Stroke is a leading cause of serious adult disability and death in the United States. A significant proportion of stroke survivors require long-term rehabilitation. NICHD is one of several federal agencies and NIH Institutes that supports and conducts research on stroke. NICHD’s research includes examining underlying mechanisms of stroke, improving treatment, creating preventive strategies, and developing methods and technologies for rehabilitation.
The NICHD conducts and supports a variety of research activities on stroke and its rehabilitation. Through both its extramural and intramural research projects, the NICHD seeks to better understand the following:
- How to develop and improve methods of stroke rehabilitation. Research projects involve developing and assessing rehabilitation therapies and interventions designed to improve function, quality of life, and outcomes for stroke patients.
- Imaging methods for stroke. Research at the NICHD involves developing brain imaging methods to better identify and diagnose affected regions of acute stroke.
- Stroke treatment and caregiving. This research includes studies of combinations of pharmacological, surgical, and physical therapies to improve stroke outcomes and measuring the burden of caregiving at different times post stroke.
- Underlying mechanisms of stroke. Studies include efforts to find stroke susceptibility genes, understand vascular development, and examine molecular mechanisms of neuronal damage during stroke.
- Secondary conditions of stroke. Research projects aim to understand and improve treatment of secondary conditions such as muscle atrophy, speech and language problems, pain, and psychological and psychosocial effects of these conditions.
Stroke is a leading cause of serious disability and death in the United States. Although the majority of individuals who sustain a stroke survive, a significant proportion of survivors require rehabilitation, and nearly one-third have some type of permanent disability. Among those who survive stroke, 50% are alive more than 5 years after the event, which means that rehabilitation needs continue well after the initial event. NICHD supports and conducts research to better understand stroke, its prevention, treatment, and methods for rehabilitation.
Institute Activities and Advances
NICHD supports and conducts research to better understand stroke, its prevention, treatment, and methods for rehabilitation through several organizational units. NICHD-supported research covers multiple effects of stroke, including motor, cognitive, swallowing, and communication deficits.
- National Center for Medical Rehabilitation Research (NCMRR)
- Projects involve studying how to improve recovery of abilities that can be affected by stroke, including movement, mobility, and language, as well as investigating potential treatments for other side effects of stroke, such as mental health problems. Other ongoing areas of research include studies of combinations of pharmacological, surgical, and physical therapies to improve stroke outcomes; the effect of compensatory training for unimpaired extremities; and measuring caregiver burden at different times post stroke.
- The center supports clinical studies of interventions that promote development of emotional, cognitive, and physical attributes. The work also supports basic behavioral studies on factors such as plasticity. Other work focuses on identifying individuals with disabilities and measuring their abilities to investigate the disabilities' effects on the individual and the family. The rehabilitative engineering portion of this program develops and supports the application of engineering and bioengineering principles to study the rehabilitation of individuals with disabilities. A major focus of the Center's mission is to support research for developing assistive technology aimed at helping individuals with disabilities perform daily activities.
- The center supports basic research on substrate responses to injury and on strategies to promote regeneration, recovery, plasticity, adaptation, and recovery. This type of research could include studies of activity-mediated processes, such as treadmill training and constrained-use therapy for movement problems from stroke and other conditions; muscle and bone function, such as contractures and sarcopenia that result from chronic disuse of muscles; secondary conditions, such as pain, depression, and cardiovascular dysfunction; and genomic influences, meaning that slight differences in genetic code could influence response to injury and interventions.
- One of the longstanding program project grants supported by the Intellectual and Developmental Disabilities Branch (IDDB) focuses on the natural history of a large cohort of individuals with MELAS (Mitochondrial Encephalopathy, Lactic Acidosis, and Stroke-like Episodes) syndrome. Researchers involved with this project have examined treatments for this and related disorders as well as genes that may be involved.
- Division of Intramural Research (DIR)
- The Section on Cellular and Synaptic Physiology studies the development and regulation of excitability in the brain’s cortex. In a recent study, section scientists and their colleagues described how brain cells known as dentate gyrus granule cells shift which roles they play in memory as they age, a discovery that has implication for treating people who have experienced strokes. (PMID: 22365813)
- The Section on Neurophysiology and Biophysics studies how dysfunction of ionotropic glutamate receptor (iGluR) activity mediates several neurological and psychiatric diseases and damage during stroke. This group analyzes iGluR function at the molecular level.
- The aim of the Section on Tissue Biophysics and Biomimetics is developing novel next-generation in vivo imaging methods to gain a better understanding of brain function and organization and to improve the diagnosis of neurological and developmental disorders, including stroke.
- The Section on Vertebrate Organogenesis research group studies zebrafish vasculature. Projects include a genetic screen to identify hemorrhagic stroke—susceptibility genes and molecular analysis of the formation and maintenance of vertebrate vasculature.