Research roundup: improving stroke treatment, gene variant doubles dementia risk for men, and more
NR Times explores the latest research developments impacting on neuro-rehab.
Newly developed technique may improve success rates in treating strokes
Researchers at Stanford Engineering have developed a new technique called the milli-spinner thrombectomy that could significantly improve success rates in treating strokes.
The treatment may also improve success rates for treating heart attacks, pulmonary embolisms, and other clot-related diseases.
Current technologies only successfully remove clots on the first try about 50 per cent of the time, and in about 15 per cent of cases, they fail completely.
In a new paper, the researchers used both flow models and animal studies to show that the milli-spinner significantly outperforms available treatments and offers a new approach for fast, easy, and complete clot removal.
“For most cases, we’re more than doubling the efficacy of current technology, and for the toughest clots – which we’re only removing about 11 per cent of the time with current devices – we’re getting the artery open on the first try 90 per cent of the time,” said co-author Jeremy Heit, chief of Neuroimaging and Neurointervention at Stanford and an associate professor of radiology.
“It’s unbelievable. This is a sea-change technology that will drastically improve our ability to help people.”
“With existing technology, there’s no way to reduce the size of the clot. They rely on deforming and rupturing the clot to remove it,” said Renee Zhao, an assistant professor of mechanical engineering and senior author on the paper.
“What’s unique about the milli-spinner is that it applies compression and shear forces to shrink the entire clot, dramatically reducing the volume without causing rupture.”
The milli-spinner, which also reaches the clot through a catheter, consists of a long, hollow tube that can rotate rapidly, with a series of fins and slits that help create a localized suction near the clot. This applies two forces – compression and shear – to roll the fibrin threads into a tight ball without breaking them.
Zhao and her colleagues showed that the milli-spinner could reduce a clot to as little as 5 per cent of its original volume. The process shakes free the red blood cells, which move normally through the body once they aren’t trapped in fibrin, and the now-tiny fibrin ball is sucked into the milli-spinner and out of the body.
“It works so well, for a wide range of clot compositions and sizes,” Zhao said.
“Even for tough, fibrin-rich clots, which are impossible to treat with current technologies, our milli-spinner can treat them using this simple yet powerful mechanics concept to densify the fibrin network and shrink the clot.”
“We’re exploring other biomedical applications for the milli-spinner design, and even possibilities beyond medicine. There are some very exciting opportunities ahead.”
Knowing the difference it could make for stroke patients and those with other blood clot-related diseases, Zhao, Heit, and their colleagues are hoping to get the milli-spinner thrombectomy approved for patient use as soon as possible.
They have started a new company that licenses the technology from Stanford in order to develop and bring it to market, with clinical trials planned for the near future.
“What makes this technology truly exciting is its unique mechanism to actively reshape and compact clots, rather than just extracting them,” Zhao said.
“We’re working to bring this into clinical settings, where it could significantly boost the success rate of thrombectomy procedures and save patients’ lives.”
Common gene variant doubles dementia risk for men
New research has revealed that men who carry a common genetic variant are twice as likely to develop dementia in their lifetime compared to women, a new study has revealed.
The research used data from the ASPirin in Reducing Events in the Elderly (ASPREE) trial to investigate whether people who had variants in the haemochromatosis (HFE) gene, which is critical for regulating iron levels in the body, might be at increased risk of dementia.
According to co-author of the study, Professor John Olynyk from Curtin Medical School, one in three people carry one copy of the variant, known as H63D, while one in 36 carry two copies.
Olynyk said that while having one copy of this gene variant does not impact someone’s health or increase their risk of dementia, having two copies of the variant more than doubles the risk of dementia in men, but not women.
Professor Olynyk said: “While the genetic variant itself cannot be changed, the brain pathways which it affects – leading to the damage that causes dementia – could potentially be treated if we understood more about it.”
P2Y12 drugs may be better than aspirin to prevent stroke in patients with coronary artery disease
Patients with coronary artery disease are less likely to experience a heart attack or stroke if they take a P2Y12 inhibitor anti-clotting drug, according to new research.
This is compared with traditional aspirin, with no increased risk of major bleeding, the study found.
P2Y12 inhibitors are often given to patients alongside aspirin, known as dual therapy, after percutaneous coronary intervention (PCI) – a procedure to widen or unblock a coronary artery – to help prevent cardiovascular events including heart attack and stroke.
Typically, patients are switched from dual therapy to lifelong aspirin after several months. However, some trials have suggested that a P2Y12 inhibitor may be more effective for long term prevention than aspirin.
To find out more, researchers analysed five randomised clinical trials involving 16,117 patients who were assigned to a P2Y12 inhibitor of clopidogrel or ticagrelor or aspirin after completing dual therapy following PCI.
The team found that after an average follow-up period of around four years, P2Y12 inhibitor therapy was associated with a 23 per cent lower risk of an outcome that combined cardiovascular death, heart attack, or stroke, compared with aspirin, with no significant difference in major bleeding.
This means that for every 46 patients taking a P2Y12 inhibitor instead of aspirin after dual therapy, one cardiovascular death, heart attack, or stroke would be prevented.
However, all-cause death, cardiovascular death, and stent thrombosis were similar between the treatments.
“Overall, this study supports preferential P2Y12 inhibitor monotherapy prescription over aspirin due to reductions in major adverse cardiac and cerebrovascular events (MACCE) without increasing major bleeding in the medium term,” the researchers say.
However, they note that “medium term efficacy does not necessarily extend lifelong, which is the duration we advise patients to continue these medications”, suggesting that “a large-scale globally representative trial directly comparing different monotherapy strategies (including discontinuation) with extended follow-up would benefit our understanding of the long-term impact of P2Y12 inhibitor monotherapy across the treatment class for secondary prevention following PCI.”
Personalised exercise boosts health for people with neuromuscular disease
The health of people living with neuromuscular diseases may benefit from a personalised exercise and coaching programme that could improve their fitness.
The researcher team highlight that physical inactivity is common among people with neuromuscular diseases, often due to symptoms such as muscle weakness, fatigue and pain
The new study looked at people with a variety of neuromuscular diseases that cause muscle weakness and loss, including muscular dystrophies; post-polio syndrome, a condition that appears decades after a polio infection; and Charcot-Marie-Tooth disease, which affects nerves in the arms and legs.
Participants in the exercise programme completed workouts at home using a stationary bike. Most workouts were done at low intensity and some at high intensity with help from physical therapists through face-to-face and phone sessions.
Alongside the exercise, they received coaching to stay motivated and active, including goal setting and feedback on daily activity, with the goal of making it easier to integrate physical activity into daily life.
Author Eric Voorn, of Amsterdam University Medical Center in the Netherlands, said: “Our study found that personalised home-based aerobic exercise combined with coaching is a safe and effective way to improve physical fitness in people with these diseases.”
The team found that immediately after the exercise programme, the exercise group had average oxygen levels 2.2 ml/min/kg higher than the usual care group. This shows that the people in the exercise group had about a 10% increase in physical fitness.
One year after the programme, the exercise group had average levels of 23.9 ml/min/kg respectively compared to 20.9 ml/min/kg respectively in the usual care group. Over the entire study, the exercise group had average oxygen levels 1.7 ml/min/kg higher than the usual care group.
The number of adverse events like falls or pain was similar between the two groups. The exercise group experienced 22 adverse events compared to 25 adverse events in the usual care group.
“Future research should look at how changes in fitness levels affect how well people with neuromuscular diseases can do everyday activities,” said Voorn.
“It should also look at ways to motivate people to keep exercising regularly in their daily lives to make sure the benefits of long-term treatments are maintained.”
New non-invasive method discovered to enhance brain waste clearance
Scientists have uncovered a non-invasive method to boost the brain’s natural waste drainage system- a discovery that could open new avenues for tackling age-related neurological disorders such as Alzheimer’s Disease.
Researchers from the IBS Center for Vascular Research demonstrated that precisely stimulating the lymphatics under skin on the neck and face can significantly enhance the flow of cerebrospinal fluid (CSF) – the liquid that cushions the brain and helps remove toxic waste – through lymphatic vessels.
This offers a new approach to clearing brain waste using safe, non-invasive mechanical stimulation, rather than relying on drugs or surgical interventions.
The IBS Center for Vascular Research previously published landmark studies in Nature (2019 and 2024) demonstrating that CSF drains to deep cervical lymph nodes via meningeal lymphatic vessels at the base of the skull and the nasopharyngeal lymphatic plexus.
They also showed that age-related degeneration of these lymphatics impairs CSF clearance.
Furthermore, the team found that CSF drainage could be enhanced or suppressed pharmacologically by targeting cervical lymphatic vessels outside the skull. However, clinical applications remained limited because these lymphatics are located too deep in the neck for non-invasive access.
“This research not only completed the map of cerebrospinal fluid drainage pathways that clear brain waste, but also provided a new method to enhance CSF drainage from outside the brain,” stated KOH Gou Young, centre director and corresponding author.
“We expect this will serve as a milestone for future research on neurodegenerative diseases including dementia.”
Now, using genetically modified mice and monkeys with fluorescent tracers, the researchers have mapped out a new CSF drainage route from the brain to superficial cervical lymph nodes – via a network of lymphatic vessels in the face, nose, and hard palate.
In older animals, many of these routes had degenerated – except for the vessels just beneath the facial skin, which retained full functionality despite ageing.
“We confirmed that lymphatic vessels beneath facial skin connect to submandibular lymph nodes through various pathways,” explained JIN Hokyung, senior researcher and co-first author.
“Through these connections, we can regulate the reduced cerebrospinal fluid drainage function seen in aging and neurodegenerative diseases. Further research is needed to determine how this newly identified pathway can be applied in actual patients.”
Recognising this, the team developed a force-regulated mechanical stimulator – a handheld device that gently presses and strokes the skin in a controlled manner. When applied to aged mice, the device restored CSF clearance to youthful levels, dramatically improving drainage without disrupting natural lymphatic contractions.
This technique could pave the way for wearable or clinical devices that enhance brain waste clearance in older adults or patients with neurological conditions. The team is now investigating how this drainage system behaves in diseases like Alzheimer’s – and whether mechanical stimulation could serve as a preventive or therapeutic tool.
