Today is World Stroke Day. One in four people will suffer from a stroke within their lifetime. The consequences of having a stroke are often life changing, dramatically altering both physical and mental capacities. Common effects post-stroke include pain, depression, changes in cognition (including dementia), communication difficulties (aphasia) and spasticity (the often-painful, involuntary contraction of muscles and stiffening and tightness of the muscle and joints). It is perhaps therefore unsurprising that stroke is one of the leading causes of disability worldwide.

Strokes occur when the blood supply to the brain is disrupted, resulting in oxygen starvation and the death of brain cells. The most common form of stroke is an ischemic stroke in which a clot occurs in an artery supplying the brain. The second type of stroke is called a haemorrhagic stroke in which a blood vessel within the brain burst, resulting in bleeding into the brain. The severity of a stroke and the resulting complications depend on the location and extent of the damage caused to the brain.

This year, World Stroke day aims to highlight the preventability of strokes and the importance of FAST acting treatment and, to support survivors in enjoying their life after stroke.

90% of strokes are associated with just 10 risk factors that everyone can act to minimise: High blood pressure, exercise, diet, weight, smoking, alcohol consumption, cholesterol, diabetes management, depression and stress, and atrial fibrillation (an irregular heartbeat).

For those who are unlucky enough to suffer from a stroke, minimising the damage caused to the brain is crucial. Many of the drugs available for stoke treatment include drugs that break up clots to restore blood flow to the brain. However, even then, damage to the brain often occurs with 1 in 4 survivors suffering from another stroke.

Advances in Regenerative Medicine are paving the way for a future in which some aspects of brain function could be recovered, thereby alleviating certain stroke symptoms. Both for ischemic and haemorrhagic strokes, the possibility of stem cell therapies are being investigated as a means to restore function to damaged parts of the brain. For ischemic stroke treatment there are now PhaseII/III clinical trials ongoing, however for haemorrhagic stroke treatment, trials are still at Phase I/II. Progress in other areas of advanced therapeutic strategies, for example bio printed scaffolds, have largely only been applied to treatment of the more common ischemic stroke. Development of these new technologies is still in the early phases, however, in preclinical animals models the results are promising. Nonetheless, many questions remain as to the safety of the materials used and the true efficacy of these treatments in restoring human brain function after stroke. The aim of RESTORE is to support and accelerate the development and availability of such Advanced Therapies such that all patients in need can benefit from the ongoing innovative research in Regenerative Medicine.

The two reviews below provide detailed information about the development of Advanced Therapies in relation to the treatment of stroke patients. The first review considers haemorrhagic stroke treatments, whilst the second covers Ischemic stroke treatment and what the future might look like in terms of tissue engineering approaches to therapy. (haemorrhagic) (Ischemic)