Washington University SPOTRIAS Center

这一专门的急性卒中转化研究(SPOTRIAS)应用项目的总体目标是开发诊断和治疗急性卒中患者的新方法。NINDS已经认识到有必要发展地区性跨学科中心，致力于推进急性中风患者的早期治疗：他们已经邀请申请急性中风翻译研究(SPOTRIAS)的专门项目。SPOTRIAS计划的明确意图是“支持来自不同专业的临床研究人员的合作，他们的共同努力将导致对急性中风患者的早期诊断和治疗的新方法”。我们的SPOTRIAS建议直接支持这一目标。目前的建议借鉴了我们机构的几个临床和研究优势。我们已经建立了一支积极的急性卒中团队，在快速静脉注射tPA方面取得了令人印象深刻的成果。这是通过急诊医学和血管神经学领导的跨学科努力实现的。我们是急性脑血管疾病的主要转诊中心，每年治疗近150名动脉瘤性蛛网膜下腔出血患者。最后，我们有大量经验丰富的、由美国国立卫生研究院资助的研究人员，致力于脑血管疾病的基础、翻译和临床研究。这个多学科小组有着悠久的合作历史。这项建议建立在这一经验的基础上，将使我们能够将注意力和资源集中在推进急性中风患者的护理上。它将有助于支持我们的外展努力，并维护我们的急性中风治疗网络(患者通道核心)。它将帮助我们为急性脑血管疾病(职业发展核心)培养未来的临床医生-科学家。它将支持我们维护中风患者相关临床信息、成像以及血清和DNA样本的存储库(患者访问核心、生物医学核心、数据管理和生物统计核心以及成像核心)。这一独特的数据集将供校内和校外SPOTRIAS调查人员进行初步调查。我们将研究他汀类药物对动脉瘤性蛛网膜下腔出血患者脑血流、脑缺血和自我调节功能的影响(项目1)。我们希望在项目2中扩大静脉注射tPA的窗口和适应症，这是一项针对发病24小时的后脑卒中患者静脉注射tPA的试点研究。最后，我们将评估一个新的磁共振序列，以确定大脑的氧合(项目3)。这是一种很有希望的方法，可以可靠地识别不经治疗就会进展为脑梗塞的受损组织。

The overall aim of this specialized program of translational research in acute stroke (SPOTRIAS) application is to develop new approaches to the diagnosis and treatment of acute stroke patients. The NINDS has recognized the need to develop regional interdisciplinary centers dedicated to advancing the early treatment of patients with acute stroke: they have invited applications for specialized programs in translational research in acute stroke (SPOTRIAS). The expressed intent of the SPOTRIAS program is "to support a collaboration of clinical researchers from different specialties whose collective efforts will lead to new approaches to early diagnosis and treatment of acute stroke patients". Our SPOTRIAS proposal is in direct support of this goal. The present proposal draws on several clinical and research strengths of our institution. We have built an active acute stroke team that has achieved impressive results in the rapid administration of intravenous tPA. This was accomplished through an interdisciplinary effort led by Emergency Medicine and Vascular Neurology. We serve as a major referral center for acute cerebrovascular disease and treat nearly 150 patients per year with aneurysmal subarachnoid hemorrhage. Finally, we have a large number of experienced, NIH-funded investigators dedicated to basic, translational, and clinical research in cerebrovascular disease. This multi-disciplinary group has a long-standing history of collaboration. This proposal builds on this experience and will allow us to focus attention and resources on advancing the care of patients with acute stroke. It will help to support our outreach efforts and maintain our acute stroke treatment network (Patient Access Core). It will help us train future clinician-scientists for careers in acute cerebrovascular disease (Career Development Core). It will support our efforts to maintain a repository of linked clinical information, imaging, and serum and DNA samples of stroke patients (Patient Access Core, Biospecimen Core, Data Management and Biostatistics Core, and Imaging Core). This unique dataset will be available to intramural and extramural SPOTRIAS investigators for preliminary investigation. We will investigate the effects of statins on cerebral blood flow, ischemia, and autoregulatory function in patients with aneurysmal subarachnoid hemorrhage (Project 1). We hope to expand the window and indications for iv-tPA in Project 2, a pilot study of intravenous tPA for patients with hindbrain stroke presenting with 24 hours of onset. Finally, we will evaluate a novel MR sequence for the determination of cerebral oxygenation (Project 3). This has promise as a method to reliably identify injured tissue that will progress to infarction without therapy.