UCLA SPOTRIAS Center Application

急性中风是一种常见的破坏性疾病，是美国第三大死亡原因和成人残疾的主要原因。本申请旨在建立UCLA急性中风中心转化研究专业项目，提出了一项综合研究/培训计划，以开发急性缺血性和出血性中风的创新疗法。提出了三个研究项目。项目1，“使用栓塞术的脑卒中血栓的MR和再通（MR RESCUE）试验”，将确定扩散-灌注MRI是否可以识别从症状出现后8小时内使用同心凝块检索器进行机械栓塞切除术的患者。本研究是一项多中心、随机、对照的2期试验，对120例大血管前循环缺血患者进行血管内凝块回收与传统医疗护理的对比

Acute stroke is a common and devastating disorder, the 3rd leading cause of death and the leading cause of adult disability in the US. This application to establish a Specialized Program of Translational Research in Acute Stroke Center at UCLA proposes an integrated research/training program to develop innovative therapies for acute ischemic and hemorrhagic stroke. Three research projects are proposed. Project 1, "The MR and Recanalization of Stroke Clots Using Embolectomy (MR RESCUE) Trial," will determine whether diffusion-perfusion MRI can identify patients who will benefit substantially from mechanical embolectomy with the Concentric Clot Retriever device for acute ischemic stroke up to 8 hrs from symptom onset. This study is a multicenter, randomized, controlled phase 2 trial of endovascular clot retrieval versus conventional medical care in 120 patients with large vessel, anterior circulation ischemic stroke 0-8 hrs from onset. Project 2, the "Hemorrhage Evacuation Employing MR-Guided Endoscopic Surgery (HEME-Surgery) Trial," is a phase 2, randomized, controlled, 60 patient trial of magnetic resonance guided endoscopic surgical evacuation vs. medical therapy within 24 h of acute intracerebral hemorrhage. This trial tests an innovative, minimally invasive surgical technique, applied early after onset, utilizing standard and novel clinical measures of outcome. In addition, studies interrogating the fundamental pathophysiology of brain injury in human ICH are proposed delineating differential gene expression, tissue morphometrics, and multimodal MR signatures in the perihematomal region. In Project 3, "Optimizing and Accelerating Prehospital Care of Acute Stroke," 3 inter-related studies will: prospectively validate a novel field measure of stroke severity, the Los Angeles Motor Scale (LAMS); improve dispatcher recognition of stroke by testing a new dispatcher-specific version of the Los Angeles Prehospital Stroke Screen (LAPSS-Dispatch); and demonstrate the feasibility, validity, and impact upon care of paramedic use of a novel, point of care test that assays 5 serum biomarkers to distinguish true stroke from nonstroke in the field. Five Cores will support the Projects: A) Patient Access, B) Blood / Tissue Specimen, C) Biostatistics / Data Management, D) Neuroimaging, E) Career Development.