NINDS conducts stroke research at its laboratories and clinics at the National Institutes of Health (NIH) and through grants to major medical institutions across the country.
What are the Latest Updates on Stroke?
A better understanding of the causes of stroke has helped people make lifestyle changes that cut the stroke death rate nearly in half in the last two decades. NINDS supports a wide range of basic and clinical research aimed at finding better ways to prevent, diagnose, and treat stroke, and restore functions lost due to stroke.
The overall goal of stroke research is to translate basic research findings into useful therapies and effective interventions for people with stroke. Basic research helps scientists gain new knowledge and increase their understanding of stroke. This research creates the foundation for diagnosing and treating stroke. Clinical research, which makes up for a large portion of stroke research, gives scientists a way to test new treatments for people - including surgical devices, procedures, medications, and rehabilitation therapies.
NINDS-supported scientists are working to develop new and more effective treatments for stroke, discover ways to restore blood flow to the brain after stroke, and protect brain cells from dying during and after stroke. Scientists are also looking at ways to improve rehabilitation and post-stroke recovery and learn more about the risk factors for stroke to discover new methods of stroke prevention. And researchers are using imaging techniques to learn more about how stroke affects the brain and which stroke treatments might be most effective.
NIH StrokeNet
NINDS created a stroke clinical trials network that serves as the infrastructure and pipeline for exploring new potential treatments for people with stroke and those at risk for stroke. The NIH StrokeNet, a centralized coordinating and data management center with 27 regional coordinating centers that are linked to more than 500 stroke hospitals across the U.S., conducts small and large clinical trials and research studies to advance acute stroke treatment, prevention, and recovery and rehabilitation following a stroke. Since its inception in 2013, StrokeNet has completed nine stroke studies and is currently conducting 17 more.
The NINDS-funded DEFUSE 3 trial, which was conducted through StrokeNet, used advanced techniques in brain imaging to identify individuals who still might benefit from having blood clots physically removed outside of the traditional six-hour window of use from stroke onset. This trial demonstrated that thrombectomy, conducted up to 16 hours after the stroke began, led to improved outcomes compared to standard medical therapy in selected individuals. Advanced brain imaging helped identify which patients could benefit from restoring blood flow beyond standard treatment timelines.
Another NINDS-funded trial through StrokeNet, the MISTIE III trial, tested combining t-PA with minimally invasive surgery to remove the clot. While the intervention was successful in lowering the volume of blood in the brain, more research is needed to understand if this technique should be used in patients with intracerebral hemorrhage.
Research into More Effective Treatments for Stroke
NINDS-funded research has been at the forefront of groundbreaking medical treatments for stroke, including the first approved drug to treat ischemic stroke--t-PA, or tissue plasminogen activator--and the finding that aspirin is just as effective as warfarin for preventing additional strokes. Researchers now hope to discover more effective medications and continue building on the success of t-PA.
Current NINDS-funded stroke treatment research includes:
Thrombolytic interventions
These inventions are designed to prevent further brain injury caused by the stroke by dissolving blood clots that block blood flow to the brain. Several projects are testing techniques such as combining thrombolytic drugs with other drugs and delivering clot-dissolving medications directly into the clot. Researchers also hope to find out if perfusion imaging can identify patients who can be effectively treated with t-PA when the timing of stroke onset is not know. Through StrokeNet, the FASTEST trial is seeking to understand whether giving factor VIIa within two hours of hemorrhagic stroke onset can improve outcomes for people with the most dangerous types of strokes.
Antithrombotic interventions
These drugs are designed to prevent clot formation. One example is the NINDS-funded ARCADIA trial, which compared two blood-thinning drugs (aspirin and a drug called apixaban) to determine which is better for preventing recurrent stroke in people who have stroke of unknown cause and abnormal atrial function. The trial found no significant difference in risk of recurrent stroke between the two drugs.
Restoring blood flow
Continuous blood flow to the brain is essential to brain cell health and proper function. Researchers are using neuroimaging techniques to gain a better understanding of how blood flows to the brain--when the brain is healthy and when it is not--to improve diagnosis, guide treatment, monitor response to therapy, identify new targets for therapy, and develop new treatments.
Genetics
NINDS supports research to identify the role genetics play in stroke. Several rare inherited disorders cause an increased risk of stroke. Researchers hope to identify the genes responsible for other genetic disorders, with the goal of discovering treatments and learning more about stroke.
Risk factors and health disparities
The Reasons for Geographic and Racial Differences in Stroke (REGARDS) study focuses on racial and geographic differences in the prevalence of stroke risk factors by tracking health and disease in an ethnically and demographically diverse sample of U.S. adults age 45 and older. Another research effort hopes to better understand stroke disparities and develop effective interventions to reduce uncontrolled high blood pressure among minority populations.
Recovery
NINDS-funded scientists are studying how the brain responds to experiences and adapts to injury to one section of the brain by having other part or parts take over and reorganize their functions. Noninvasive imaging technologies can map patterns of activity inside the brain to help understand this brain adaption. Other scientists are working to develop new and better ways to help the brain rewire and repair itself to restore basic functions following a stroke.
Rehabilitation
Despite recent advances in stroke treatment, more than half of people who have a stroke are left with impairments after stroke. NINDS-funded scientists are looking at whether specific rehabilitative techniques, such as constraint-induced movement therapy (which involved constant restraint of the unaffected hand and arm so that the person is forced to use the affected hand and arm for daily activities), direct current stimulation, and transcranial magnetic stimulation can kickstart brain plasticity and lead to improved motor function and decreased disability. NINDS-funded scientists also tested a home-based telehealth rehab approach to determine if it is as effective as in-clinic rehabilitation in helping people recover from stoke. This is particularly important because not all populations have ready access to local stroke rehab centers. The findings of this study suggest that telehealth rehab programs have the potential to substantially increase access to rehabilitation therapy.
Cytoprotection
Recent advances in clot removal offer new opportunities to extend the time window to restore blood flow to the brain, protect surrounding tissue, and improve long-term functional outcomes using cytoprotective agents (chemicals to protect the cells). The NIH Stroke Preclinical Assessment Network (SPAN) aims to determine if add-on intervention can improve outcome compared to simply restoring blood flow alone.
Outreach programs
NINDS outreach programs also play an important role in linking research with people's everyday lives by educating individuals, their families and friends, and healthcare providers about the latest advances in treatment and prevention. The Know Stroke campaign encourages the public to learn the signs of stroke and to seek immediate medical help. Mind Your Risks is a public health campaign that educates Black men with, or at risk of, high blood pressure about the importance of taking charge of their health. Controlling high blood pressure between the ages 28 and 45 can help reduce the risk of having stroke and developing dementia later in life.
Estimates of Funding for Various Research, Condition, and Disease Categories
| Research/ Disease Area* | FY 2020 | FY 2021 | FY 2022 | FY 2023 (est.) |
|---|---|---|---|---|
| Stroke | 441 | 447 | 415 | 432 |
*Dollars in millions and rounded
Featured NINDS Stroke Research Initiatives
NIH StrokeNet
This network of regional academic centers across the United States, including roughly 550 stroke hospitals, conducts clinical trials and research studies to advance acute stroke treatment, stroke prevention, and recovery and rehabilitation following a stroke.
Learn More About NIH StrokeNet
Stroke Preclinical Assessment Network (SPAN)
The Stroke Preclinical Assessment Network (SPAN) seeks to conduct late-stage preclinical studies of putative cerebroprotective interventions combined with reperfusion. Using a multi-arm multi-stage design, six independent academic laboratories under the leadership of a Coordinating Center test candidates using a standard focal cerebral ischemic insult in five animal models that included equal numbers of males and females: young mice, young rats, aging mice, mice with diet-induced obesity, and spontaneously hypertensive rats.
NINDS Intramural Stroke Research
One of the largest neuroscience research centers in the world, the NINDS Division of Intramural Research is home to more than 500 scientists who conduct leading-edge basic, translational, and clinical research in neuroscience, neurology, and neurosurgery research at NINDS laboratories in Bethesda, Maryland.
Learn More About NINDS intramural stroke research
Resources and Tools
NIH RePORTER
Use this searchable database to find current and past research projects supported by NIH and other federal agencies, including links to publications and resources from these projects.
NINDS Common Data Elements (CDE): Stroke
Common Data Elements (CDE) are standards that enable clinical investigators to systematically collect, analyze, and share harmonized data across the research community. NINDS strongly encourages researchers who receive funding from the Institute to ensure their data collection is compatible with these CDEs.
Learn More About NINDS CDEs: Stroke
NINDS Funding Opportunities
Learn about opportunities, how to prepare and submit applications, and more—including how to manage your award.
PubMed
A comprehensive biomedical search engine for articles from MEDLINE, life science journals, and online books.
NINDS Clinical Trials
For information about NINDS-funded trials for people who have had a stroke, see www.clinicaltrials.gov and search for “post-stroke and NINDS” and “stroke and NINDS.”
NINDS Contributions to Approved Therapies
Tissue Plasminogen Activator for Acute Ischemic Stroke (Alteplase, Activase®)
Contacts
Stroke extramural staff contact info: