According to the , more than 750,000 people in the U.S. will have a stroke each year. In Kentucky, strokes are the fifth leading cause of death, underscoring their significant impact both locally and nationally.

Recognizing the urgent need for improved therapies, and the University of Louisville are actively participating in a pivotal clinical trial known as the . This study focuses on patients who come to the emergency department 4.5 to 24 hours after the onset of an ischemic stroke and who are not candidates for standard treatment methods, such as previously approved clot-dissolving medications or mechanical interventions.

Upon arrival, patients undergo a comprehensive evaluation and advanced imaging to determine eligibility. If they meet all criteria, they may be enrolled in the study and randomly assigned to receive one of five doses of the investigational drug TS23, a type of clot-dissolving drug, or a placebo. The treatment is delivered through a single 20-minute infusion, followed by close monitoring and imaging at 30 hours post-treatment, with additional follow-up evaluations at 30 and 90 days to assess outcomes and recovery.

a neurosurgeon with , a part of , and associate professor in the Department of Neurological Surgery at the , leads the study at the Louisville site.

“By bringing this trial here, we are creating an opportunity for patients in town to get access to cutting-edge therapies that they otherwise could not access and at time windows during a stroke that typically prohibit them from getting a treatment drug. That is exciting,” Abecassis said.

Through innovative research initiatives like the SISTER trial, and UofL School of Medicine are working to enhance recovery, reduce long-term neurological damage and expand access to advanced stroke care. These efforts create opportunities for more personalized treatment, offering hope to patients and their families facing the life-altering effects of stroke.

Recognizing the signs and symptoms of a stroke is crucial. The acronym BE FAST can help you remember the most common warning signs:

• Balance lost – sudden loss of balance or coordination
• Eyes blur – sudden trouble seeing or blurred vision in one or both eyes
• Face drooping – one side of the face droops or is numb
• Arm weakness – sudden weakness or numbness of an arm or leg, especially on one side of the body
• Speech difficulty – sudden confusion, trouble speaking, or difficulty understanding speech
• Time – note the time the symptoms started and call 911 immediately

If you or someone around you experiences any of these symptoms, seek emergency medical care right away. Quick action can make a significant difference in treatment and recovery.

By Allison Dulin, UofL Health

Norman Lehman, UofL professor of pathology and biochemistry and molecular genetics, led the study of the origins of uncommon brain tumors called astroblastomas that most often affect children and young adults.

“This research gives us a new understanding of how childhood brain tumors with origins in early embryonic development arise,” Lehman said. “It could lead to detection very early in the formation of these types of tumors, new treatments or potentially even strategies to prevent their formation.”

The research, published this week in , revealed two distinct subtypes of these tumors, one that develops in early childhood, the other developing later in life.

The type of astroblastoma that occurs in young children is derived from radial glia that arise very early in the embryonic brain and are biologically related to tumors known as ependymomas. The other type of astroblastoma, typically occurring in young adults, is derived from later neural stem cells called outer radial glia and are biologically related to astrocytomas.

The research also has implications in understanding differences in tumor occurrence based on sex.

“The early-development astroblastoma tumor appears to occur exclusively in females, which may give us a better understanding of why certain types of tumors not involving the reproductive system are found more frequently in males or females,” Lehman said.

Lehman also said the tumors’ mechanisms likely involve alterations in DNA methylation that could possibly be exploited to detect tumor development early on or mitigate their development, but also are associated with other types of neural conditions.

“The altered genes that are associated with the development of these tumors are genes that also are associated with developmental neurocognitive disorders such as autism spectrum disorder, attention deficit hyperactivity disorder and schizophrenia,” he said.

Contributors to the work included Brian Williams and Akshitkumar Mistry, both assistant professors in the UofL Department of Neurological Surgery and neurosurgeons with UofL Health, UofL biochemistry and molecular genetics graduate student Müge Sak and former UofL pathology resident Khaled Alkhateeb.

“We have very few treatments for brain tumors,” Mistry said. “If we can get to the bottom of this very rare brain tumor in terms of its biological origins or its biological behavior, then that knowledge could be applied to some of the other aggressive brain cancers. The question is, how does this sort of research apply to other tumors that are not well understood, and can we gain insight into those other tumors to hopefully figure out how they’re behaving?”

Other important contributors included developmental biologist Nathalie Spassky of the Institut de Biologie de l’École Normale Supérieure in Paris and Kenneth Aldape of the National Cancer Institute Center for Cancer Research. 

“Management of Primary Glioma in Adults,” co-hosted by the UofL Department of Neurology and the James Graham Brown Cancer Center, a part of KentuckyOne Health, will be Friday, July 8 from 7:15 a.m. to 1 p.m. at the Kosair Charities Clinical and Translational Research Building, 505 S. Hancock St. on the University of Louisville Health Sciences Campus. The event is open to patients and their families, as well as physicians and health care professionals.

Conference director Eric Burton, MD, assistant professor in the UofL Department of Neurology and director of neuro-oncology at JGBCC, will provide an overview of adult glioma, a tumor that develops in the supportive tissue of the brain. Presenters from MD Anderson Cancer Center, University of California, San Francisco, Toronto General Hospital and the University of Louisville will then address best current practices and future treatment directions for patients with primary gliomas using surgery, radiation and chemotherapy, as well as a discussion of molecular markers in adult glioma.

“These are some of the most influential and highly respected physician researchers in neuro-oncology and neuropathology,” Burton said. “This is an excellent opportunity for physicians across the region, as well as patients and their families, to learn about the latest developments in the pathology and treatment of brain tumors.”

In addition to Burton, presenters include:

senior scientist and director of MacFeeters-Hamilton Brain Tumor Centre at Toronto General Hospital and professor in the Department of Laboratory Medicine and Pathobiology at the University of Toronto. Aldape is a neuropathologist with a research interest in primary brain tumors. His work includes the identification of biomarkers in gliomas, characterizing glioma subtypes and identifying clinically relevant molecular alterations in these tumors. In 2014, Aldape received the Guha Award for Excellence in Neuro-Oncology Research from the Society for Neuro-Oncology.

Charles B Wilson Chair in Neurosurgery and professor emeritus at the University of California San Francisco. Prados led the North America Brain Tumor Consortium for 15 years and was co-project leader of the Adult Brain Tumor Consortium until 2014. He formed and is co-project leader of the Pacific Pediatric Neuro-Oncology Consortium, a consortium of 15 major academic centers across the U.S., and is co-project leader of a pediatric brain tumor SPORE project at UCSF. Prados has been NIH/NCI funded continuously since 1994 and is a member of the NCI/CTEP Brain Malignancies Steering Committee. In 2014, he was awarded the Victor Levin Award for lifetime clinical research excellence from the Society of Neuro-Oncology.

chair and professor of the Department of Neurosurgery at the University of Texas MD Anderson Cancer Center in Houston. He is director of the Brain Tumor Center at MD Anderson and served as professor and chair of the Department of Neurosurgery at Baylor College of Medicine from 2005-2014. His awards include the Joseph P. Evans Award in Neurosurgery at the University of Cincinnati and the Charles Wilson Award from the National Brain Tumor Society. He is past chairman of the American Association of Neurological Surgeons/Congress of Neurological Surgeons Section on Tumors. Sawaya has particular expertise in primary and metastatic brain tumors and is renowned for his strides in enhancing the accessibility and safety of brain tumor surgery.

chair and professor in the UofL Department of Radiation Oncology, professor in the UofL Department of Pediatrics and the Kosair Children’s Hospital/Norton Healthcare Chair in Pediatric Oncology. His clinical focus and research is on brain and spine tumors, pediatric cancer and lung cancer. Woo has received Clinical Fellowship Awards from the American Cancer Society, Teacher of the Year Award from the Association of Residents in Radiation Oncology and the Patient Golden Apple Award from the MD Anderson Cancer Center. He also served as president of the MD Anderson Radiation Oncology Gilbert H. Fletcher Society.

Continuing education credit is available for health care providers. The event is free for UofL-affiliated providers, $15 for nurses and $20 for all others. For additional information, visit the or contact Emily Rollins at emily.rollins@louisvilleneuroscience.com.