When a stroke occurs, the brain can't wait for treatment. This invasive condition affects nearly 800,000 people yearly in the United States alone, according to the Centers for Disease Control, and for every minute of delay in therapy, millions of brain cells die. Optimizing care for these patients requires rapid stroke diagnosis and triage to accelerate the recovery process.
Better therapy in one drop
Sunil A. Sheth, MD, a fellow of radiological sciences in the David Geffen School of Medicine at UCLA, is working on a new technique to diagnose a stroke accurately and quickly using a small blood sample. "We have blood tests that tell us what's going on with many organs of the body," Dr. Sheth says. "These tests are fundamental to modern-day clinical medicine. However, there's no blood test that can reliably tell us what's going on in the brain."
Prior efforts to develop such a test have relied on proteins and have yet to result in a clinically useful blood test. Dr. Sheth and his colleagues are taking an entirely new approach.
"The vast majority of the brain is made of fat," he says. "We wanted to tailor our efforts to take advantage of this unique composition, as these molecules may be highly specific to the brain and not found in significant concentrations elsewhere in the body."
The presumption is that when the brain is injured — as it is in a stroke — these unique fatty acids are released into the blood stream. Dr. Sheth's test then detects these brain-specific molecules, and requires only a drop of blood to do so.
"Ultimately, our goal is to develop a test that could be done by the patient's bedside or in the ambulance," he says. "We hope this test can help reduce uncertainty in diagnosis that results in delay in treatment. We want to get our patients to the right place that can give them the right treatment as quickly as possible. This is the best way to [maximize their] chance for a good outcome."
Moving research forward
Dr. Sheth's research had early success when using mice and rats. A small sample of 15 people later showed promising results and led to a grant award to continue his work. Earlier this year, the neurologist received the Lawrence M. Brass, M.D., Stroke Research Award, affording him $154,000 to continue his research.
Under the grant, Dr. Sheth and his colleagues will expand their research to test patients who present at the hospital with various stroke symptoms. Using the blood from clinical draws upon admission, the team will validate the test against the current standard of diagnosing stroke, which includes detailed neurological testing and brain imaging.
Dr. Sheth looks to build upon his work and test his technique in other neurological conditions. In particular, he hopes to see if this form of stroke diagnosis is effective in identifying concussions or minor traumatic brain injuries that are too subtle to be seen in brain scans.
By Patricia Chaney