Created through a $50 million gift from the government of Abu Dhabi, the Johns Hopkins Sheikh Khalifa Stroke Institute (SKSI) continues to revolutionize stroke prevention and treatment as it celebrates its fifth anniversary.
“The world of stroke has really changed tremendously in the last five years, from acute therapeutics to prevention and recovery,” says Victor Urrutia, MD, the Sheikh Khalifa Stroke Institute Director. “And the impact of the SKSI extends beyond Baltimore and the United States to Abu Dhabi and other parts of the world.”
For patient Dana Goldstein, this impact hits closer to home, as she benefitted from surgery and other acute treatment as well as occupational, physical, and speech therapy at Johns Hopkins after suffering from stroke.
“I’m constantly seeing improvement, and Johns Hopkins saved my life,” Goldstein says.
About 12 million strokes occur each year worldwide, and one-third of the individuals affected have lasting impairment. Building on strengths in biomedical engineering, artificial intelligence, and precision medicine, the SKSI has established three centers of excellence to change how patients experience life after stroke.
For example, a direct current electrical stimulation study led by Argye Hillis, Med ’95 (MD), MA — director of the Center of Excellence in Stroke Detection and Diagnosis and the SKSI Professor of Acute Stroke Diagnoses and Management — has shown as much as a 20% increase in spelling and word recall for patients suffering from aphasia, a language disorder that can follow stroke.
An area of focus for Preeti Raghavan, MBBS — the SKSI Professor of Stroke, Recovery, and Rehabilitation and director of that related center of excellence — is how to address the sugar molecules that congeal inside muscles after a stroke, causing stiffness. In her clinical trial, when patients were injected with the enzyme hyaluronidase, to dissolve these sugar molecules, upper body joints with extreme stiffness were reduced from 50% to 10%.
Another member of the leadership team, John Krakauer, MD, MA — the John C. Malone Professor and director of the Center for the Study of Motor Learning and Brain Repair — has been a force behind the neurorestorative gaming utilized in MindPod Super Rooms, which provide fully immersive experiences to encourage interaction from patients. These games include the “Nono” device to aid in hand dexterity and “I am Dolphin” where an animated, on-screen dolphin mirrors patients’ movements as it swims through simulated waters. Clinical trials with the dolphin game have shown double the rate of motor recovery compared to traditional therapies alone.
By integrating these Super Rooms on the hospital floors and having bedside applications, “we are introducing therapies that will be the most efficient for patients in terms of their brain healing, during that critical period of the first couple of weeks after stroke,” says Mona Bahouth, MD, PhD, the medical director of the Brain Rescue Unit at Johns Hopkins Hospital. “We really set out to create the stroke unit of the future, and we’ve done just that.”
“And we want the journey for the patient to be as seamless and continuous as possible,” according to Raghavan, in reference to the Johns Hopkins continuum of care model which extends to outpatient, post-acute therapy and at-home rehabilitation kits.
With the Abu Dhabi Department of Health’s launch of the newly approved Standards for Licensed Stroke Centers, the SKSI is collaborating with this agency in the implementation of these standards. Other planned international projects include combining real-time video capture with artificial intelligence to assess motor deficits and an AI-driven platform to geo-map the incidence of intracerebral hemorrhages to inform public health interventions.
“We’ve also created a larger community of practice with standardized outcome measurement tools and protocols to make sure the highest level of patient care is provided, with local customizations,” says Michael Friedman, PT, MBA, director of SKSI’s Rehabilitation Programs and International Initiatives.
Looking forward to even greater collaboration across Johns Hopkins and with colleagues in the UAE and beyond, Urrutia predicts, “In the next five years, we’re going to see the expansion of the acute treatments like thrombolytics for 24 hours, the expansion of neurorestorative treatments based on video gaming, and notable advances in the prevention of stroke worldwide.”
“This is the tip of the iceberg,” Krakauer concurs. “We’ve only just begun.”
Topics: Johns Hopkins Medicine, Neurology, School of Medicine, Fuel Discovery, Johns Hopkins Medicine