Extending over five years, the funding will support three new research projects: one of the first clinical trials of statin medications as a potential stroke treatment; an imaging study of brain reorganization caused by stroke; and a novel stroke educational and behavior modification program.
The studies draw on the expertise of clinician-scientists at Columbia's College of Physicians and Surgeons and Columbia's Mailman School of Public Health. Patients from NewYork-Presbyterian/Columbia will be enrolled in clinical trials focused on treating stroke in its acute phases - immediately after onset.
"This grant validates the quality of our prior research and represents important opportunity for discovery of new treatment modalities for the 700,000 people in the U.S. who suffer strokes every year," says Gerald D. Fischbach, M.D., executive vice president and dean, Columbia University Medical Center.
"Translational studies, which the award supports, are critical to academic medical centers such as our own, allowing research advances in the laboratory to bear fruit at the bedside," says Herbert Pardes, M.D., president and CEO of NewYork-Presbyterian Hospital. "Part of this translational research includes the development of protocols for stroke treatment aimed at reducing hospital stays and improving outcomes nationwide."
"Importantly, the SPOTRIAS Award will also support improved delivery of stroke care for high-risk persons in medically underserved areas, including Washington Heights and Inwood," adds Dr. Pardes.
"As a SPOTRIAS site, our goal is to reduce disability and mortality by promoting rapid diagnosis and effective interventions in acute stroke patients," says principal investigator Ralph L. Sacco, M.D., M.S., associate chairman of neurology and professor of neurology and epidemiology at Columbia University College of Physicians and Surgeons, and director of stroke and critical care at NewYork Presbyterian/Columbia. "Columbia University Medical Center, together with our colleagues at NewYork-Presbyterian Hospital/Columbia, is uniquely qualified to do this because of our broad wealth of talent in neurology, emergency medicine, biostatistics, epidemiology, and sociomedical science."
The project, called the New York Columbia Collaborative (NYCC) SPOTRIAS, is the only new SPOTRIAS grant issued this year. Four other institutions have ongoing SPOTRIAS grants.
The three research efforts:
- The safety study of high-dose statins - typically used to lower cholesterol - is led by Mitchell S.V. Elkind, M.D., M.S., assistant professor of neurology and assistant attending neurologist. The study evolved from another Columbia study, the Northern Manhattan Stroke Study (NOMASS), which has found that people already taking statins before having a stroke tended to have less severe strokes and a better recovery. Tests of high-dose statins as a stroke treatment in animal models have shown promise.
- Randolph S. Marshall, M.D., M.S., associate professor of clinical neurology and associate attending neurologist, is directing the fMRI study to see if altered patterns of brain activity shortly after the onset of stroke can predict recovery. Dr. Marshall's preliminary studies have demonstrated emergence of activity on the other side of the brain from where the stroke is. If these differences have functional significance, the researchers will investigate whether treatment can mitigate the neurological deficits.
- Bernadette Boden-Albala, Dr.P.H., assistant professor of sociomedical sciences in neurology, leads the Stroke Warning Information and Faster Treatment study to see if a novel technique in behavioral change directed at stroke survivors will result in quicker patient response in getting to the hospital and ease in navigation of the Emergency Department if they have stroke symptoms. (Stroke survivors are at increased risk of having additional strokes.) In the future, this type of stroke education will be offered to more people in northern Manhattan to see if the information can help facilitate quicker treatment of stroke in this population.
The project also has four core organizational elements for patient access, biostatistics and data management, blood and tissue pathology, and a career development element to train future stroke researchers.
Columbia University Medical Center provides international leadership in basic and clinical research, medical education, and health care. The medical center includes the dedicated work of many physicians, scientists, and other health professionals at the College of Physicians & Surgeons, the School of Dental & Oral Surgery, the School of Nursing, the Mailman School of Public Health, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. The pioneering tradition of Columbia University health scientists, who achieved some of the 20th century's most significant medical breakthroughs, continues today.
New York-Presbyterian Hospital is the largest not-for-profit, non-sectarian hospital in the country. It provides state-of-the art inpatient, ambulatory and preventive care in all areas of medicine at five major centers: New York-Presbyterian hospital/Columbia University Medical Center, New York-Presbyterian Hospital/Weill Cornell Medical Center, Children's Hospital of New York-Presbyterian, the Allen Pavilion, and the Westchester Division. It consistently ranks as one of the top hospitals in the country U.S. News & World Report's guide to "America's Best Hospitals." The New York-Presbyterian Healthcare System - an affiliation of acute-care and community hospitals, long-term care facilities, ambulatory sites, and specialty institutes -serves one in four patients in the New York metropolitan area.