National Stroke Awareness Month

A co-worker of mine had a stroke while chatting with me at a picnic table on the campus of the University of Houston about a decade ago.

There we were in the sunshine, probably commiserating about work or the heat, and she said she was feeling a bit off. I can’t remember if it was a numbness in her face or in her hand or both. I do remember her joking that maybe she was having a stroke.

I wasn’t sure how concerned to be. She looked perfectly fine and wasn’t, in my youthful and erroneous estimation, at 40-something really old enough to be having a stroke. Maybe just the heat, I reasoned.

When the episode didn’t pass, we decided she should get inside and so we parted ways. She somehow made the quarter-mile trek by herself to her building before her condition worsened to the point that her officemates had to get her medical attention.

If caught early, most strokes are treatable. Columbia University’s neurology department offers this list of signs and symptoms: numbness or weakness in the face, arms or legs, often on one side of the body; episodes of dizziness; loss of vision in one eye or double vision; difficulty speaking or understanding speech; and a severe, sudden headache.

I regret that I didn’t recognize that my co-worker was having a stroke, despite the now-obvious-to-me signs. I regret that I allowed her return to her office alone instead of taking her inside the nearest building, staying with her and calling campus police. I regret that I failed her on just about every level. 

It wasn’t easy, but she recovered and is doing just fine now. Thank goodness.

It was President George H.W. Bush who signed a proclamation in 1989 to establish May as National Stroke Awareness Month.

Presidential proclamation 5795 noted that about 600,000 Americans were affected by stroke annually. As the population has aged in the decades since, that number has risen to almost 800,000.

Bush himself was later affected by stroke. He died late last year of vascular parkinsonism, a condition that mimics Parkinson’s disease but that is caused by a series of small strokes rather than neurodegeneration.

Below you’ll find a collection of recent research published in ASBMB journals about the mechanisms of stroke. The collection was curated primarily by Jonathan Griffin, our science communicator.

How the brain rebuilds after stroke

Restoring the complex network of synapses in the brain after stroke-induced injury requires careful reorganization of the neuronal cytoskeleton. In a study in the Journal of Biological Chemistry, a team of researchers report that the enzyme uPA and its receptor uPAR help orchestrate this repair process. They discovered that uPA–uPAR binding induces synthesis of the protein ezrin in the injured brain, which triggers cytoskeletal reorganization, promoting recovery of synaptic contacts. Read the paper.

Let’s talk about aphasia

When a blood vessel gets blocked or ruptures, as in the case of stroke, and blood can’t get to the language centers of the brain, aphasia can set in. Aphasia affects a patient’s ability to speak, understand speech and/or read and write. Find out more about the neural plasticity and therapies that help patients recover.

New drug target could save cells from stroke

The protein Cited2 is vital for a multitude of life-sustaining processes such as development and metabolism. But in recent experiments Cited2 promoted cell death after DNA damage. To uncover whether Cited2 plays a part in neuronal injury after stroke, an international team of researchers studied knockout mice that could not express the protein. They report in the Journal of Biological Chemistry that the protein is required for neuronal cell death after stroke and represents a potential drug target for saving neurons in stroke patients. Read the paper.

Cooling off an inflamed brain

After enduring the initial injury of a stroke, the brain undergoes further damage stemming from inflammation. The protein TIPE2 has demonstrated an ability to temper inflammation but has not been studied in the brain before. In a study in the Journal of Biological Chemistry, a team of researchers in China and the United States show that when this protein is absent in the brains of mice following stroke, the extent of inflammation and injury is far greater. The researchers suggest that targeting TIPE2 could become a new strategy for stroke treatment. Read the paper.

Fatty acids to the rescue

When ischemia occurs in the brain, large amounts of stored fatty acids are released, including arachidonic acid, or AA. Research has shown that 12(S)- and 15(S)-HETE, metabolites of AA, can activate the anti-inflammatory receptor PPARγ in tissues outside of the brain. To find if these molecules provide benefits after stroke, researchers measured activation of PPARγ in a rat model of brain ischemia after delivering 12(S)- and 15(S)-HETE. The results of their study in the Journal of Lipid Research suggest that these metabolites indeed inhibit pro-inflammatory signaling by turning on PPARγ. Read the paper.

Insights into genetic vulnerability to stroke

The enzyme paraxonase-1, or PON1, is known to protect against carotid artery disease, which is a risk factor for stroke. However, previous studies have not shown strong evidence linking PON1 genetic variants to cerebrovascular disease. Recently, a team of researchers analyzed data from the National Heart, Lung, and Blood Institute’s Exome Sequencing Project, which contains genetic information from more than 4,000 participants, of which 496 had experienced strokes. In a study published in the Journal of Lipid Research, they revealed that a rare genetic variation that encodes a less stable version of PON1 strongly associated with stroke and existed almost exclusively in participants of African ancestry. Read the paper.

Drinking milkshakes for science

From 2002 to 2005, about 800 people in Minnesota and Utah drank more than 1,500 milkshakes, and they got to say they were doing it for science. As participants of the Genetics of Lipid-Lowering Drugs and Diet Network, or GOLDN, they were helping researchers better understand cardiovascular risks. The scientists in charge reported last summer in the Journal of Lipid Research that they’d found new uncommon gene variants that affect patients’ response to fenofibrate, a medication that can lower cholesterol and triglyceride levels. Learn more about the study. Read the paper.

How strokes shake up fats

Strokes radically disrupt the phospholipids that serve as building blocks of neuronal membranes. Researchers at Konkuk University in South Korea used a technique called MALDI imaging mass spectrometry to track how particular phospholipids are altered in damaged brain tissue. In a study published in the Journal of Lipid Research they report changes in several specific lipids that are important for cell structure and signaling. They suggest that these lipid measurements could be used as biomarkers for stroke. Read the paper.

About that aspirin a day

It was hematologist Philip W. Majerus who determined that low-dose aspirin prevents blood clots, reducing the risk of heart attack and stroke. Majerus, who died in 2016, showed that aspirin interferes with platelet activation, reducing blood vessel constriction and dialing down the cascade of events that leads clots to form. Read about Majerus’ life and work.

Snakebites and strokes

A bite from a lancehead viper can be fatal. Species in the family, among the most dangerous snakes in Central and South America, have venom that can disrupt blood clotting and cause, among other things, hemorrhages and strokes. Researchers in Sao Paulo report in the journal Molecular & Cellular Proteomics their structural analysis of glycoproteins in the venom that may give insight into toxic proteins’ solubility and stability. Read a story about the team. Read the paper.