A Novel Habituation Method Could Limit Stroke Damage

A new study examines whether using a simple blood-pressure cuff could help reduce damage from stroke while a patient is being transported to the hospital.

A researcher at Henry Ford Hospital (Detroit, MI, USA) carried out an up-to-date review of stroke ischemic preconditioning (IPC), an emerging field of study that is working to see whether using blood-pressure cuffs or other methods of "training the brain" could help reduce damage from a stroke during triage. In one ongoing study of 250 patients in Denmark, for example, a blood-pressure cuff is inflated above the patient's normal pressure for five minutes then released for a five-minute rest period; this is repeated four times. The IPC intervention is applied to the arm with the aim of limiting the damage occurring in the brain.

Ischemic preconditioning in general is an intervention whereby a decrease of blood flow to an organ is applied to create tolerance to the reduced blood supply in the same organ or in an organ that is further downstream. The intervention is designed not to produce tissue damage when applied, but rather to stress the organ so that it can adapt to a lower level of blood supply. It has so far been tested as a way to limit harmful effects of reduced blood flow to the heart and liver, as well as a potential means to improve performance in competition swimmers. In stroke therapy, the goal of preconditioning is to prepare the brain to tolerate reduced blood flow without lasting damage. The review of studies was presented at the International Stroke Conference held during February 2010 in San Antonio (TX, USA).

"All of this research is driving us to rethink how we can develop new ways to limit the damage caused by stroke, one of the leading causes of disability in the U.S.,” said study presenter neurologist and stroke specialist Brian Silver, M.D. "Ischemic preconditioning is a novel technique for potentially improving tissue survival following acute stroke; human trials in a variety of conditions, including stroke, are underway to assess the efficacy and safety of this intervention.”

IPC protects the tissue by initiating a cascade of biochemical events that allows for an up-regulation of the energy demands of the tissue. The locus of this phenomenon is the intracellular organelle, the mitochondrion. Investigations of various exogenous circulating ligands have shown that delta active opiates and opioids simulate the phenomenon of IPC, thus protecting the downstream tissues without the intermittent ligating procedure.

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