After a stroke, patients can experience a wide range of symptoms depending on where the stroke occurred in the brain and how severe it was.
Patients who experience facial paralysis and speech impairment after a stroke typically need ongoing speech therapy. At Memorial Regional Hospital, Speech Language Pathologist Joan Parnell works with doctors and patients to develop specialized treatment plans. The treatment begins by understanding the area in the brain where the stroke has occurred.
“Every patient is different, so it varies patient to patient,” Parnell said. “Their age, prior level of function, severity of CVA (cerebrovascular accident), and a patient’s motivation all have an affect on how the treatment is provided and the outcome of treatment.”
A stroke happens when blood flow to an area of the brain is cut off. Brain cells are then deprived of oxygen and begin to die.
“When brain cells die during a stroke, abilities controlled by that area of the brain, such as memory and muscle control, are lost,” according to the National Stroke Association.
When a stroke happens in the left side of the brain, the right side of the body is affected, and when a stroke happens in the right side of the brain, the left side of the body is affected.
The left side of the brain involves speech and language. The left frontal lobe, or Broca’s area, involves speech production. Impairment here usually means the patient can’t form words properly and has slurred or slow speech but can typically understand, she said. The left temporal lobe, or Wernicke’s area, is responsible for comprehension of language.
“When someone has facial paralysis, typically, a speech therapist would have the patient do exaggerated lip, face, tongue exercises, such as smiling, puckering of lips, protruding, lateralizing, and elevating tongue,” Parnell said. “The patient’s prior level of health, severity of CVA/TBI, and motivation/diligence of performing treatment tasks will affect outcomes. Speech therapy is just like any other task — if you don’t practice outside of the treatment room, then typically, your progress is not as great as someone who does.”
Following any brain injury, some patients may experience depression and feel their intelligence has been taken away, Parnell said.
“I typically educate them that they haven’t lost their intelligence, but that a storm has come through their brain and damaged some of the lines/wires, like electrical and phone wires would be damaged in a bad storm,” she said. “They then need to perform therapy to improve the damaged wires of their brain. They may not only feel ‘dumb’ — as they often say to me — or they are embarrassed, so I celebrate the smallest successes to improve their confidence and keep building from there.”
Because these patients have experienced this storm within their brains, it’s important for friends, family and other caregivers to be patient. Parnell suggests keeping commands and directions simple, allowing the person plenty of time to communicate and not answering questions for them.
“Continue to treat them as a loved one, not as a patient.”
The year was closing out…but I had one more opportunity to present my speech to MY insurance company.
But let me back up to when I met JR, my rep. I met JR about 6 years ago.
He called me on the phone…4 years later…a cool-warm call at best. He said he wanted to meet with me to discuss our Auto Insurance. I had this company since 2001 and I didn’t like the service I was getting, so I agreed to meet.
He showed me what he had and he made a convincing case to switch…so I did. Since switching, I had to call JR one time for my daughters car. As soon as I called him, he picked up on the third ring and answered my question! This was the service that I had been waiting for!!! JR, you are the man.
Anyway, I made a luke warm call to HIM, and said I was looking to speak at one of their COMPANY events and do you think you can help. (OK, I think BIG.) A few weeks passed and I got a call from Christi and she wanted me to speak at her upcoming sales meeting. And Christi told me she lived on the same BLOCK as me (about 12 houses down)! I gladly accepted, but now I had to practice my speech again.
I thought “how hard came that be? I gave this speech over 500 times.” Well, it was hard. The first time thru the speech, I was terrible!!! Luckily, I had a few weeks to practice and I THINK I did ok.
I have to ask my wife Jill….to give me the truth…no holding back. In the past, these were tough to hear, but I think this time, I gotten better. I will ask her one the post is done…so she can’t change it!
Allison Pataki and her husband Dave Levy were returning to their Chicago apartment following a walk in the park. He was humming the Bee Gees hit “Stayin’ Alive.”
“Hey Dave! Guess what the name of this song is that you are humming,” said Pataki. “Stayin’ Alive. No wonder you have it stuck in your head. You know about staying alive.”
Levy recalls hearing the song as background music while he did physical therapy following his stroke on June 9, 2015.
“That became his theme song,” said Pataki.
The couple were flying to their Hawaiian babymoon—a getaway before the birth of their daughter, Lilly—when Levy’s life took a threatening turn.
At thousands of feet in the air, Levy turned to his wife and asked, “Does my right eye look weird? I can’t see anything out of it.”
Pataki turned to her college sweetheart and asked, “Dave, are you having a stroke?”
“Maybe,” he replied before losing consciousness.
Within 30 minutes the plane made an emergency landing in Fargo, North Dakota, where Levy, a healthy 30-year-old athlete and surgical resident, was in a coma following a rare bithalamic midbrain stroke.
Five months pregnant and alone, Pataki outwardly appeared calm and composed at the hospital but her body was shaking and shivering in shock. Purchase the book HERE.
Pataki’s parents and in-laws soon arrived at the hospital—and her dad, former New York Gov. George Pataki—temporarily suspended his presidential campaign. Levy’s father—a neurosurgeon—was there to answer questions.
“At one point I asked my mother if I was going to be a widow, if my baby would grow up without ever knowing her father,” Pataki writes in her memoir, Beauty in the Broken Places (Random House).
The best-selling author of historic fiction was at her husband’s bedside when she decided to write daily letters to Levy to not only make sense of her husband’s stroke journey but to create memories for him.
“I thought I would write it all down and maybe someday he’ll read it and maybe someday our daughter will read it,” said Pataki. “These ‘Dear Dave’ letters were also for me because I needed to speak to my husband and he wasn’t there.”
The letters also became the basis for her first work of non-fiction.
“The book turned into something we did as a family,” said Pataki. “In some ways it was very healing for us to do it together.”
After four days in the Fargo hospital Levy was stable enough to be airlifted to Rush University Medical Center in Chicago—the very hospital where he had been doing his orthopedic surgery residency.
“I literally don’t remember the town of Fargo at all or being airlifted to Rush but those doctors saved my life,” said Levy of the healthcare team at Sanford Medical Center. “We typically learn about bithalamic strokes in med school and they are usually fatal. For me, I was young enough where I was able to recover. If this stroke had occurred 10 years later, I might not be here.
“The very challenging thing in stroke medicine is that no two strokes are the same,” said Levy. “Everybody is recovering differently and the brain is so many complex things that the manifestations of your injury are completely different.”
Pataki spent long hours at Rush, never wanting to leave her husband’s side. Over time she fed him, signed paperwork, tracked monitors and watched him struggle to take a few steps and say a few words.
“It was scary to see my brilliant husband’s body and mind kidnapped by this new helpless, disoriented foreigner,” Pataki writes.
She reflected back on an August day in 2010 when during a visit to the Pataki farm in upstate New York, the couple became engaged. The next day they found three four-leaf clovers which Pataki glued to a photo and gave Levy on their wedding day with a note that read: “Dear Dave, May we always remember how ‘lucky’ we are to have one another. Love, Alli.”
When she returned to their empty apartment, she wanted to throw that framed photo across the room but ultimately would come to write those words again while Levy lay comatose: “Dear Dave . . . I love you . . . I miss you . . .May we always remember how lucky we are.”
Now they were members of “the Club of the Bad Things,” coined by Lee Woodruff, wife of ABC News reporter Bob Woodruff, who suffered a traumatic brain injury in 2006 when a roadside bomb struck his vehicle while on assignment near Taji, Iraq. Woodruff wrote the forward in Pataki’s memoir.
“We became members of the Club of Bad Things,” said Pataki. “This (book) was really an experience that enabled me to connect with people both in my life and new people.”
One of the new people in their lives was Omar Lateef, MD, chief medical officer at Rush, who was the first to give the couple hope.
“He believed that Dave’s brain could heal, and that Dave’s recovery could be nothing short of our wildest hopes,” writes Pataki.
“Dave had youth on his side; he had neuroplasticity on his side,” said Pataki. “He had great rehab. Our life might not necessarily be the Plan A that we had planned on but we had every hope to expect that Dave would be a participating, thriving member of his family and in his life. We had to stay hopeful that the brain had this remarkable ability to heal.”
Levy transferred to inpatient rehab before heading home where he was lethargic and laid back—a far cry from his Type A personality which routinely had him putting in 15-hour days.
“When I asked Dave’s therapists about this, I learned that this apathy had to do with Dave’s still-inadequate executive functioning,” writes Pataki. “This was a tough place for us to be. He was lucid enough to resent my urgings (nagging, as he called it), but not sharp enough to initiate and take over all of his self-care.”
Pataki struggled in her roles of both wife and caregiver. Four months after his stroke, Levy was in the delivery room when their daughter, Lilly, was born. The couple last August welcomed a second daughter, Grace.
“As a caregiver you can go through therapy and you can see your loved one regain their ability to walk or run or go on the treadmill—those are great milestones,” said Pataki. “But there are so many unknowns—the invisible aspects of the injury that are just so excruciatingly painful.
“So I think it’s important to connect with others who are walking a similar road. Some of the most hope-giving moments for me were when I connected to other people—caregivers, survivors and advocates and said, ‘OK, I’m not the only one who has walked this road.’”
Levy chose not to return to his grueling medical residency and today works as a medical consultant, saying, “I really do feel like I’m 100 percent better. I had absolutely wonderful therapy and that is what made me what I am today.”
One year after his stroke he writes in an epilog to Pataki’s memoir that “gratitude is the first thing that comes to mind.
“It was certainly a scary experience to have almost died, but one positive I can unequivocally point to is that it has truly brought me closer to my entire family,” he writes. “My entire life is a second turn—a second look, a second attempt at trying to lead a happy and meaningful reality.”
As for Pataki, she writes, “Dear Dave, May we always remember how lucky we are to have one another.”
One minute I could make out fuzzy images moving around the ICU, and the next minute I was the one moving. What is happening? I demanded, but no one could hear me. I couldn’t talk …I couldn’t even move… and I was losing consciousness.
At age 9, I had a hemorrhagic stroke, a bleeding into brain tissue, and the result of a brain tumor. The tumor was growing into nerves surrounding the brain stem. A blood vessel had ruptured, and the time frame between onset of stroke and onset of treatment was closing fast. The next 90 minutes would be crucial in order to stop the bleeding and significantly reduce disability. It was within this time frame that I lost the childhood I had known, but I am eternally grateful for the life I gained.
For several months afterward, I could not talk — my only means of communication a spelling board. Regular speech therapy—first at the hospital and then at the children’s rehabilitation center—changed that, but progress was slow and there was a lot of frustration and anger.
There were little things I took for granted until they were gone. I had to learn everything again. I felt betrayed by my own body; my memory wiped clean. I couldn’t walk, talk, feed myself, or even roll over in bed without assistance. Between lengthy stays at the hospital of the University of Virginia and the children’s rehabilitation center, it took speech therapy, occupational therapy, recreational therapy, and several additional years of physical therapy to get me where I am today…a survivor.
For me the question was never “Will I walk again?” but rather “How soon before I get out of this wheelchair?” Persistence can go a long way, but I’d be lying if I said it wasn’t difficult. Now was the time to rebuild my life, to make use of the abilities I still had.
At that time, during the 1980s, medical technology was not as advanced as it is today, but the only option was surgery to remove the tumor growing into the delicate network of nerves and blood vessels that surrounded the brainstem. Mine was a surgery that would not have been possible 20 years earlier. If I survived, a 3 1/2-month ordeal would begin that would leave me struggling to make sense of the world.
It’s remarkable how the mind continues to function even when the body is barely functional. I knew my surroundings. Even as I lay helpless in the ICU, dependent on machines to monitor my heart rate and control my breathing, I knew I was there because of a brain tumor and the damage it had done. I just didn’t know how much damage.
How does a 9-year-old deal with the fact that she can no longer do ‘normal’kid stuff, like participate in after-school activities, go to the mall with friends, or even go on trips without having to plan beforehand for handicap accessibility? How do you explain to a child that the rest of her life will be governed by nerve damage? At the time did anyone know?
I needed answers. I needed to connect with others dealing with the same issues.
Recovery is a long, hard road to travel and sometimes there is no pot of gold at the end of the rainbow, but when I focused on the abilities I still had (even if they were once taken for granted) only then did I no longer see myself as victim, but rather as a survivor.
With nerve damage and a severe balance problem, grade school was a challenge, but after high school I went on to college. I graduated with honors from Shenandoah University where, relying on assistance for balance, I walked across the stage at graduation to receive a Bachelor of Science degree, for which my efforts earned me a standing ovation.
Now, at age 45, I can still see that girl, limp and helpless in the ICU bed. Turning back the pages of time, how could I explain to someone else, especially a child, that her life will be forever changed? I’d tell her, “Never give up. You will face new challenges, even struggles, but your hard work will inspire other people, and show them what it means to be a survivor.”
My friend, Jake French, Introduced my to Roni Sasaki. She does interviews with people like Jake who have gone through the unimaginable but have come back with a strong purpose. Although my experience is VERY different, Jake thought that it would be of interest to her listeners. After listening, please tell me your impression??
An automotive outsider groomed as an accountant and financial officer, Marchionne engineered the merger of Fiat and Chrysler in 2009. By the time he was replaced as CEO by Jeep chief Mike Manley in a hastily called board meeting Saturday, Marchionne had revived the fortunes of both companies as a growing, international conglomerate encompassing 10 brands under the corporate umbrella Fiat Chrysler Automobiles LLC.
“His unbelievable turnaround left Fiat so much healthier than when he found it,” says Jeremy Acevedo, manager of industry analysis for Edmunds. “He’ll be remembered as one of the early 21st-century’s great auto leaders along with Alan Mulally and Elon Musk.”
The holding company of Fiat’s founders, the Agnelli family, announced in a statement of Marchionne’s death due to complications from surgery in Zurich.
“Unfortunately what we feared has come to pass,” Fiat heir John Elkann said. “Sergio Marchionne, man and friend, is gone. I believe that the best way to honor his memory is to build on the legacy he left us, continuing to develop the human values of responsibility and openness of which he was the most ardent champion.”
Bill Ford, executive chairman of Ford Motor Company, said Marchionne was an admired industry leader.
“Sergio Marchionne was one of the most respected leaders in the industry whose creativity and bold determination helped to restore Chrysler to financial health and grow Fiat Chrysler into a profitable global automaker,” he said in a statement. “His extraordinary leadership, candor and passion for the industry will be missed by everyone who knew him.”
Noted for a minimalist wardrobe that seemed limited to a closet full of black sweaters, Marchionne was as colorful as his sartorial taste was monochromatic.
“He was well-known for his business prowess as well as his disdain for suits and neckties,” says Rebecca Lindland, senior auto analyst at Kelley Blue Book.
Never shy with a quip, the profane, funny, driven CEO bucked industry trends and questioned industry traditions.
He famously said of the Fiat 500e, a poor-selling electric vehicle sold in California to meet the state’s zero-emission mandates: “I hope you don’t buy it, because every time I sell one it costs me $14,000. I’m honest enough to tell you that.”
He was reticent to invest in electric vehicles at a time when competitors like General Motors Co. were rushing them to market. “Better late than sorry,” he said in 2016.
Yet, Fiat Chrysler was the first major automaker to announce a partnership with Google’s Waymo subsidiary to put hybrid, self-driving minivans on the road.
Critical of the industry business model to build lookalike, compact four-cylinder sedans, he publicly courted other automakers — most notably GM — to merge and build common automobiles to save costs. No competitor took him up on the offer.
A quick study
Marchionne’s family crossed the Atlantic from Italy to Toronto, Canada, in 1965 when Sergio was 13 years old.
After graduating from the University of Toronto with a degree in philosophy, the ambitious Italian-Canadian citizen added a bachelor of commerce degree and MBA from the University of Windsor, and a law degree from York University in Toronto.
He spent the 1990s working in financial positions with a series of international corporations culminating in his first chief executive appointment at Swiss aluminum company Algroup in 1997. In 2002 he became CEO of Geneva’s SGS, a Forbes Fortune 2000 company that works with companies to assure products meet regulatory standards.
Two years later, the Agnelli family, which holds a controlling interest in Fiat, plucked him from Switzerland to become CEO despite Marchionne’s lack of auto industry experience. He would prove a quick study and a shrewd judge of talent.
But Marchionne’s signature move was acquiring crippled Chrysler out of bankruptcy in 2009 for no cash down and commitments to the U.S. government to meet a series of sales, engineering and technology goals in return for a controlling interest in the company.
Key to that promise was bringing Fiat’s know-how to develop a 40-mpg vehicle for Chrysler. Marchione accomplished the feat with the fuel-efficient 2013 Dodge Dart. But Marchionne had his eyes on a bigger prize: unlocking the international potential of Chrysler’s Jeep brand at a time when consumers were moving toward SUVs.
“He saw the pendulum swinging away from cars and towards SUVs,” says Edmunds’ Acevedo, who notes that Maserati and Alfa Romeo also expanded their SUV offerings under Sergio’s watch. “He had the grit to make the hard decisions.”
Also upon assuming control of Chrysler, Marchionne spun off Ram from Dodge as a stand-alone truck brand, remade Dodge as a performance icon and re-introduced Alfa Romeo to the U.S. as a luxury automaker.
“He understood the legacy of a brand like Jeep, but at the same time he could bring back an old brand like Alfa,” says KBB’s Lindland. “He had the discipline of an accountant and the creativity of an entrepreneur.”
Marchionne’s tenure was not untouched by trouble.
Seven people have pleaded guilty in a widening corruption scandal involving Fiat Chrysler and the United Auto Workers union. Federal prosecutors describe a pattern of company officials funneling illegal payments to UAW leaders through a joint training center. The case already has ensnared former Fiat Chrysler executive Alphons Iacobelli and Monica-Morgan Holiefield, widow of former UAW Vice President General Holiefield.
Federal prosecutors say the automaker conspired with the UAW from before 2009 through 2015 to violate the Labor Management Relations Act. The law prohibits employers or those working for them from paying, lending or delivering money or other valuables to officers or employees of labor organizations — and from labor leaders from accepting such items. Prosecutors allege that Iacobelli and at least four other unnamed Fiat Chrysler officials were funneling more than $1.5 million worth of illegal payments to UAW officials.
Marchionne was questioned during a private meeting in July 2016 with the U.S. Attorney’s Office in Detroit, sources familiar with the investigation said. He was escorted to the meeting by his white-collar criminal-defense lawyer. Marchionne had not been charged with a crime during the ongoing federal grand jury investigation.
The automaker also faced allegations it cheated on pollution testing for diesel engines.
In May 2017, Fiat Chrysler said it would modify around 104,000 diesel vehicles after the U.S. Justice Department sued the the automaker, accusing it of illegally using software in diesel-powered Jeep Grand Cherokees and Ram 1500 pickups sold since 2014 to mask true pollution levels during testing. Court filings in May 2018 cited emails that diesel engine subsidiary VM Motori knew as early as 2010 that an auxiliary emissions control device would be illegal if concealed from regulators.
Marchionne’s bold plans were laid out in public five-year plans beginning in 2010 with the CEO and his team telegraphing their product moves in the normally secretive auto industry.
The ambitious plans sometimes fell short, yet Marchionne would reboot five years later with another five-year salvo.
“He was a very plain-spoken person,” says Lindland. “He was a risk-taker but also able to motivate his team to take those risks with him.”
Fiat Chrysler got an infusion of cash by spinning off Ferrari in 2015 in an IPO valued at over $12 billion. With its 9 percent stake in the prancing horse, Chrysler made off with nearly $1 billion. By the end of 2017, Fiat Chrysler’s net profit had doubled over the previous year with the company predicting its profits would outrun Ford by the end of 2018.
Presiding over a final four-year-old plan in Milan in June, Marchionne celebrated the impending elimination of the company’s industrial debt by ditching his signature sweater for a tie. He also laid plans to turn over a company radically different from the one he had inherited 13 years earlier — its namesake Fiat and Chrysler brands a shadow of their former selves, and American and luxury SUVs carrying the sales load.
“He has left FCA in a good place,” says analyst Lindland. “It will be interesting to see if Manley and his executive team can protect his legacy. Can they execute his five-year plan?”
She added: “They have large sweaters to fill.”
Henry Payne is auto critic for The Detroit News. Find him at email@example.com or Twitter @HenryEPayne.
If you’re a man and you suffer from heart disease or diabetes, stress at work may shorten your life, a new study finds.
The researchers said a demanding job in which you have little or no control over your work environment is a formula that can increase the risk of dying early whether you suffer from heart disease or not. But that risk jumps 68 percent for men with heart disease or diabetes, the investigators found.
“These findings suggest that working very hard might not be a good idea for people with a serious cardiometabolic disease, such as those with diabetes, coronary heart disease or a history of stroke,” said lead researcher Mika Kivimaki, chair of social epidemiology at University College London.
Physiological stress response is a normal reaction to a challenge in work and private life, but can involve a number of changes that might affect heart function, clotting and plaque in blood vessels, he explained.
“These changes, in turn, can trigger a fatal heart attack or stroke,” Kivimaki added. And work-related stress may be particularly harmful for men with diabetes or a history of heart attack or stroke, he said.
“We found the stress-mortality link in men but not in women, which is consistent with the fact that atherosclerosis [hardening of the arteries] is more common in working-aged men than women,” Kivimaki noted.
Dr. Satjit Bhusri, a cardiologist at Lenox Hill Hospital in New York City, said the mind has a direct link to the heart. “There is a mind-heart loop, which can affect your heart,” he said.
Bhusri believes that reducing work stress can reduce the risk to the heart. But reducing work stress might mean quitting a stressful job, he noted.
“I’ve had patients who have retired or quit their job,” Bhusri said. “What you have to realize is that your job is a slice of the whole pie of your life. And without a life, there are no slices,” he said.
To reduce stress, Bhusri promotes mediation, yoga and exercise. “More importantly, if it’s the job that’s toxic, get rid of the job,” he advised.
For the study, Kivimaki and his colleagues collected data on more than 100,000 men and women from Finland, France, Sweden and the United Kingdom, including more than 3,400 who had heart disease and diabetes. At the start of the study (between 1985 and 2002), participants completed a questionnaire on their lifestyle and health.
Over an average of nearly 14 years, the researchers tracked participants’ medical records. During that time, more than 3,800 individuals died.
The investigators looked at two types of work stress: job strain — having high work demands and little control over them; and effort-reward imbalance — putting in lots of effort, but getting little reward.
After Kivimaki’s team took into account socioeconomic status and some lifestyle factors — including high blood pressure, high cholesterol, smoking, obesity, physical inactivity and high alcohol consumption — it found that men with heart disease or diabetes who had job strain had a 68 percent greater risk of premature death than men who had no job strain.
This increased risk was seen in men who were being treated and had achieved their blood pressure and cholesterol targets. The risk was also seen in men with a healthy lifestyle, including being of normal weight, being physically active, not smoking and not drinking heavily.
No association was seen, however, between a risk for premature death and effort-reward imbalance in men with heart disease or diabetes. The study did not prove a cause-and-effect link between the two.
Neither type of work stress was linked with an increased risk of dying among healthy or unhealthy women, the findings showed.
Stress may affect the body in several ways, including changing natural responses to stress through higher levels of the stress hormone cortisol, which increases glucose production and limits the effect of insulin, thereby worsening diabetes, the study authors said.
In addition, stress can increase inflammation that can raise blood pressure and affect clotting, thus increasing the risk of heart problems in people who already have hardening of the arteries.
Because the researchers measured stress only at the start of the study, they could not take into account changes in the severity of diseases over time. They also did not take into account blood pressure or cholesterol levels in all the participants, which might lead to an overestimation of the effect of job strain.
In addition, people with more severe disease tended to work fewer hours, which might explain why no association between effort-reward imbalance and risk of premature death in men with heart disease or diabetes was seen, the researchers said.
The report was published online June 5 in the journal The Lancet Diabetes & Endocrinology.
A response to a person new to caregiving, trying to figure out what to do while at the same time, grieving what has been lost.
I have been the caregiver to my husband for 10 years.In those early years, I regularly reminded myself who he had been before the stroke–vibrant, sharp, fun, funny, successful–all things that the stroke took away from him.It was important for me to remember those things and treat him like that person, not as a victim or an invalid.Even though he was terribly disabled, our interaction was always about working toward a new normal that valued a good man.
One thing that really helped us was setting goals together.Setting goals allowed us to look forward and move forward.Yes, I took care of his needs, but working together on recovery and a useful life was essential. We got excited each day to see what he could do.We did not focus on what we lost.We focused on the new life we were creating.It wasn’t easy.We also had kids at home who needed mom and dad.I like to think one day they will reflect on those years and know what love and commitment really look like.
My husband deserved the best I had to give.In return, he gives his best.I hope you, the team, and your friend can rally and help him create a meaningful life.It isn’t easy but it is worth doing.Good luck.
The same medication used to save lives by reversing opioid overdoses may also benefit nonopioid users. In a new study done in rats, the medicine, called naloxone, was shown to help the brain to recover from a stroke.
Researchers found that when male rats were treated for one week with naloxone after having an ischemic stroke, they had an improved recovery, compared with rats who did not receive naloxone. (An ischemic strokeoccurs when blood flow to the brain is interrupted, usually because of a blood clot, which deprives the brain of oxygen and damages nerve cells in the area.) [Strange Stroke Stories: Ebola, Hickeys and Other Weird Causes]
Because the study was done in rats, more research is needed to confirm the findings in people. However, naloxone might play a role in stroke recovery because the drug has anti-inflammatory properties and can reduce the activity of the microglia, which are the primary immune cells of the brain, according to the study findings, published today (April 16) in the journal eNeuro
Previous research has shown that naloxone affects the microglia, which are very active contributors to the inflammation that occurs in the brain following a stroke, said study co-author Brandon Harvey, a researcher at the National Institute on Drug Abuse in Baltimore. So, in this study, the researchers wanted to see whether giving naloxone after a stroke could decrease the activity of the brain’s immune cells and reduce the associated inflammation, leading to improved recovery from the stroke, he said.
Improved stroke recovery
In the new study, the researchers gave 65 male rats naloxone twice a day through the nose at a dose considered to be safe in humans. (Naloxone is often given as a nasal spray to reverse an overdose, according to the study.) The study showed that the drug was most effective when treatment was started within 16 to 36 hours after a stroke and lasted for seven days.
The findings showed that when naloxone was given after a stroke, during a period when immune-cell activity in the brain was peaking, it had beneficial effects on recovery, said study co-author Mikko Airavaara, principal investigator at the Institute of Biotechnology at the University of Helsinki in Finland. (Immune cells in the rats’ brains were active as early as two days after a stroke and reached their peak activity seven days after a stroke, according to the findings.)
Airavaara said that naloxone works reducing inflammation in the brainand reducing the loss of nerve cells, which can improve the brain’s ability to recover after a stroke.
These findings are important because there is no drug treatment now that helps the brain recover after a stroke, Airavaara told Live Science. So, developing a drug therapy that could promote recovery for the 10 million people worldwide who have strokes each year would be groundbreaking, he said.
Indeed, because naloxone has been used to treat opioid overdoses for nearly 50 years, the idea of repurposing the drug for stroke is intriguing, Harvey said.
It would be important to establish that the drug’s beneficial effects would work not only in male rats but in female rats as well, Harvey told Live Science.
The current study was able to establish an effective delivery method for the drug — through the nose, which is one of the methods already used to reverse opioid overdose — and a suggested dosing pattern (when to give the drug) to possibly translate these findings into clinical practice in the future, Harvey said.
Daniel Lackland, a professor of epidemiology in the neurology department at the Medical University of South Carolina in Charleston, who was not involved in the new research, said that there is a need to identify other treatments for stroke recovery. Currently, rehabilitation includes physical-, occupational- and speech-therapy programs; however, treatments that target physiological changes in the brain are lacking, he said.
In addition, recovering from a stroke has not had the same success rates as recovering from heart disease, said Lackland, who is a spokesperson for the American Stroke Association.
This study explored the possibility that a new drug may contribute to stroke recovery, and this drug appears to have some benefits in animals, Lackland told Live Science. Though the findings need to be replicated in additional animal studies, these results give hope for the future of possible trials in humans, he said.