.  However, these are usually targeted at patients shortly after their traumatic brain event, with the hope of relieving the pressure on the still-fragile brain.   There are not treatments commonly devised for chronic stroke and brain trauma.  For the long term patients and their carers are advised to use as much physical and mental therapy as they can.  In fact, it is often thought that the rehabilitation process should be more intense.

According to Steven Ralph in Australia, “these results represent a sea change in the therapeutic possibilities for stroke and TBI patients”.  Such ‘radical breakthroughs’ are rare – this finding has the potential to radicalise current chronic brain injury treatment.