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Posted by bookofjoe 17 hours ago

UCLA discovers first stroke rehabilitation drug to repair brain damage (2025)(stemcell.ucla.edu)
352 points | 70 comments
padolsey 11 hours ago|
My understanding was that strokes caused brain cell death, and that there was no coming back from that, but my neurologists would speak of 'bruised' brain cells, and that after weeks or months or even years you can see recovered function. UCLA's work here is targeting this disconnection and the lost rhythm in the surviving, distant networks. However there is, as yet, NO concievable intervention that could recover function from cell death at that center of the infarct.
asdff 9 hours ago||
There are people who are missing huge percentages of their brain from injury or other issues and lead a seemingly normal life.

https://www.cbc.ca/radio/asithappens/as-it-happens-thursday-...

throwup238 7 hours ago||
The original paper did not say that a huge percentage of their brain was missing [1], that was the journalist's flourish based on their own misunderstanding.

Tissue can be compressed, stretched, reorganized, or displaced especially to compensate for a congenital condition - the patient's brain had a lifetime to adapt to hydrocephalus, which pushed on the other brain tissue. The gray cortical shell is clearly visible in those images and their volume on a scan is not representative of neuron count or synaptic capacity.

There are far more dramatic cases of brain damage and neuroplasticity that reorganizes major functions, but there are a lot of caveats.

[1] https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

CamelCaseCondo 3 hours ago||
Was expecting an article about

https://en.wikipedia.org/wiki/Hemispherectomy

chmod775 22 seconds ago||
It's wild to me that this can have effectively no impact on a person's cognitive ability.
deepsun 4 hours ago|||
My understanding is that brain is composed of way more neurons than required, for resiliency. So if it gets a "bruise" in some part, when even a large portion of the cells are dead -- it can still function at 100%. Like a programmer without a finger. The problem is visible only when all the cells in some part are dead.

That's why crows, with their low brain mass are pretty clever (and why all arguments equating brain size and smartness are wrong).

Just my layman understanding.

sigmoid10 3 hours ago||
Crows (and certain other bird species) have a peculiar forebrain (different in structure but similar in function/evolution to the neocortex in mammals) with neuron counts rivalling primates. So the nr of neurons still matters, but likely not across the entire brain.
metalman 1 hour ago||
my understanding is that extream migrators actualy consume (use as energy) parts of there own brains durring there epic flights, and other species do something similar in the winter and regrow parts of there brains every spring.
sigmoid10 1 hour ago||
It is true that they can shrink some organs to reduce weight and store extra fat, but the brain is not one of them. Would be pretty bad, because brain cells can't regrow like e.g. a liver can.
jmalicki 7 hours ago|||
This talks about connections.

My understanding is that while brain cell death (outside of the hippocampus, at least) cannot regenerate, the connections and networks can.

But neurons regenerating connections between each other is, afaik, been pretty mainstream for awhile. The brain can't generate new cells, but it can rewire the connections between them, is what I understand. From reading the article, it seems to only claim rewiring connections, not regenerating cells.

There are a ton of upcoming drugs that help stimulating rewiring, for instance:

https://www.nia.nih.gov/news/new-drug-candidate-targeting-sy...

https://pmc.ncbi.nlm.nih.gov/articles/PMC8190578/

https://www.medicalnewstoday.com/articles/324410

etc.

adastra22 6 hours ago|||
There is lots of neural regeneration in the brain at the cellular level. The science on this is changing quickly.

But even though there are new brain cells growing, that does not mean you can reform lost structure.

oneshtein 5 hours ago|||
Lion’s mane mushroom and extracts are used by boxers to repair their brains. But it cannot be patented.
rasmus1610 2 hours ago|||
it is more like that the brain learns to use other regions or neurons to do the tasks of the dead brain cells. The brain cells that are dead due to ischemia are dead and will usually be collected by microglia and after some time there are defects in the brain where the ischemia was.
foota 10 hours ago||
One wonders if someday we might be able to resurrect the neural network from dead cells by somehow reviving the connections between neurons. I imagine that the connections stay, but become dormant when the neuron dies.
asdff 9 hours ago|||
There is nothing to resurrect. They get digested by the microglia.
foota 6 hours ago|||
Ah, I didn't know that existed. TIL
s5300 5 hours ago|||
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steve_taylor 9 hours ago|||
Perhaps, but I think that by the time we're that far advanced, strokes will be entirely preventable.
OneDeuxTriSeiGo 9 hours ago|||
Strokes will never be preventable. You can mitigate them but a stroke isn't really a disease. It's a symptom.

An ischemic stroke (i.e. stroke due to a clot) caused by vascular or cardiac issues can be mitigated. A cryptogenic stroke however is idiopathic and therefore has no understood cause. These types of strokes make up 30-40% of all strokes. Unless we figure out their cause, there's no way to really prevent them.

But then there's also hemorrhagic strokes which are an entirely separate category that has causes and mitigations more or less diametrically opposed to those for ischemic strokes.

And of course those are just your broad painted categories and they are generally looked at as the start of a medical emergency but strokes happen all the time as a consequence of other medical emergencies.

Even if you could perfectly prevent strokes in generally healthy populations, those same people may still end up suffering from a stroke during a surgery or during/after a major accident or injury. No amount of preventative medication can prevent someone suffering a stroke caused by a brain bleed after a car accident. Likewise for someone with a crush injury, internal bleeding, or broken bones that end up throwing a clot which makes it into the brain.

So any advancement in halting and reversing damage from a stroke will be a massive boon for emergency medicine until the end of time. Unless of course we somehow find a way to cure/render humans immune to blunt force trauma or lacerations.

adastra22 6 hours ago||
Sure you can. Just not with any technology on the horizon. But there is conceivable technology (e.g. medical nanotechnology) that could prevent strokes or stop them as they are happening.
s5300 5 hours ago|||
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MattCruikshank 13 hours ago||
If you've read Ted Chiang's "Understand," you'll understand why this headline made my eyes pop out. For those who haven't, it's in the "Stories of Your Life and Others" collection, which includes the short story that the film Arrival was based on.
jadbox 12 hours ago||
I'm a big fan of Ted Chiang's "Understand" short story, but I think your way over hyping the study there: more neuron growth does not even generally translate to higher intelligence and can often introduce a variety of degenerative effects because pathways are not being grown a an organized systematic way through natural process of experience adaptation.
TheGRS 13 hours ago|||
I just read this a few months ago and it was my first thought as well! Like Flowers for Algernon taken to its extremes.
locallost 4 hours ago|||
Thanks for the hint. I'd always thought the movie was inspired by Vonnegut's Slaughterhouse 5. The premise was the same, and even the aliens looked somewhat similar. Vonnegut jokingly described them as an upside down toilet brush.
naxios_official 13 hours ago||
[flagged]
kleton 12 hours ago||
It is this compound https://pubmed.ncbi.nlm.nih.gov/39106304/
elevaet 10 hours ago|
DDL-920, which apparently looks like this: https://www.probechem.com/userfiles/product/PC-22875.gif

"DDL-920 is a potent, selective and brain permeable negative allosteric modulator (NAM) of the γ-aminobutyric acid type A receptors (GABARs), inhibits parvalbumin (PV) expressing interneurons (PV+INs) and consequently enhances γ-oscillations both in vitro and in vivo."

https://www.probechem.com/products_DDL-920.html

xbmcuser 5 hours ago||
So my question does it work with Alzheimer's.?
hank2000 9 hours ago||
My understanding was that psychedelics have proven to be effective at opening up a “critical period” where a brain can rewire itself like when in childhood. Wonder if this is related.

https://academic.oup.com/brain/article/148/6/1862/8052899?gu...

nose 11 hours ago||
Could this treatment also help with other neurodegenerative diseases?
benoau 16 hours ago||
> “The goal is to have a medicine that stroke patients can take that produces the effects of rehabilitation,” said Dr. S. Thomas Carmichael, the study’s lead author and professor and chair of UCLA Neurology. “Rehabilitation after stroke is limited in its actual effects because most patients cannot sustain the rehab intensity needed for stroke recovery.

Sounds truly amazing, I have known two people who had severe strokes - one's PT was contingent on triaging resources to whoever was likely to recover more, another simply hated PT and speech therapy and often refused to participate or do the exercises. Even if it didn't help recovery a medicine like this would have reduced the stress of everyone involved.

trhway 11 hours ago||
> This type of neuron helps generate a brain rhythm, termed a gamma oscillation, which links neurons together so that they form coordinated networks to produce a behavior, such as movement. Stroke causes the brain to lose gamma oscillations. Successful physical rehabilitation in both laboratory mice and humans brought gamma oscillations back into the brain and, in the mouse model, repaired the lost connections of parvalbumin neurons.

>Carmichael and the team then identified two candidate drugs that might produce gamma oscillations after stroke. These drugs specifically work to excite parvalbumin neurons.

Asking while being total layperson here - can we generate those gamma oscillations by an [may be implanted] electronic device?

Edit: and google search to help, judging by the dates seems to be a pretty fresh field :

https://journals.plos.org/plosbiology/article?id=10.1371/jou...

"... by pairing robotic rehabilitation with a clinical-like noninvasive 40 Hz transcranial Alternating Current Stimulation, we achieved similar motor improvements mediated by the effective restoring of movement-related gamma band power, improvement of PV-IN maladaptive network dynamics, and increased PV-IN connections in premotor cortex. "

It also sounds like getting an exoskeleton for such patients can be helpful not only to perform immediate tasks, it also can be a part of the restoring process.

0xWTF 14 hours ago||
... in male mice.

I think savvy universities want PIs who are savvy enough to realize that the point of these is to boost measurable visibility like citation count and h-index, so the headline of a news release boosting the article doesn't matter. They can always blame a copy editor for the headlines. It could read "world peace solved with moon juice." The provost would only care if it generated negative feedback. So it's the PR department's job to juice it as much as possible without getting blowback.

somewhatgoated 14 hours ago|
Isn’t that where all drugs start out? But yea the headline doesnt tell the full story
cwillu 10 hours ago|||
“…in mice” isn't a criticism of the science, it's a criticism of the popularization.
adastra22 6 hours ago|||
There are many drugs that don’t work on mice.
nubg 13 hours ago|
How do they test this on mice? Do they trigger brain seizures in them?
Traubenfuchs 13 hours ago|
Many different techniques for different types of stroke:

We can block certain arteries mechanically by inserting a tool, inject photosensitive agent then cause a targeted clot with a laser, inject clotting agent, choke, inject blood vessel dissolving agent and re-inject its own blood.

I understand why we research this but I just could not do it.

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