This week, the American Stroke Association’s International Stroke Conference 2023 will be held in person in Dallas beginning today and virtually Feb. 8-10, 2023. The conference is a world premier meeting for researchers and clinicians dedicated to the science of stroke and brain health.
Strokes are one of the leading causes of death and disability in the US. There are two types of stroke: hemorrhagic and ischemic. A hemorrhagic stroke occurs when a blood vessel ruptures and causes bleeding in the brain; an ischemic stroke occurs when a blood clot blocks a blood vessel or artery, preventing blood from reaching the brain. About 85 percent of all strokes in the US are ischemic strokes. To spot a stroke, think FAST. This acronym stands for:
Face drooping?
Arm weakness?
Speech problems?
Time to get help!
Finding #1: New A1 App May Recognize Common Stroke Symptoms as They’re Occurring
A new smartphone application called FAST.AI may help people who are having a stroke or their family and caregivers recognize common stroke symptoms in real time, prompting them to quickly call 9-1-1. In a recent study, the smartphone app is said to have accurately detected stroke-associated facial asymmetry in nearly 100 percent of patients! It also detected arm weakness in more than two-thirds of the cases, and while the slurred speech module remains to be fully tested, preliminary analyses confirmed that it may be able to reliably detect slurred speech, as well, according to the researchers.
Here’s how the app works (please note that the mobile app is still in development and not yet available to the public):
- FAST.AI uses machine learning algorithms to recognize facial asymmetry (drooping of the muscles in the face), arm weakness, and speech changes – all common stroke symptoms.
- The smartphone application uses a facial video of the patient to examine 68 facial landmark points; sensors that measure arm movement and orientation; and voice recordings detect speech changes. Information from each test was sent to a database server for analysis.
- The app provides the user with an easy assessment of signs of a stroke and prompts them to seek care immediately.
Researchers validated FAST.AI’s performance by testing nearly 270 patients with a diagnosis of acute stroke (41 percent women, average age of 71 years) within 72 hours of hospital admission at four major metropolitan stroke centers in Bulgaria from July 2021 to July 2022. Neurologists who examined the patients tested the app and compared the FAST.AI results with their clinical impressions. Preliminary research suggests that the app might be as accurate at diagnosing stroke as a neurologist! A limitation of the study, however, is that neurologists (not the individuals, family members, or caregivers) conducted the screenings and taught patients how to use the application.
Why Is the App so Important?
Early recognition of stroke symptoms may result in more timely treatment, which may minimize the long-term effects of a stroke and improve chances for a full recovery. In fact, research has shown that stroke patients who are treated within 90 minutes of their first symptoms were almost three times more likely to recover with little or no disability in comparison to those who received treatment more than 90 minutes after symptoms begin.
“Many stroke patients don’t make it to the hospital in time for clot-busting treatment, which is one reason why it is vital to recognize stroke symptoms and call 9-1-1 right away,” said study author Radoslav I. Raychev, M.D., FAHA, a clinical professor of neurology and a vascular neurologist at UCLA. “These early results confirm the app reliably identified acute stroke symptoms as accurately as a neurologist, and they will help to improve the app’s accuracy in detecting signs and symptoms of stroke.”
For those who are experiencing a stroke, clot-busting medication should be administered within three to four hours after symptoms begin because an average of 1.9 million brain cells die every minute that a stroke goes untreated, according to the American Stroke Association. Using the app, individuals can assess the signs of a stroke without the need to recall what the warning signs are.
Finding #2: Scientists Suggest Patient’s Own Cells Could Be Grown in the Lab and Used to Repair Stroke or Trauma Injuries
As just mentioned, when blood flow to the brain is blocked to the point of causing an ischemic stroke, the affected brain tissue dies. Neuroplasticity, also known as brain plasticity, includes the ability of neural circuitry in the brain to rewire and reorganize around the dead brain tissue after a stroke. A recent study has shown that the capacity of the human brain to recover and rewire itself peaks at around two weeks after a stroke and then starts to diminish. But what if the dead brain tissue could instead be replaced? Isaac Chen, a neurosurgery researcher and clinician at the University of Pennsylvania (my alma mater), has been interested in fixing injured brains, such as those affected by a stroke, since his medical school days. Chen and his colleagues recently conducted a study where they transplanted organoids (three-dimensional tissue cultures grown from stem cells produced in a lab) into the visual cortices — the parts of their brains responsible for vision — of 10 adult rats after sucking out the brain tissue that previously existed in the region. They did this to test the organoid’s ability to both integrate with the rest of the rat’s brain and compensate for the injury it had sustained. The researchers transplanted full, complete organoids and ones broken apart into individual cells, finding that the survival of the cells was much higher when the structure of the organoid was maintained.
One month after the transplant, the researchers noted that the grafted area looked similar to the surrounding brain, and blood vessels had grown into the organoid to supply it with oxygen. When Chen and his team attached electrodes to the rats to measure their brain activity, all 10 grafts showed neural activity with similar characteristics as those from two normal rats.
Chen and his team are testing out different regions of the brain for these transplants and studying the factors that influence graft integration. According to Chen, “(w)e’re years away from using organoids to treat humans, but one can imagine a future where surgeons have the option of healing patients’ injured brains with new neural tissue. Strokes, traumatic brain injuries, cancer, and other severe diseases will no longer be thought of as events that permanently alter one’s ability to think and process information.”
Plan in Advance: You Never Know When a Stroke Can Happen
Sixty percent of strokes happen in adults 65 years and older, according to the Centers for Disease Control and Prevention. Many don’t realize that strokes are becoming much more common at a younger age, as well. For more details on strokes, and symptoms to look out for, click here.
Plan Ahead for Peace of Mind
Healthy habits are sometimes not enough to prevent a medical emergency such as a stroke. That’s why adults of all ages should sign an advance medical directive and a general power of attorney. Signing these incapacity planning documents is the only way to ensure that your wishes are met in the simplest and least expensive manner if you should become unable to make important decisions for yourself.
If you have not done incapacity planning or estate planning, or if you have a loved one who is nearing the need for long-term care or already receiving long-term care, please contact the Farr Law Firm as soon as possible to make an appointment for an initial consultation:
Northern Virginia Elder Law: 703-691-1888
Fredericksburg Elder Law: 540-479-1435
Maryland Elder Law: 301-519-8041
DC Elder Law: 202-587-2797
About Evan H Farr, CELA, CAP
