Investigators in the Stroke Program are dedicated to the study of stroke health disparities, mostly pertaining to racial and ethnic minorities and women. They are well known for their work conducted in Corpus Christi, Texas, including the Brain Attack Surveillance in Corpus Christi (BASIC) Project, work that has been funded by the NIH since 1999 and has resulted in many important discoveries about stroke-related health disparities in Mexican Americans and women.
Stroke Program investigators are committed to improving stroke preparedness and stroke prevention through community-based work. This work, funded by the NIH, includes completed projects such as Kids Identifying and Defeating Stroke (KIDS), the first project to improve middle school children’s stroke preparedness, and ongoing work such as the Preparing to ReACT Immediately to Stroke through Education (PRAISE) and Stroke Health and Risk Education (SHARE) projects.
Stroke Program faculty investigate the relationship between sleep disorders and stroke and stroke outcome, and the treatment of sleep apnea in post-stroke patients. Two ongoing NIH-funded projects investigate the epidemiology of sleep apnea after stroke and health disparities related to sleep apnea after stroke.
The Stroke Program investigates stroke pathogenesis and outcomes using molecular, biochemical, cellular, model organism, and human tissue approaches. A federally-funded program seeks to understand the molecular mechanisms of cerebral small vessel disease, with a focus on the genetic disorder CADASIL (Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopthy). In addition, UM Stroke Program investigators are identifying roles of nuclear hormone receptors in neuronal injury, recovery, and adaptation using animal models. Several projects are underway that seek to define physiological regulation of heart rate, sleep, biological rhythms, and brain electrophysiology in response to stroke.
Stroke health services research seeks to improve the design of systems to deliver high quality, high value stroke care. Ongoing funded NIH research seeks to improve techniques to individualize clinical decisions, improve systems of care and understand the limitations of existing systems.
Much clinical research is performed at the University of Michigan’s Comprehensive Stroke Center [link: http://www.uofmhealth.org/
After a severe stroke, patients and families face difficult decisions about what type of treatments to pursue now that they may be facing new limitations in their abilities. Family members are asked to participate in decisions about use of breathing machines, feeding tubes, and resuscitation status, often with little background knowledge on which to base their decisions. Our investigators are working to learn more about this process so that we can improve current practice to help make the most appropriate decisions for each individual, and minimize the long- term negative impact on patients and family decision makers. Prior work has investigated the impact of do-not-resuscitate orders on prognostic models, patient outcomes as well as hospital quality rankings. Currently, we are working to better understand the perspectives of family decision makers so that we can design future intervention projects.