Research
Grant Scholars
With generous support from Pfizer Pharmaceuticals and private donors, The Goddess Fund has awarded five grants to promising young scholars. Our scholars are redefining stroke research: see for yourself by reading about their results. Simply click on the links below to read each scholar's research report and summary.
Transcranial Doppler and Recent Preeclampsia Pilot Study Protocol
Cheryl Bushnell, MD, MHS
Associate Professor, Department of Neurology
Wake Forest University Health Sciences
Preeclampsia is one of the hypertensive disorders of pregnancy that affects 5% of all pregnancies, and accounts for about 12% of maternal deaths. About 25 to 45% of women with pregnancy-associated stroke have preeclampsia or eclampsia. However, there is currently no method to predict which women with preeclampsia will be at higher risk of stroke. This study will examine ways to better predict which women with preeclampsia are at higher risk using a non-invasive method (Transcranial Doppler or TCD) to monitor blood flow velocity and vasomotor reactivity. The hypotheses that will be tested in this study are that women with mild to moderate preeclampsia (cases) will have elevated blood flow velocities and abnormal cerebral vasomotor reactivity as measured by Transcranial Dopplers (TCDs) compared to pregnant women without preeclampsia (controls). In addition, they will have abnormal levels of biomarkers reflecting inflammation, endothelial dysfunction, neuronal injury, and thrombosis in peripheral blood that represent the pathophysiology of preeclampsia compared to controls.
Estrogen-Mediated Neuroprotective Gene Expression in Brain
Nabil J. Alkayed, MD, PhD
Associate Professor, Department of Anesthesiology & Peri-Operative Medicine
Oregon Health & Science University
These studies will increase the understanding of the effects of hormone replacement therapy on the brain and their implications for stroke injury prevention and treatment. The goal is to identify genes expressed in the brain after stroke that are specifically modulated by estrogen. This information will be used to understand the role of genes in mediating the effects of estrogen in stroke, with the ultimate goal of targeting specific genes as a novel strategy to modulate stroke risk and outcome.
The Beauty Shop Education Project: Educating African-American Women About Stroke
Dawn Kleindorfer, MD
Assistant Professor, Department of Neurology
University of Cincinnati
This study will target the stroke education of African-American women by performing an educational intervention project in beauty parlors in Cincinnati, Ohio and Atlanta, Georgia. Beauticians that serve mostly African-American women will be taught about stroke, including a new easy-to-remember mnemonic for stroke warning signs. Beauticians will then educate their clients regarding stroke, and will hand out educational materials. Women who participate will be tested on their knowledge of stroke at six weeks and four months to identify sustained increases in knowledge.
Healthcare Utilization, Costs and Outcomes of Older Women with Stroke
Judith H. Lichtman, PhD, MPH
Assistant Professor, Department of Epidemiology and Public Health
Yale School of Medicine
This effort will analyze the gender gap in healthcare utilization patterns, costs, and outcomes of stroke. A particular emphasis will be placed on understanding why revascularization procedures, a preventative step, are applied differently and have different outcomes in women. The study will track Medicare data longitudinally to:
- Provide best estimates of long-term outcome following stroke in women;
- Inform planning for current stroke prevention therapies;
- Identify new opportunities for stroke prevention, and
- Provide data for influencing health policy related to stroke in women
Estrogen and Neurogenesis: Understanding Functional Recovery After Stroke
Louise D. McCullough, MD, PhD
Instructor, Departments of Neurology, and Anesthesiology and Critical Care Medicine
Johns Hopkins University School of Medicine
This study will analyze the effect of estrogen on the brain after stroke. The primary goal of this study is to evaluate the mechanisms by which estrogen enhances cell regeneration or proliferation in the brain after stroke, a process known as neurogenesis. This study will also determine if hormonal status impacts long-term behavioral recovery after injury. This research will lead to an improved understanding of stroke-induced neurogenesis, with the hope that this process can be enhanced and lead to improved recovery after stroke.
Research Summary: Repair and Regrowth of Brain Cells With Estrogen
Johns Hopkins University Assistant Professor and Dr. Louise McCullough received a Goddess Fund Career Development Grant in 2002. For the past two years, Dr. McCullough has studied the effects of the female hormone estrogen on the development and repair of brain cells in mice. Previous research by Dr. McCullough and others had shown that female animals suffer less damage from stroke than male animals. It was unclear, however, whether estrogen aided the healing process after a stroke, and whether estrogen could be of use in males as well. Understanding the relationship between estrogen, brain cell repair, and gender has significant implications for the rehabilitation of stroke patients in the future.
Dr. McCullough studied both the behavior, and later the brains, of male and female mice after ischemic strokes. Focusing on damage and recovery at the cellular level, Dr. McCullough has made several discoveries that have far-reaching significance. Some of the highlights of Dr. McCullough's research are:
- Stroke leads to cell death among males and cell survival among females at the cellular level as well as in intact animals: gender differences may exist at the cellular level, meaning that female brain cells react differently than male brain cells during a stroke.
- Estrogen significantly improves the growth of new neurons in stroke-damaged brains, regardless of gender: estrogen may improve and hasten recovery after a stroke in both females and males.
- Females with reduced estrogen levels had greater damage to brain cells than those with normal estrogen levels: estrogen protects brain cells and may reduce brain damage as a result of stroke.
Additionally, this Career Development Award has led to 9 published articles, 2 chapters in press, as well as 5 additional articles that are currently in preparation. Dr. McCullough has been invited to give several talks on the subject of gender and stroke, and has been actively involved in the "Stop Stroke" campaign in Maryland. In addition, she has obtained grant funding from the American Heart Association until 2007.
Carotid Artery Properties, Stroke Risk & Mortality in Multi-Ethnic Women
Tanja Rundek, MD, PhD
Assistant Professor of Clinical Neurology, Department of Neurology, Stroke Division
Columbia University Neurological Institute
This study has the potential to increase the ability to predict stroke among postmenopausal women and may ultimately lead to new ethnic-specific interventions to prevent cerebrovascular disease. The research will assess the association of specific carotid artery wall properties and carotid plaque with menopausal status and risk of stroke, myocardial infarction and mortality in an ethnically diverse population. A primary goal is to determine whether the progression of subclinical atherosclerosis in the carotid artery is influenced by age at menstruation, years since menopause and hormone replacement therapy, independent of conventional risk factors.
Research Summary: Using Ultrasound to Identify Stroke Risk
Columbia University Assistant Professor Dr. Tanja Rundek received a Goddess Fund Career Development Grant in 2001. During the past three years, Dr. Rundek has been using ultrasound - a form of sonar best known for its use in obstetrics - to study the build up of plaque in the carotid arteries of the neck. Hardening of artery walls due to plaque buildup, a condition known as atherosclerosis, is a common cause of stroke. Unfortunately, people with atherosclerosis generally do not manifest symptoms until the condition is considerably advanced. If caught early enough, however, atherosclerosis can be treated and the risk for a later stroke greatly reduced.
Through ultrasound analysis of carotid arteries, Dr. Rundek sought to identify atherosclerosis among women from diverse racial and ethnic backgrounds before symptoms developed. Her work established a promising foundation for exciting new research in the use of ultrasound in stroke prevention. Among her results, Dr. Rundek found that:
- The carotid arteries of postmenopausal women are smaller and have stiffer walls: postmenopausal women may have a greater risk of stroke than men of similar age.
- There is a significant association between the metabolic syndrome (obesity, high cholesterol, high insulin, high blood pressure, and high triglycerides) and thickened carotid arteries: women with the metabolic syndrome may be at greater risk of developing atherosclerosis, and thus be at greater risk for stroke.
- Carotid ultrasound can be used for early identification of atherosclerosis: carotid ultrasound is a promising technique for identifying individuals with higher stroke risk.
These data have been of enormous scientific interest and have generated hypotheses for future research. As a result of her Career Development Grant research, Dr. Rundek has been lead author on 15 papers and abstracts, and has presented her results at 12 different research conferences worldwide. She has also received the prestigious Gilbert Baum Memorial Grant for promotion of ultrasound in medicine from the American Institute of Ultrasound in Medicine. Finally, Dr. Rundek has received three subsequent research grants to test the hypotheses generated from her Career Development Grant research.