The study was published recently in Jama Network Open.

“Children who have ASD often have a number of co-occurring maladaptive behaviors, such as irritability. We wanted to know whether these maladaptive behaviors can be addressed by an intervention with a low risk of side effects,” said Deborah A. Pearson, PhD, professor of psychiatry and behavioral sciences at McGovern Medical School at UTHealth Houston and lead author on this paper. Pearson is also the director of the Developmental Neuropsychology Clinic at UTHealth Houston.

Pearson said many children with ASD are selective about the foods they eat, often preferring carbohydrates like bread and pasta over protein. Some amino acids necessary for building neurotransmitters such as serotonin and dopamine, which are associated with behavioral and cognitive function, can only be obtained from food through protein digestion. 

A total of 190 children, ages 3-6, participated in the study. In the first double-blind phase of the trial, 92 children were randomized to the active treatment arm, and took 900 mg of a microencapsulated high-protease pancreatic porcine enzyme that was sprinkled on their food three times daily. In the other arm, 98 children had a placebo sprinkled on their food for 12 weeks. In the second open-label phase, all of the children received the active medication for 24 weeks.

According to the 12-week results, parents of children in the active treatment arm reported significant decreases in their child’s symptoms of irritability, hyperactivity/noncompliance, and inappropriate speech, relative to parents of children in the placebo arm. In the second 24-week phase, significant decreases were reported in all of the above behaviors, as well as in lethargy/social withdrawal. No serious adverse events were associated with the treatment.

“This study demonstrated that pancreatic enzymatic replacement — which is thought to enhance the supply of essential amino acids necessary for the synthesis of neurotransmitters — was associated with improved behavioral function in preschoolers with ASD, with minimal side effects,” Pearson said.

Co-authors on the paper included Robert L. Hendren, DO, with the University of California San Francisco School of Medicine, as well as Matthew F. Heil, PhD, and William R. McIntyre, PhD, with Curemark LLC, sponsor of the study.

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Just a few months ago, Cruz co-authored a UTHealth Houston-led study that found several routine vaccinations – including tetanus and diphtheria, with and without pertussis (Tdap/Td); shingles (HZ); and pneumococcal – were all associated with a reduced risk of developing Alzheimer’s disease. The study’s senior author was Paul E. Schulz, MD, the Rick McCord Professor in Neurology, the Umphrey Family Professor in Neurodegenerative Diseases, and director of the Neurocognitive Disorders Research Center with McGovern Medical School.

Having always been intrigued by the brain and neurocognitive disorders, Cruz connected with Schulz when she was considering participating in the medical school’s summer research program.

“After speaking with Dr. Schulz, it sunk in that we only have a few treatments for Alzheimer’s disease, and the majority of them are fairly recent,” Cruz said. “The idea that something as simple as a vaccine could have such a significant impact on your health really interested me.”

Through their research, which was published in July, they discovered patients who received the Tdap/Td vaccine were 30% less likely than their unvaccinated peers to develop the disease; HZ vaccination was associated with a 25% reduced risk of developing the disease; and the pneumococcal vaccine was linked to a 27% reduced risk.

For Cruz – whose family is from Brazil, Portugal, Spain, and Puerto Rico – this work holds special significance, as the Latino and Hispanic community is estimated to be 1.5 times more prone to develop Alzheimer’s disease than white non-Hispanics. It’s also personal, as Cruz lost her grandmother to dementia and remembers the emotional toll it took on her family.

“It seems that several social determinants of health are very influential in this discrepancy. This could also involve cultural barriers or limited access to health care services,” Cruz said. “What I think is really great about our study is that it highlights preventive medicine and provides even more incentive to get vaccinated, especially during a time with so much vaccine hesitancy.”   

This isn’t the only Alzheimer’s-related discovery Cruz has had a hand in. Earlier this year, she presented an abstract to the Alzheimer’s Association International Conference (AAIC) Neuroscience Next that investigated the association between Alzheimer’s disease and potential transmissible routes.

According to the preliminary findings, certain dental procedures – including dental cleanings, tooth extractions, and more – reduced the odds of developing Alzheimer’s disease. On the other hand, smoking, obesity, and unhealthy levels of cholesterol or fats in the blood increased the odds of the disease.

“More broadly, we are investigating whether there is a transmissible component to Alzheimer’s disease,” Cruz said of the overarching project, on which she is collaborating with Schulz; Kristofer Harris, RN, program manager in the Department of Neurology at the medical school; and Jenna Thomas, another medical student. “One of the more interesting things we’ve found so far is that greater access to dental care was associated with a decreased risk of Alzheimer’s disease, so that’s all the more reason to go to the dentist.”

To further examine the results from the transmissibility study, the researchers are delving deeper into the mechanisms underlying the protective effect of dental procedures against Alzheimer’s disease. The results will hopefully be available in December, but so far, the preliminary analysis is consistent with earlier findings.

With one year left in medical school, Cruz is still deciding whether she wants to apply for a residency in neurology or anesthesiology. But regardless of which path she chooses, she’s already made her mark with useful information to help guard older generations against a debilitating disease.

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Researchers leading the project are Sandra McKay, MD, associate professor of pediatrics with McGovern Medical School at UTHealth Houston, and Alexander Testa, PhD, assistant professor in the Department of Management, Policy and Community Health at UTHealth Houston School of Public Health.

According to the Centers for Disease Control and Prevention, in 2022 there were more than 48,000 firearm-related deaths in the United States based on provisional mortality data — that’s about 132 people dying from a firearm-related injury each day.

“Gun violence disproportionately impacts communities of color. Black Americans are 10 times more likely than white Americans to be victims of firearm homicide, and 18 times more likely to be victims of firearm assault injury,” said McKay, principal investigator of the study. “So, we have an opportunity to impact that here in the Greater Houston area. Our goal is to reduce those numbers of people who are victims of gun violence.”

For people caught in a cycle of violence, hospital-based violence intervention programs (HVIPs) can be crucial to provide holistic services and connections to critical community-based violence interventions that support them and reduce reinjury risk.

“Developing interventions to impact firearm violence requires a transdisciplinary approach with community–city–hospital interventions,” McKay said. “The lack of a current HVIP in the Greater Houston area — the fourth largest city in the United States — highlights the need to develop and implement this program as a critical community-based intervention to reduce firearm violence.” 

In order to begin implementing an HVIP at Memorial Hermann-Texas Medical Center, researchers have received $1.55 million for the ramp-up phase of the study. Over those two years, they will develop a coalition of internal and external stakeholders to advise on the formation and oversee the implementation of the Houston-HVIP, and implement and evaluate the program to determine the effectiveness of reducing repeat violent events.

Once the program is established, a randomized, controlled trial will be conducted to determine the effectiveness of the program, the impact of reinjury on those enrolled in each arm of the program, and the role of social determinants of health on firearm injury to the participant and the community. Researchers will also examine the program’s impact on racial and ethnic disparities in those impacted by firearm violence.

“This program has the chance to directly affect the lives of thousands, tens of thousands, of people in Houston, and it’s going to indirectly affect the lives of tens of thousands of more people, their families, their friends, and their networks,” said Testa, the co-principal investigator of the study. “So, I think this program holds a lot of potential to save a lot of lives, make Houston safer, and to deliver a large cost-effective return on assets and residents.”

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Pinpointing the location of these traumatic memories is the work behind a clinical trial, “Neuromodulation of the fear extinction circuit using temporally and anatomically specific TMS in humans,” led by Mohammed Milad, PhD, professor in the Louis A. Faillace Department of Psychiatry and Behavioral Sciences at McGovern Medical School at UTHealth Houston.

The 5-year project is now in its third year and recruiting patients in the Houston area. Milad joined the McGovern Medical School faculty in August from New York University, where the clinical trial began.

“The brain forms associations with significant emotions,” Milad said. “You can be listening to your favorite artist and then get in a car accident. Hearing the song a year later, the memory will never go away, but the visceral reaction will go away for 85 percent of us. The rest will still have that trigger of fear.”

The research aims to accelerate the reduction of the trigger artificially through the use of transcranial magnetic stimulation – a noninvasive approach to Pavlovian conditioning.

The study is looking to recruit 250 healthy volunteers, from ages 18 to 70. Volunteers will first have their brain imaged to produce individualized targeting of the TMS, which is used clinically to treat depression.

“If we can pair TMS to an event or stimuli, it will be much more effective,” Milad said. “We are looking at enhancing our capacity to regulate fear.”

For more information on the clinical trial, please see https://www.uth.edu/ctrc/ongoing-clinical-trials.

The institute, part of The Brown Foundation Institute of Molecular Medicine for the Prevention of Human Diseases with McGovern Medical School at UTHealth Houston, focuses on antibody drug resistance mechanisms, biomarkers for therapeutic antibodies, and antibody drug discovery targeting human diseases.

The new 250,000-square-foot building is set to open at the end of the month and will house translational research initiatives for UTHealth Houston, the Texas Medical Center, The University of Texas MD Anderson Cancer Center, and Texas A&M University Health Science Center.  

“It’s an honor to be one of the first labs in the building,” said An, professor of molecular medicine and director of the Texas Therapeutics Institute at McGovern Medical School and vice president of drug discovery at UTHealth Houston. “The Texas Medical Center recognizes the benefit of collaborative work, so the beauty of TMC³ is that it will allow us to work closely with other members in the medical center.”

The Antibody Drug Conjugate Lab led by Kyoji Tsuchikama, PhD, associate professor; the Antibody Drug Discovery Lab led by An and Ningyan Zhang, PhD, professor; and the Antibody Structural Biology and Virology Lab led by Kai Xu, PhD, will be based in the new TMC³ space.

“The institute’s faculty have generated more than 12 novel antibody drug leads that UTHealth Houston’s Office of Technology Management has licensed to eight biotechnology companies, six of which advanced to multiple clinical trials for diseases including breast cancer bone metastasis, solid tumor, spinal cord injury, acute myeloid leukemia, COVID-19, and other diseases,” said Bruce D. Butler, PhD, vice president of research and technology in the Office of Technology Management at UTHealth Houston.

The institute is, in part, supported by grants from the National Institutes of Health, the U.S. Department of Defense, and the Cancer Prevention Research Institute of Texas (CPRIT), which includes two CPRIT CORE grants for antibody drug development totaling $11.2 million. The institute also has support from the biotechnology and pharmaceutical industry and has established collaborations with numerous state and national leaders in drug discovery in both academia and industry.

“I am looking forward to expanding our labs into the new collaborative building, and I am thankful to the medical center and the faculty and staff at UTHealth Houston who support our translational research and believe in our work,” said An, who is the Robert A. Welch Distinguished University Chair in Chemistry.

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“I was floored. I consider myself to be relatively healthy, so I wasn’t expecting it,” Stroubakis said. “I was fortunate my wife Shannon recognized the jaundice conditions. She rushed me to the emergency room and after several scans and a tissue biopsy over the course of few days, I got the bad news.”

The pancreas produces enzymes to help digest food and makes the hormone insulin, which controls blood sugar. About 64,000 people will be diagnosed with pancreatic cancer this year, and nearly 51,000 will die from it. Pancreatic cancer is the third leading cause of cancer death in the U.S. and has a five-year survival rate of 12.5%.

Stroubakis was referred to Nirav Thosani, MD, professor in the Department of Surgery with McGovern Medical School at UTHealth Houston, to learn more about a unique clinical trial. Thosani is the co-lead investigator of PANCARDINAL-1, a single-site, single-arm, Phase II study that is evaluating the treatment of endoscopic ultrasound guided radio frequency ablation (EUS-RFA) in combination with standard-of-care chemotherapy.

The supplemental radiofrequency ablation treatment, in combination with chemotherapy, works to shrink tumors so there is less chance of the cancer spreading into blood vessels and patients can have a less invasive tumor removal procedure.

In a minimally invasive procedure, EUS-RFA is performed with an ultrasound-guided endoscope that delivers a high-frequency alternating current, which increases the temperature inside the cells of the targeted tissue, or tumor. This induces coagulative necrosis, or cell death, in solid tumors.

“We currently have two ongoing clinical trials and most patients with pancreatic cancer may qualify for one or the other trial. We have strict inclusion criterion for the PANCARDINAL-1 trial and we determined that he was a good candidate for the trial. His tumors were near critical blood vessels, so it was crucial to shrink them before surgery,” said Thosani, who is the director of the Center for Interventional Gastroenterology with McGovern Medical School.

In the span of a week, Stroubakis was enrolled in the trial and began receiving rounds of chemotherapy in September. By the end of 2021, he began the EUS-RFA treatment.

“What Dr. Thosani is doing with EUS-RFA made complete sense to me. You attack it from the inside out,” Stroubakis said.

After four months of chemotherapy and three EUS-RFA treatments, Stroubakis went to exploratory surgery for resection of the cancer on Feb. 4, 2022. However, there was significant inflammation of the pancreas, and the surgery could not be completed. Stroubakis recovered from the initial exploratory surgery and went back to systemic chemotherapy and RFA. After 14 months and nine more ablation treatments, Stroubakis’ tumor size was significantly reduced and he underwent the Whipple operation for resection of the pancreatic cancer on April 5, 2023. Stroubakis went home six days after surgery.

“From the beginning, Mr. Stroubakis and his wife have had an amazing, positive attitude. They have been through so much to get to this point today where he is six months out from surgery,” said Curtis Wray, MD, professor in the Department of Surgery with McGovern Medical School and co-lead investigator on the study. “Pancreatic cancer treatments have largely remained unchanged for the past 30 years. This new RFA treatment may help to improve outcomes and survival in a cancer with a high mortality rate. This pilot study may provide information to help design further trials involving RFA.”

Stroubakis is back working as an engineer and spending quality time with his wife and kids. He is amazed at how good he feels. “The team never lost hope; they got it done and now I’m back on track,” Stroubakis said.

For patient information about the trials, please email pancreasresearch@uth.tmc.edu.

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The findings were published today in Nature Cardiovascular Research.

Moyamoya disease is a condition where the arteries going through the neck and into the brain become blocked right when the arteries enter the brain. Moyamoya disease can lead to strokes and seizures. Children only a few months old can suffer a stroke due to the disease. Current treatments are limited to medications to reduce the risk of stroke and surgery to open or bypass blocked arteries.

“This disease is one of the major causes of stroke in children and nobody knows why this happens or why these arteries get clogged,” said Milewicz, senior author of the study and professor and director of the Division of Medical Genetics at McGovern Medical School at UTHealth Houston. “These children don’t smoke; they don’t have hypertension and they don’t have any of the other usual risk factors that cause strokes in adults.”

Researchers identified that a change in the gene called ACTA2 caused children to have moyamoya disease and strokes starting shortly after birth, a condition called Smooth Muscle Dysfunction Syndrome, and have been working to figure out how and why this ACTA2 change causes moyamoya disease and strokes. Previous research led by Milewicz identified that ACTA2 mutations are the cause of Smooth Muscle Dysfunction Syndrome. In addition to moyamoya disease, this condition causes dysfunction of smooth muscle cells throughout the body.

ACTA2 is found in the smooth muscle cells, which line the arteries and allow them to contract to control blood pressure and flow. Using model systems, including cells from patients with the ACTA2 variant that causes moyamoya disease, Milewicz and her team found that a mutation in ACTA2 causes the cells in the walls of the arteries in the brain to not differentiate properly, an essential component of vascular development.

“We found a new job that the ACTA2 protein is supposed to do that the mutant version cannot: to help make differentiated smooth muscle cells that stay in the blood vessel and contract to regulate blood pressure,” said Callie Kwartler, PhD, first author of the study and assistant professor in the Division of Medical Genetics at McGovern Medical School.

The result is that the cells with the ACTA2 variant continue to grow out of control and move into the inside of the artery, which may be the cause of blockages in the arteries.

“This is the first step into really understanding the cause of moyamoya disease,” said Milewicz, the President George Bush Chair in Cardiovascular Medicine with McGovern Medical School. “This is a disorder that starts out in childhood, and children with Smooth Muscle Dysfunction Syndrome die from strokes. We are working to use the information to prevent strokes in these children.”

Researchers will continue to focus on exploiting the mechanism of disease that they identified to find new treatment options for children with moyamoya disease.

This work was supported by an America Heart Association Merit Award; the National Heart, Lung and Blood Institute (RO1 HL146583); Marylin and Frederick R. Lummis, MD, Fellowship in the Biomedical Sciences (NIH TL1TR003169, NIH UL1TR003167, NIH F32HL154681 and NIH R01HL157949); British Heart Foundation (RG/17/5/32936 and FS/18/46/33663); and American Heart Association (20CDA35310689). Confocal microscopy was performed at the Center for Advanced Microscopy, Department of Integrative Biology and Pharmacology at McGovern Medical School.

Additional UTHealth Houston authors include Anita Kaw, MD, PhD; Pujun Guan, MM; Xue-yan Duan, PhD; Jose Emiliano Esparza Pinelo, BASc; Mikayla S. Borthwick Bowen, BS; and Jiyuan Chen, PhD. Other authors include Shuangtao Ma, MD, MSc, with Michigan State University College of Human Medicine (a former postdoctoral fellow at UTHealth Houston); Caroline Kernell, BS, with UT Southwestern Medical Center (a former student at UTHealth Houston); Charis Wang, BA, with Mayo Clinic (a former undergraduate student at UTHealth Houston); Albert J. Pedroza, MD, and Michael P. Fischbein, MD, PhD, with Stanford University; Yuan Zhong, PhD, with The University of Texas MD Anderson Cancer Center; Sanjay Sinha, MD, with the University of Cambridge; and Xuetong Shen, PhD, with the Institute of Cancer Research in Shenzhen, China.

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Researchers leading the project are Jair Soares, MD, PhD, professor and chair and the Pat R. Rutherford, Jr. Chair in Psychiatry in the Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences at McGovern Medical School at UTHealth Houston; and Rodrigo Machado-Vieira, MD, PhD, professor of psychiatry and director of the Bipolar Disorder Program in the department.

“This is a landmark initiative that will bring together several prestigious institutions and some of the leading scientists working in this area,” said Soares, who is also the director of the Center of Excellence on Mood Disorders. “We are excited to be part of this important effort and hopeful that the development of key knowledge will help us move towards the goal of precision psychiatry.”

Affecting nearly 40 million people worldwide, bipolar disorder is a serious mental health condition with dramatic and often unpredictable shifts in mood, energy, activity, and cognition. The BD² Integrated Network brings together two key models of advancing medicine. The first is the systematic collection of data from a defined set of participants over time, known as a longitudinal cohort study.

The second is the development of a system to repeatedly improve care for patients, known as a learning health network. The BD² Integrated Network aims to bring scale, time, and depth to phenotyping a cohort of people living with bipolar disorder.

“The goal is to address how symptoms are presented in relation to biomarkers that could be helpful to define best treatments,” Machado-Vieira said. “So, if a patient is presenting some symptoms with some biological findings, we aim that those findings will help to identify what would be the best treatment for that patient in a naturalistic setting.”

Researchers and clinicians see this data as the key to understanding patient subtypes, trajectories, and developing targeted interventions that will transform patient experience. This initial focus on bipolar I disorder allows the initiative to identify relevant patterns faster because diagnostic validity is stronger leading to less variation in the participants.

“Based on the profile of the individuals identified, clinicians could partner with researchers to identify and test alternative treatment approaches that are aligned with their biological profile,” Machado-Vieira said. “While these sub-studies are several years away, our infrastructure and network of providers make this vision uniquely possible and rapidly scalable.”

UTHealth Houston is one of the six regional centers in this initiative. Others are Brigham and Women’s Hospital-McLean Hospital, Johns Hopkins University, the University of Michigan, Mayo Clinic, and University of California Los Angeles. Researchers at UTHealth Houston will enroll up to 200 patients with bipolar disorder, who will be characterized through the collection of clinical, cognitive, imaging, and physiological markers over several years.

About UTHealth Houston

Established in 1972 by The University of Texas System Board of Regents, The University of Texas Health Science Center at Houston (UTHealth Houston) is Houston’s Health University and Texas’ resource for health care education, innovation, scientific discovery and excellence in patient care. The most comprehensive academic health center in the UT System and the U.S. Gulf Coast region, UTHealth Houston is home to Jane and Robert Cizik School of Nursing, John P. and Kathrine G. McGovern Medical School, D. Bradley McWilliams School of Biomedical Informatics, and schools of biomedical sciences, dentistry, and public health. UTHealth Houston includes the Dunn Behavioral Sciences Center and Harris County Psychiatric Center, as well as clinical practices UT Physicians, UT Dentists, and UT Health Services. The university’s primary teaching hospitals are Memorial Hermann-Texas Medical Center, Children’s Memorial Hermann Hospital, and Harris Health Lyndon B. Johnson Hospital. For more information, visit www.uth.edu.

About BD²

Breakthrough Discoveries for thriving with Bipolar Disorder is the first organization focused on funding and advancing research and care for bipolar disorder on a global scale. Our collaborative, open-science approach is designed to transform and shorten the time it takes for scientific breakthroughs to make a meaningful difference in the lives of the tens of millions of people with bipolar disorder. For more information, please visit bipolardiscoveries.org.

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The prostate gland, found only in men, produces seminal fluid. Risk factors for prostate cancer include age (most cases are diagnosed in men over 65), family history, and inheriting a gene mutation. Having a father or brother with prostate cancer doubles the risk of developing the disease. Mutations of the BRCA1 or BRCA2 genes, linked to ovarian and breast cancer in some families, can also increase the risk of prostate cancer in men.

Prostate cancer is generally slow-growing and, if found early, can be successfully treated. The prostate-specific antigen test, or PSA, in combination with new techniques in magnetic resonance imaging (MRI), can diagnose early disease.

McPhail, whose father also had prostate cancer, had regular checkups and it paid off. After his less aggressive form of cancer was diagnosed, it was monitored until it grew to a size that required surgery. Standard treatment is a radical prostatectomy (complete removal of the prostate gland) that may come with side effects including urinary incontinence and erectile dysfunction.

But tissue-sparing treatments using focal therapy are now becoming available for prostate cancer patients. McPhail joined a first-of-its-kind clinical trial at UTHealth Houston led by Steven Canfield, MD, that used gold nanoparticles to seek out and infiltrate cancerous tissue, after which a light was applied through a laser to excite the particles and destroy the cancer. Canfield is professor and chief of the Division of Urology in the Department of Surgery at McGovern Medical School at UTHealth Houston and the C.R. Bard, Inc./Edward J. McGuire, MD, Distinguished Chair in Urology.

The surgery was successful, but the cancer appeared in a new area in the prostate two years later. Canfield told him about another focal-therapy treatment, this time using the NanoKnife System to place electrodes that destroy the targeted tissue with electrical pulses. McPhail, a former Houstonian who retired to the Hill Country, just completed the second procedure last month and is back to exercising and writing with academic colleagues.

“Better MRI imaging allows us to see the cancer inside the prostate, which allows us to treat the area instead of removing the entire prostate,” Canfield said. “Surgeons can insert a probe and treat the cancer with thermal ablation therapies. The newest techniques, like the NanoKnife system, use no heat at all, so there is little to no damage to the surrounding tissues.”

Canfield said focal-therapy treatments can be used when the cancer is only within the prostate and hasn’t spread, which is why early diagnosis is so important.

“It’s a relief to have these kinds of procedures,” McPhail said. “It turns prostate cancer into something you live with and are treated for instead of a life-altering event with side effects that can be dreadful. The risk of those side effects is very small with the focal procedures. And I am confident I won’t die from prostate cancer.”

The study, which was published today in JAMA Neurology, was led by co-first authors Youngran Kim, PhD, assistant professor of management, policy, and community health with UTHealth Houston School of Public Health; and Juan Carlos Martinez-Gutierrez, MD, a former surgery fellow in the Vivian L. Smith Department of Neurosurgery with McGovern Medical School at UTHealth Houston, and as well as co-senior authors Sunil A. Sheth, MD, associate professor of neurology and director of the vascular neurology program with McGovern Medical School, and Luca Giancardo, PhD, associate professor at McWilliams School of Biomedical Informatics at UTHealth Houston.

LVO occurs when a major artery in the brain is blocked. Considered one of the more severe types of strokes, an LVO accounts for an estimated 24% to 46% of acute ischemic strokes. Prompt endovascular thrombectomy – a minimally invasive surgical procedure involving the removal of a blood clot from a blocked artery in the brain – can dramatically improve outcomes in patients with LVO acute ischemic stroke; however, its efficacy is highly time-dependent.

“The benefit of endovascular thrombectomy on functional recovery is time-sensitive, so early identification of patients with strokes with large vessel occlusions, and process improvements to accelerate in-hospital care, are critical,” Kim said. “Our study has shown that the implementation of AI software has improved workflows within the comprehensive stroke centers.”

To test how to improve in-hospital endovascular therapy workflows, researchers conducted a cluster-randomized, stepped-wedge clinical trial from Jan. 1, 2021, to Feb. 27, 2022, analyzing 243 patients with LVO stroke who presented at four comprehensive stroke centers in the Greater Houston area.

Viz LVO – artificial intelligence-enabled automated LVO detection from a computed tomography (CT) angiogram, coupled with secure messaging, was activated at the four sites in a random-stepped fashion. Once activated, clinicians and radiologists received real-time alerts to their mobile phones, notifying them of possible LVO within minutes of CT imaging completion. Members of the patient’s treatment team were also able to share information on cases in real time.

Critically, implementation of automated LVO detection software led to patients experiencing, on average, a statistically significant reduction of 11 minutes in time to thrombectomy initiation. Time from CT scan initiation to the start of endovascular therapy also fell by nearly 10 minutes.

“We are just at the beginning of automated machine-learning algorithms to benefit acute stroke care,” Giancardo said. “Many other applications are being developed, such as using CT angiograms to detect infarcted areas of the brain without advanced imaging, an NIH-funded effort by our research group which we recently published, or even the use of retina imaging as a proxy for brain imaging.”

The findings come shortly after the publication of another study led by Kim, Sheth, and other UTHealth Houston researchers, which found that, despite having worse stroke symptoms and living within comparable distances to comprehensive stroke centers, women with LVO acute ischemic stroke were less likely to be routed to the centers compared to men. Both studies are part of a broader effort to discover ways to improve stroke outcomes.

“Nearly 2 million brain cells die every minute the blockage remains, so speeding up treatments by 10 to 15 minutes can result in substantial improvements,” Sheth said. “Our study is the most rigorous of its kind to address the question of whether machine-learning software can result in a clinically meaningful improvement for patients with acute stroke, and here, we see that the answer is ‘yes.’”

Other co-authors with McGovern Medical School included Sergio Salazar-Marioni, MD; Muhammad Bilal Tariq, MD; Rania Abdelkhaleq, MPH; Arash Niktabe, BS; Anjan N. Ballekere, MS; Ananya Iyyangar, BS; Mai Le, BS; Hussain Azeem, BS; Charles Miller, PhD; Jon Tyson, MD, MPH; Sandi Shaw, RN; Peri Smith, RN; Mallory Cowan, RN; Isabel Gonzales, RN; Louise McCullough, MD, PhD; and Andrew Barreto, MD. Abdelkhaleq and Le are also with UTHealth Houston School of Public Health, and McCullough and Giancardo are also with The University of Texas MD Anderson Cancer Center UTHealth Houston Graduate School of Biomedical Sciences.

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