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8 Headlines Stories from the front lines of stroke research Stroke is a major health issue. While prevention is the most important tool, providing those Kiwis who have had a stroke with the best acute care and rehabilitation is also vital. New Zealand leads some incredible stroke research, with many projects benefitting from the support of the Neurological Foundation. Professor Cathy Stinear TWIST: Time toWalking Independently after Stroke Cathy Stinear is a Professor at the University of Auckland and is currently Director of the Clinical Neuroscience Laboratory in the Department of Medicine, the University's Pro Vice-Chancellor Equity, and the Chair of the Neurological Foundation’s council. Professor Stinear is part of a team of scientists and clinicians who are predicting and promoting recovery after stroke. Around 9,500 people experience stroke each year in New Zealand, and most will have difficulty walking. Being able to walk independently is the most common rehabilitation goal for patients, and around three-quarters of patients achieve this goal in the weeks and months after stroke. The time it takes can vary significantly. Some are able to walk safely on their own again within just a day or two, and others need several months of therapy to achieve this goal. Unfortunately, predicting walking recovery is difficult based on clinical experience alone. This is because patients with similar stroke severity can have very different walking recovery trajectories and outcomes. At present, patients and their whānau are given little information about what to expect for walking recovery. This can create a long period of uncertainty about whether they will be able to live independently, return home, or require care, which creates additional stress in an already very difficult situation. Most patients whose walking is affected by stroke want more information about what to expect for their recovery. Having an accurate prediction early in recovery helps to plan a person’s care and rehabilitation, and enables their whānau to make informed decisions about the best way to care for their loved one. Professor Stinear and her team have identified the benefits that accurate predictions can have for patient care, reducing uncertainty for patients and their whānau regarding their recovery. They developed the Time to Walking Independently after Stroke (TWIST) prediction tool, which predicts when a patient will recover independent walking after stroke with >90% accuracy. In 2021, Professor Stinear and her teamwere awarded a project grant from the Neurological Foundation to validate TWIST so it can be implemented in clinical care and benefit the thousands of New Zealanders who experience stroke each year. This tool can then be used by clinicians 1-week post-stroke to predict both whether and when an individual patient will recover independent walking within the next 6 months. It is expected this will improve rehabilitation quality and efficiency, discharge planning, and patient and whānau experiences of stroke care. We are hosting an online talk with Professor Stinear and Professor Alan Barber on Tuesday 5 July. See page 3 for more details. Dr Ailsa McGregor Investigating the anti-inflammatory effects of novel curcumin analogues in stroke Dr Ailsa McGregor is a Senior Lecturer in Clinical Pharmacology at the University of Otago. Her area of interest is neurodegenerative diseases, in particular developing disease models to investigate potential therapies and the pharmacological enhancement of motor recovery after stroke, Huntington's disease, and vascular dementia. In 2018, Dr McGregor and her team were awarded a Neurological Foundation project grant to investigate the anti-inflammatory effects of curcumin on stroke. Curcumin is found in the popular cooking spice turmeric. It is a natural polyphenol that has been used for centuries in Ayurvedic and Traditional Chinese Medicine to help manage inflammation. Injuries like stroke are associated with profound inflammation in the brain. While inflammation helps the body repair, prolonged inflammation hampers repair and leads to poor outcomes in stroke patients. Dr McGregor’s research investigates the use of curcumin in stroke patients who are not suitable for clot busting therapy but have inflammation in the brain. This work will provide supporting evidence for developing a pharmacological therapy that could be easily translated to the clinical setting. Identifying an intervention that increases recovery after stroke has the potential to reduce the number of patients who live with severe disabilities and the costs of long-term healthcare. Designed to be administered days after stroke, this treatment would improve prospects for many stroke patients with delayed hospital admission, particularly those of Māori and Pacific descent who suffer more severe strokes at a younger age and have poorer outcomes.