Cheeran, B and Cohen, L and Dobkin, B and Ford, G and Greenwood, R and Howard, D and Husain, M and Macleod, M and Nudo, R and Rothwell, J and Rudd, A and Teo, J and Ward, N and Wolf, S and Cumberland Consensus Working Grp, (2009) The Future of Restorative Neurosciences in Stroke: Driving the Translational Research Pipeline From Basic Science to Rehabilitation of People After Stroke. NEUROREHAB NEURAL RE , 23 (2) 97 - 107. 10.1177/1545968308326636.
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Background. Major advances during the past 50 years highlight the immense potential for restoration of function after neural injury, even in the damaged adult human brain. Yet, the translation of these advances into clinically useful treatments is painstakingly slow. Objective. Here, we consider why the traditional model of a "translational research pipeline" that transforms basic science into novel clinical practice has failed to improve rehabilitation practice for people after stroke. Results. We find that (1) most treatments trialed in vitro and in animal models have not yet resulted in obviously useful functional gains in patients; (2) most clinical trials of restorative treatments after stroke have been limited to small-scale studies; (3) patient recruitment for larger clinical trials is difficult; (4) the determinants of patient outcomes and what patients want remain complex and ill-defined, so that basic scientists have no clear view of the clinical importance of the problems that they are addressing; (5) research in academic neuroscience centers is poorly integrated with practice in front-line hospitals and the community, where the majority of patients are treated; and (6) partnership with both industry stakeholders and patient pressure groups is poorly developed, at least in the United Kingdom where research in the translational restorative neurosciences in stroke depends on public sector research funds and private charities. Conclusions. We argue that interaction between patients, front-line clinicians, and clinical and basic scientists is essential so that they can explore their different priorities, skills, and concerns. These interactions can be facilitated by funding research consortia that include basic and clinical scientists, clinicians and patient/carer representatives with funds targeted at those impairments that are major determinants of patient and carer outcomes. Consortia would be instrumental in developing a lexicon of common methods, standardized outcome measures, data sharing and long-term goals. Interactions of this sort would create a research-friendly, rather than only target-led, culture in front-line stroke rehabilitation services.
|Title:||The Future of Restorative Neurosciences in Stroke: Driving the Translational Research Pipeline From Basic Science to Rehabilitation of People After Stroke|
|Keywords:||Rehabilitation, Research pipeline, Translation, QUALITY-OF-LIFE, RANDOMIZED CONTROLLED-TRIAL, RECOVERY FOLLOWING STROKE, EARLY SUPPORTED DISCHARGE, MOTOR CORTEX STIMULATION, EAST MELBOURNE STROKE, CORTICAL STIMULATION, BRAIN-INJURY, PROMOTES RECOVERY, OCCUPATIONAL-THERAPY|
|UCL classification:||UCL > School of Life and Medical Sciences > Faculty of Brain Sciences > Psychology and Language Sciences (Division of) > Institute of Cognitive Neuroscience|
UCL > School of Life and Medical Sciences > Faculty of Brain Sciences > Institute of Neurology > Motor Neuroscience and Movement Disorders
UCL > School of Life and Medical Sciences > Faculty of Life Sciences
UCL > School of Life and Medical Sciences > Faculty of Medical Sciences > UCL Medical School
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