Stroke and Cerebrovascular Research

URMC Neurology Research

Scope of Research: Basic Science and Clinical Research

Research goals of the Stroke Unit include 1) expanding our understanding of the mechanisms of ischemic injury to the brain; 2) improving acute ischemic stroke treatment; 3) developing more effective strategies in secondary stroke prevention; and 4) identifying cost-effective diagnostic testing and treatment.

Clinical stroke research includes:
• Active participation in clinical trials of novel treatment agents for acute stroke (Activated Protein C), endovascular interventions in acute stroke, insulin in hyperglycemic patients with intracerebral hemorrhage, and secondary prevention in patients with insulin resistance, small vessel ischemic disease or patent forament ovale.
• Identifying predictive factors for the use of transesophagel echocardiography in acute stroke
• Cost-effectiveness of carotid artery stenting vs endarterectomy
• Characterizing risk of stroke in patients with ventricular-assist devices
• Utility of telemetry in acute stroke monitoring
• Use of anti-platelet agents following carotid interventions
• Medical vs. surgical management of unruptured brain AVMs
• Genetic study of strokes in siblings

Basic science research includes:
• Investigating the response of the brain to hypoxia and how it influences cell death during stroke. In particular, we are interested in the role of Hypoxia-inducible factor 1 alpha in altering cell death during hypoxia and stroke.
• Collaborative research on putative neuroprotectants in acute ischemic stroke (Berislav Zlokovic, M.D., Ph.D.)

References
Vangeison, G., Carr, D., Damsker, Jesse M. , Nowak, Romana A., Constant, Stephanie L. ,Federoff, HJ and Rempe D. Astrocytic CD147, which is partially regulated by HIF-1, enhances hypoxia-induced neuronal death. Journal of Neuroscience (2008); accepted pending revisions

Vangeison, G., Carr, D., Federoff, HJ and Rempe D. The Good, the Bad, and the Cell-Type Specific Roles of HIF-1? in Neurons and Astrocytes. Journal of Neuroscience (2008); 28(8):1988-1993 View PubMed Reference

Halterman MW, De Jesus, C., Rempe D., Schor, N., and HJ Federoff. c/EBP- ß Inhibits the Adaptive to Pathologic Switch in a Model of Hypoxia-Induced Neuronal Apoptosis. Molecular and Cellular Neuroscience (2008) Jun;38(2):125-37 View PubMed Reference

Rempe, D., Lelli, K., Vangeison, G., Federoff, H. In cultured astrocytes, p53 and MDM2 do not alter hypoxic HIF-1? function regardless of presence of DNA damage. Journal of Biological Chemistry (2007); 82(22):16187-201. View PubMed Reference

Kasner, S E. MD; Lynn, M J. MS; Chimowitz, M I. MB, ChB; Frankel, M R. MD; Howlett-Smith, H RN; Hertzberg, V S. PhD; Chaturvedi, S MD; Levine, S R. MD; Stern, B J. MD; Benesch, C G. MD; Jovin, T G. MD; Sila, C A. MD; Romano, J G. MD; for the Warfarin Aspirin Symptomatic Intracranial Disease (WASID) Trial Investigators. Warfarin vs aspirin for symptomatic intracranial stenosis: Subgroup analyses from WASID. Neurology 2006;67:1275-1278. View PubMed Reference

Kelly A, Thompson JB, Tuttle D, Benesch CG, Holloway RG. Public reporting of quality data for stroke; Is it measuring quality? Stroke (in publication). View PubMed Reference

Curtis Benesch, M.D., M.P.H., Unit Chief
curtis_benesch@urmc.rochester.edu
(585) 275-2530