General Research Focus: Cerebrovascular Disease/Stroke. Research efforts have involved several aspects of cerebrovascular disease. In the laboratory, work has centered on developing an understanding of the mechanisms underlying pharmacological modulation of motor recovery after injury to the cerebral cortex and has led to several clinical studies in patients with stroke and traumatic brain injury. Research in stroke has also focused on health policy issues related to the use of carotid endarterectomy and optimization of stroke prevention strategies. Research involving new therapies for acute stroke has been carried out through clinical trials. Current focus is on identifying genes associated with small-vessel type stroke.
Specific Approaches: Laboratory Research: Studies of recovery after sensorimotor cortex injury have focused on measurement of neurobehavioral recovery as influenced by systemically administered drugs modulating the activities of specific central neurotransmitters. This work has involved behavioral measures, stereotactic lesioning, basic neurochemistry, cerebral microdialysis, and immunocytochemistry. Health Policy Research: Work has focused on clinical health policy related to cerebrovascular disease carried out in conjunction with the Center for Clinical Health Policy Research. These studies have centered on the utilization of carotid endarterectomy and the optimization of secondary and tertiary stroke prevention with an emphasis on outcome measures.
Clinical Trials: Principal investigator at Duke for several stroke acute treatment trials including studies of GM1-ganglioside and several neuroprotective drugs including CGS-19755 (Selfotel), Eliprodil, and a glycine receptor anatagonist. Principal or co-investigator at Duke for several stroke prevention trials including the NIH-supported study of carotid angioplasty and stenting as compared with carotid endarterectomy (CREST), RESPECT (PFO closure), PROfESS (antiplatelet drugs and angiotensin receptor blocker). In addition, principal investigator for NIH-supported studies related to poststroke recovery and steering committee for SPARCL (statin for secondary stroke prevention).
Special Expertise: Effects of drugs on recovery after stroke and brain injury
Neuroplasticity and behavioral recovery after brain injury
Stroke trial design and outcomes measures
Carotid endarterectomy/ angioplasty-stenting
Stroke prevention (primary and secondary)
Stroke-related health policy and outcomes
Key Words: Neurorehabilitation, stroke, cerebrovascular disease, neurobehavior, carotid endarterectomy, angioplasty, health services, prevention, outcomes