A world-first human stroke trial

Stroke patients will have their brains and blood cooled in a world-first human trial in Melbourne.

Of the 60,000 Australians who have a stroke each year, only about 20% are eligible to be treated with the clot-busting drug tPA – tissue Plasminogen activator – that reopens blood supply to the brain.

But this new hypothermia technique aims to slow metabolism in the brain and extend the time stroke patients can be given the drug.

Associate Professor David Howells, head of the Florey Neuroscience Institute’s stroke unit, told DPSe News, if this multi-centre international trial proved successful, tens of thousands of Australians each year could be saved from the life-long disabilities caused by stroke.

“Once a blood vessel is blocked after a stroke, it’s being starved of oxygen and starts to die off,” Professor Howells said.

“If we can slow down the rate of damage to brain tissue and blood vessels, we will buy ourselves more time to safely clot-bust and restore blood flow.

“Instead of there being a 4 1/2-hour window where we can use tPA, you potentially have theoretically longer,” he said.

While the trial of 1,500 patients is happening this year in Europe, Professor Howells and his Melbourne team will be working on developing a biomarker to measure if the treatment is working for individual patients.

The treatment works by lowering a patients’ core temperature by three degrees to 34 degrees for 24 hours. This is done by placing cooling pads around the body or injecting into the blood of a tiny device which acts like a refrigerator.

Professor Howells said if proven effective, it would require a “major reshuffling” of hospital resources.

Professor Howells said patients of any age were recommended to participate in the research.

“All sorts of patients can and should take part regardless of age. Most patients who have stroke are the elderly. As you get older, the risk of strokes goes up,” Professor Howells said.

The majority of the trial will be conducted in Europe and will be ongoing for five years due to recruitment of patients and evaluation of the results.

“Some people never realise how much really is going on in the Australian forefront of stroke research. There are a number of different levels,” Professor Howells said.

“These types of research often have a large collaborative team. Nothing ever takes place in one place,” he said.