New York Columbia Collaborative SPOTRIAS

纽约哥伦比亚大学急性中风转化性研究合作专门项目将涉及哥伦比亚大学和纽约长老会医院的关键人员。总体目标是加强对急性中风患者的护理，重点是高危弱势人群，培训急性中风翻译研究人员，并实施3个创新的急性中风项目。这些项目共享通过患者访问核心确定的主题，并利用血液和数据管理和统计核心。项目1是一项剂量递增和先导性临床试验，以评估短期早期使用大剂量辛伐他汀治疗的效果(Neu-Start：他汀类药物治疗急性恢复的神经保护试验)。 在啮齿动物卒中模型中，辛伐他汀被证明可以减少神经元损伤和梗塞范围，主要与改善血管流量和功能有关，而不是直接对神经元细胞保护有益。该翻译项目将在12小时内随机选择60例IB期的急性中风患者和90例IIA期的6小时内的急性中风患者，并评估全身炎症标志物的安全性和替代措施。项目2(急性中风中的大脑可塑性：一项功能磁共振研究)将通过评估急性时期大脑可塑性的作用来调查早期中风结果中的不明原因的变异性。为了确定急性中风后预测中风后1周和3个月恢复良好的对侧脑区网络， 我们将招募100名急性中风患者，并在24至48小时内进行fMRI扫描。项目3(SWIFT：中风警告信息和更快的治疗)将旨在减少弱势人群中急性中风患者到医院就诊的延迟。为了评估通过三次互动会议实施的具有文化敏感性的、有针对性的教育/行为矫正计划的有效性，我们将随机抽取1400名中风ATIA幸存者和1200名社区受试者，评估中风知识和行为的变化，以及到达急诊室的时间改善。

The New York Columbia Collaborative Specialized Program on Translational Research In Acute Stroke will involve key personnel from Columbia University and the NY Presbyterian Hospital. The overall goals are to enhance the delivery of acute stroke patient care with a focus on a high-risk disadvantaged population, train acute stroke translational researchers, and conduct 3 innovative acute stroke projects. The projects share subjects identified through the patient access core, and utilize blood and data management and statistics cores. Project 1 is a dose-escalation and pilot clinical trial to evaluate the effects of short-term early use of high-dose simvastatin therapy (Neu-START: Neuroprotection with Statin Therapy for Acute Recovery Trial). Simvastatin has been shown in rodent stroke models to reduce neuronal injury and infarct size primarily related to improving vascular flow and function rather than on a direct neuronal cytoprotective benefit. This translational project will randomize 60 acute strokes within 12 hours for phase IB and 90 within 6 hours for phase IIA and evaluate safety and surrogate measures of systemic inflammatory markers. Project 2 (Brain Plasticity in Acute Stroke: a Functional MRI Study) will investigate the unexplained variability in early stroke outcomes by evaluating the role of brain plasticity in the acute time period. To determine the network of contralesional brain regions after acute stroke that predicts good stroke recovery at 1 week and 3 months, we will recruit 100 acute stroke patients, and obtain fMRI scans at 24 to 48 hours. Project 3 (SWIFT: Stroke Warning Information and Faster Treatment) will be aimed at decreasing the delay in presentation of acute stroke patients to the hospital from a disadvantaged population. To evaluate the efficacy of a culturally sensitive, targeted educational/behavioral modification program performed over three interactive sessions, we will randomize 1400 strokeATIA survivors and 1200 community subjects and assess changes in stroke knowledge and behavior, as well as improvement in time to arrival to the ED.