The Opposite Side of the Brain to a Clot Is Key to Stroke Rehabilitation

New drug targets both hemispheres to repair damaged tissue

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It's best to treat the good with the bad, new medical insights into brain attacks suggest. Doctors are beginning to think the side of the brain opposite to a clot in stroke patients is just as important a target for treatment as the damaged tissue when it comes to a faster recovery.

Only in the past few years have researchers discovered that the uninjured side of the brain becomes more active after a stroke to help its fallen neighbor. In some instances, it pumps out proteins that induce damaged neurons to begin repairs and others that trigger new blood vessels to form. It can even extend its own neurons across hemispheres to restore function.

Current stroke treatments largely target the damaged tissue. “I think everyone thought, ‘The other side of the brain is working pretty well,’” says Stanford University neurologist Gary Steinberg. “‘Why don't we leave that alone?’” In light of the growing evidence that the healthy hemisphere provides aid naturally, however, doctors are now investigating how to boost its healing actions. One such drug, shepherded by Adviye Ergul of Georgia Regents University and Susan Fagan of the University of Georgia, activates receptors on uninjured tissue that trigger pathways to reduce harmful inflammation and support the growth of neurons and blood vessels on the side of the brain with the clot. The drug increases repair rates in rats that have experienced stroke—results described recently in the Journal of Hypertension—and Ergul and Fagan say the therapy could become available to humans in the next five years.

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