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October 29, 2020
Many strokes are missed when a clinician first examines the patient. That’s often because the classic stroke symptoms – drooping face, numbness in the arm, slurred speech – aren’t as obvious as they are in the most severely presenting cases. Despite less-obvious symptoms, these events can still lead to disability and death.
Confirming a stroke diagnosis often requires an MRI or CT scan, which are often unavailable in ambulances and small emergency rooms. A simple blood test to determine one way or another whether the patient is suffering a stroke could create a significant opportunity for earlier diagnosis, correct diagnosis, and improved outcomes.
That’s the focus of research at Case Western Reserve University, where researchers have identified a number of biomarkers in the blood that are likely associated with stroke.
“If we had a blood test to tell us right away if someone is having a stroke, that could make a huge difference in patient care,” said lead researcher Grant O’Connell, an assistant professor and director of the Biomarker and Basic Science Laboratory at the university’s nursing school. “…[U]p to one-third of strokes are missed at the initial contact with a clinician, which delays treatment that could prevent death or disability.”
Every year, more than 795,000 people in the United States have a stroke, according to the CDC. About 87% of all strokes are ischemic strokes, in which blood flow to the brain is blocked. In 2018, 1 in every 6 deaths from cardiovascular disease was due to stroke.
Tissue samples advance the story
The researchers looked at thousands of tissue samples from the human brain and other organs to evaluate 17,000 protein-coding genes, according to their article in the Proceedings of the National Academy of Sciences of the United States of America.
The circulating levels of proteins associated with the top-ranked genes were then measured in blood sampled from a diverse cohort of patients diagnosed with a variety of acute and chronic neurological disorders, including ischemic stroke, hemorrhagic stroke, traumatic brain injury, Alzheimer’s disease, and multiple sclerosis, and evaluated for their diagnostic performance, the authors wrote.
The analysis revealed up to 50 new possible markers, several of which were subsequently measured and successfully detected in the blood of a cohort of patients with stroke, O’Connell said.
This work could someday lead to a simple blood test for stroke and once again points up the value of human biospecimens, both tissue and blood in this case, to advance important discoveries that can extend and save lives.
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