Principles of precision medicine in stroke
Jason D Hinman,Natalia S. Rost,Thomas W. Leung,Joan Montaner,Keith W. Muir,Scott Brown,Juan F. Arenillas,Edward Feldmann,David S Liebeskind +8 more
TLDR
The principles on a roadmap for rational application of precision medicine to stroke and cerebrovascular health are delineated and the need to identify, value, organise and analyse the multitude of variables obtained from each individual to generate a precise approach to optimise cerebroVascular health is considered.Abstract:
The era of precision medicine has arrived and conveys tremendous potential, particularly for stroke neurology. The diagnosis of stroke, its underlying aetiology, theranostic strategies, recurrence risk and path to recovery are populated by a series of highly individualised questions. Moreover, the phenotypic complexity of a clinical diagnosis of stroke makes a simple genetic risk assessment only partially informative on an individual basis. The guiding principles of precision medicine in stroke underscore the need to identify, value, organise and analyse the multitude of variables obtained from each individual to generate a precise approach to optimise cerebrovascular health. Existing data may be leveraged with novel technologies, informatics and practical clinical paradigms to apply these principles in stroke and realise the promise of precision medicine. Importantly, precision medicine in stroke will only be realised once efforts to collect, value and synthesise the wealth of data collected in clinical trials and routine care starts. Stroke theranostics, the ultimate vision of synchronising tailored therapeutic strategies based on specific diagnostic data, demand cerebrovascular expertise on big data approaches to clinically relevant paradigms. This review considers such challenges and delineates the principles on a roadmap for rational application of precision medicine to stroke and cerebrovascular health.read more
Citations
More filters
Journal ArticleDOI
A U-Net Deep Learning Framework for High Performance Vessel Segmentation in Patients With Cerebrovascular Disease.
Michelle Livne,Jana Rieger,Orhun Utku Aydin,Abdel Aziz Taha,Ela M. Akay,Tabea Kossen,Jan Sobesky,John D. Kelleher,Kristian Hildebrand,Dietmar Frey,Vince I. Madai +10 more
TL;DR: The U-net framework was optimized and evaluated with three metrics: Dice coefficient, 95% Hausdorff distance (95HD) and average Hausdorf distance (AVD) and revealed excellent performance in large vessels and sufficient performance in small vessels.
Journal ArticleDOI
Deep into the Brain: Artificial Intelligence in Stroke Imaging.
TL;DR: A glimpse at the use of AI in stroke imaging is offered, specifically focusing on its technical principles, clinical application, and future perspectives.
Journal ArticleDOI
The Use of Deep Learning to Predict Stroke Patient Mortality.
TL;DR: A deep neural network is used to detect stroke using medical service use and health behavior data and can be used by both patients and doctors to prescreen for possible stroke.
Journal ArticleDOI
Stroke in Africa: profile, progress, prospects and priorities.
Rufus Akinyemi,Bruce Ovbiagele,Olaleye Adeniji,Fred Stephen Sarfo,Foad Abd-Allah,Thierry Adoukonou,Okechukwu S Ogah,Okechukwu S Ogah,Pamela Naidoo,Albertino Damasceno,Richard Walker,Richard Walker,Richard Walker,Adesola Ogunniyi,Adesola Ogunniyi,Rajesh N. Kalaria,Rajesh N. Kalaria,Mayowa O. Owolabi,Mayowa O. Owolabi +18 more
TL;DR: The authors in this paper reviewed the unique profile of stroke in Africa and summarized current knowledge on stroke epidemiology, genetics, prevention, acute care, rehabilitation, outcomes, cost of care and awareness.
Journal ArticleDOI
Biomarker Application for Precision Medicine in Stroke
Alexis N Simpkins,Miroslaw Janowski,Helieh S. Oz,Jill Roberts,Gregory J. Bix,Sylvain Doré,Ann M. Stowe +6 more
TL;DR: It is proposed that future biomarker studies can be designed to support precision medicine therapeutic interventions after stroke, and an example of biomarker design for aneurysmal subarachnoid hemorrhage is presented.
References
More filters
Journal ArticleDOI
A Randomized Trial of Intraarterial Treatment for Acute Ischemic Stroke
Debbie Beumer,Debbie Beumer,Julie Staals,Jeannette Hofmeijer,Jelis Boiten,J. De Vries,Omid S. Eshghi,Koos Keizer,R. van den Berg,A. van der Lugt,Abstr Act +10 more
TL;DR: In patients with acute ischemic stroke caused by a proximal intracranial occlusion of the anterior circulation, intraarterial treatment administered within 6 hours after stroke onset was effective and safe.
Journal ArticleDOI
Endovascular Therapy for Ischemic Stroke with Perfusion-Imaging Selection
Bruce C.V. Campbell,Leonid Churilov,Nawaf Yassi,Bernard Yan,M. Brooks,F. Miteff,Martin Krause,M. Priglinger,Timothy Ang,Rebecca Scroop,Ben McGuinness,Tissa Wijeratne,Winston Chong,Monica S Badve,H. Rice,L. de Villiers,Henry Ma,Abstr Act +17 more
TL;DR: In patients with ischemic stroke with a proximal cerebral arterial occlusion and salvageable tissue on CT perfusion imaging, early thrombectomy with the Solitaire FR stent retriever, as compared with alteplase alone, improved reperfusion, early neurologic recovery, and functional outcome.
Journal ArticleDOI
Stent-retriever thrombectomy after intravenous t-PA vs. t-PA alone in stroke
Jeffrey L. Saver,Mayank Goyal,Alain Bonafe,Hans-Christoph Diener,Elad I. Levy,Vitor Mendes Pereira,Gregory W. Albers,Christophe Cognard,David J. Cohen,Werner Hacke,Olav Jansen,Tudor G Jovin,Heinrich Mattle,Raul G Nogueira,Adnan H. Siddiqui,Dileep R. Yavagal,Blaise Baxter,Thomas Devlin,Demetrius K. Lopes,Vivek Y. Reddy,Richard du Mesnil de Rochemont,Oliver C. Singer,Reza Jahan +22 more
TL;DR: In patients receiving intravenous t-PA for acute ischemic stroke, thrombectomy with the use of a stent retriever within 6 hours after onset improved functional outcomes at 90 days.
Journal ArticleDOI
A New Initiative on Precision Medicine
TL;DR: A research initiative that aims to accelerate progress toward a new era of precision medicine, with a near-term focus on cancers and a longer-term aim to generate knowledge applicable to the whole range of health and disease.
Journal ArticleDOI
Thrombectomy within 8 hours after symptom onset in ischemic stroke
A. Chamorro,Erik Cobo,Alex Rovira,L. San Román,Joaquín Serena,Sònia Abilleira,Marc Ribo,Mónica Millán,Xabier Urra,Pedro Cardona,E. López-Cancio,Alejandro Tomasello,Carlos Castaño,Jordi Blasco,Lucia Aja,Laura Dorado,Helena Quesada,Marta Rubiera,María Hernández-Pérez,Mayank Goyal,R. von Kummer,Antonio Dávalos +21 more
TL;DR: Among patients with anterior circulation stroke who could be treated within 8 hours after symptom onset, stent retriever thrombectomy reduced the severity of post-stroke disability and increased the rate of functional independence.
Related Papers (5)
Thrombectomy for Stroke at 6 to 16 Hours with Selection by Perfusion Imaging
Gregory W. Albers,Michael P. Marks,Stephanie Kemp,Soren Christensen,Jenny P Tsai,Santiago Ortega-Gutierrez,Ryan A McTaggart,Michel T. Torbey,May Kim-Tenser,Thabele M Leslie-Mazwi,Amrou Sarraj,Scott E. Kasner,Sameer A. Ansari,Sharon D. Yeatts,Scott Hamilton,Michael Mlynash,Jeremy J Heit,Greg Zaharchuk,Sun Kim,Janice Carrozzella,Yuko Y. Palesch,Andrew M. Demchuk,Roland Bammer,Philip W. Lavori,Joseph P. Broderick,Maarten G Lansberg +25 more
Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials
Mayank Goyal,Bijoy K Menon,Wim H. van Zwam,Diederik W.J. Dippel,Peter Mitchell,Andrew M. Demchuk,Antoni Dávalos,Charles B. L. M. Majoie,Aad van der Lugt,Maria Angeles De Miquel,Geoffrey A. Donnan,Yvo B.W.E.M. Roos,Alain Bonafe,Reza Jahan,Hans-Christoph Diener,Lucie A. van den Berg,Elad I. Levy,Olvert A. Berkhemer,Vitor Mendes Pereira,Jeremy L. Rempel,Mónica Millán,Stephen M. Davis,Daniel Roy,John Thornton,Luis San Roman,Marc Ribo,Debbie Beumer,Bruce Stouch,Scott Brown,Bruce C.V. Campbell,Robert J. van Oostenbrugge,Jeffrey L. Saver,Michael D. Hill,Tudor G Jovin +33 more
Thrombectomy 6 to 24 Hours after Stroke with a Mismatch between Deficit and Infarct.
Raul G Nogueira,Ashutosh P Jadhav,Diogo C Haussen,Alain Bonafe,Ronald F. Budzik,Parita Bhuva,Dileep R. Yavagal,Marc Ribo,Christophe Cognard,Ricardo A. Hanel,Cathy A. Sila,Ameer E Hassan,Mónica Millán,Elad I. Levy,Peter Mitchell,Michael Chen,Joey English,Qaisar A. Shah,Frank L. Silver,Vitor Mendes Pereira,Brijesh P Mehta,Blaise Baxter,Michael G. Abraham,Pedro Cardona,Erol Veznedaroglu,Frank R Hellinger,Lei Feng,Jawad F. Kirmani,Demetrius K. Lopes,Brian T. Jankowitz,Michael Frankel,Vincent Costalat,Nirav Vora,Albert J Yoo,Amer M. Malik,Anthony J. Furlan,Marta Rubiera,Amin Aghaebrahim,Jean-Marc Olivot,Wondwossen G Tekle,Ryan K. Shields,Todd Graves,Roger J. Lewis,Wade S. Smith,David S Liebeskind,Jeffrey L. Saver,Tudor G Jovin +46 more
Thrombectomy within 8 hours after symptom onset in ischemic stroke
A. Chamorro,Erik Cobo,Alex Rovira,L. San Román,Joaquín Serena,Sònia Abilleira,Marc Ribo,Mónica Millán,Xabier Urra,Pedro Cardona,E. López-Cancio,Alejandro Tomasello,Carlos Castaño,Jordi Blasco,Lucia Aja,Laura Dorado,Helena Quesada,Marta Rubiera,María Hernández-Pérez,Mayank Goyal,R. von Kummer,Antonio Dávalos +21 more