Big Ideas Fuel Stroke Recovery Research 

December 2014

With financial support from the Big Ideas in Neuroscience program, Maarten Lansberg, MD, PhD, and Marion Buckwalter, MD, PhD, have merged their basic science and clinical backgrounds, pulled in experts from across Stanford and built a collaborative network of brain power to tackle this essential question: Why do some patients recover better from stroke while others do not? The Stroke Collaborative Action Network, or SCAN, was developed to understand the mechanisms of stroke recovery and to enhance recovery through new treatments.

"The Big Ideas in Neuroscience program was the perfect vehicle for startup funding to get this project off the ground," says Lansberg, Associate Professor of Neurology. "It brought the neuroscience community together to rally around this idea of coming up with new strategies to help patients recover from stroke."

Worldwide, there are more than 33 million stroke survivors, half or a third of whom are disabled from their stroke. Yet the bulk of research dollars focus on stroke prevention and stroke management during an acute event.

"Stroke recovery research has really been neglected to some degree, considering how important a disease it is," says Buckwalter, Assistant Professor of Neurology and Neurosurgery. "Not enough people have focused on what we can do to help the brain repair itself. That's really what we've been interested in."

SCAN brings together experts in neurology, engineering, genetics, neurosurgery, linguistics, neuro-psychology, anesthesiology, psychiatry, radiology, medicine and pediatrics to look at treatment possibilities from a variety of fields: stem cells, modulating immune response, virtual reality games, transcranial magnetic stimulation and direct-current stimulation.

"We don't currently have a single effective therapy for stroke recovery," says Lansberg, who will be studying novel and standard therapies in a cohort of stroke patients experiencing arm weakness. While physical therapy, occupational therapy and speech therapy all seem to work to a certain extent in some patients, they haven't been studied rigorously, he says.

Many in the medical community feel that recovery from stroke is hopeless, that brain cells once damaged are irreparable. "But we have learned the brain is plastic, and can recover to a certain extent," says Lansberg. "We are interested in finding the mechanisms that help some patients improve more than others."

SCAN members will come together for monthly science meetings and a yearly symposium to present their progress on funded stroke research projects and new ideas. The goal, say its two creators, is to create opportunities that enable its members to share resources, pool data and learn from each other going forward.

"We want to create a vibrant culture of scientists who are all working toward solutions that will help people with stroke, whatever those solutions may be," says Buckwalter. "We will be open to new ideas, help each other evaluate ideas with the hope of increasing efficiency by recruiting people from all over the university to focus on this problem."

SCAN is just one of seven projects being funded through the Big Ideas in Neuroscience program, launched last year by William Newsome, PhD, director of the new Stanford Neurosciences Institute as a way to inspire faculty to think broadly about the intersections of neuroscience with society, engineering, medicine or other fields.

"The Big Ideas program scales up Stanford's excellence in interdisciplinary collaboration and has resulted in genuinely new collaborations among faculty who in many cases didn't even know each other prior to this process," says Newsome. "I was extremely pleased with the energy and creativity that bubbled up from faculty during the Big Ideas proposal process. Now we want to empower these new teams to do breakthrough research at important interdisciplinary boundaries that are critical to neuroscience."

The result is seven initiatives that create new interdisciplinary collaborations spanning Stanford schools and departments. The initiatives fall broadly into three categories:

NeuroDiscovery initiatives intend to probe the inner workings of the brain.

• NeuroChoice: Brian Knutson (psychology), Keith Humphreys (psychiatry) and Rob Malenka (neurobiology and psychiatry) – Probes how the brain makes decisions and expands that to influence public policy and economic decisions.
• NeuroCircuit: Amit Etkin (psychiatry) and Stephen Baccus (neurobiology) – Combines a detailed understanding of brain circuits with technology that modulates neural activity to develop improved ways of treating mental health conditions.
• NeuroVision: Steve Chu (molecular and cellular physiology), Liqun Luo (biology) and Tom Südhof (molecular and cellular physiology) – Develops optical technologies that enable neuroscientists to visualize the brain in unprecedented detail.

NeuroEngineering initiatives tap into Stanford's engineering faculty to create innovative new technologies for interfacing with the brain.

• Brain Machine Interface: Kwabena Boahen (bioengineering) and E.J. Chichilnisky (neurosurgery and ophthalmology) – Develops technology to interface with the brain and create intelligent prosthetics.
• NeuroFab: Nick Melosh (materials science) and Craig Garner (psychiatry) – Creates an incubator for next-generation neural interface platforms.

NeuroHealth initiatives create collaborations to translate neuroscience discoveries into treatments.

• Brain Rejuvenation: Aaron Gitler (genetics) and Tony Wyss-Coray (neurology) – Creates a center for neurodegeneration research focusing on brain maintenance and regeneration, and the role of the immune system in these processes.
• Stroke Collaborative Action Network: Marion Buckwalter (neurology and neurosurgery) and Maarten Lansberg (neurology). Breaches barriers in our understanding of stroke to develop therapies and improve stroke recovery.