Stroke and Cerebrovascular Disease Research

The Division of Stroke and Cerebrovascular Disease in the Department of Neurology at Columbia University Irving Medical Center/NewYork-Presbyterian has been pursuing cutting edge clinical research for nearly 30 years. Faculty within our division conduct NIH- and foundation-sponsored research in all facets of stroke and cerebrovascular disease.

Our investigators currently run a number of stroke clinical trials, including the investigation of anticoagulation for cryptogenic stroke, surgical and stent revascularization of high grade carotid stenosis to improve cognitive function, and the benefits of rapid outpatient referral in the Emergency Department to reduce hospitalization and prevent stroke recurrence.

In the area of stroke recovery we are testing transcranial direct current stimulation to the brain to improve stroke motor deficits. Other investigators have tested novel community education efforts working with school-age children to recognize signs of stroke in their family members. And in the laboratory, our basic scientists are investigating the molecular basis of blood-brain barrier breakdown in acute stroke, cellular mechanisms of acute intracranial hemorrhage, and how brain arteries remodel in response to atherosclerotic stress factors. Our group is also involved in national, multi-center trials of CPAP for stroke recovery in acute stroke-related sleep apnea, and the use of surgery and stenting versus medical therapy for asymptomatic carotid artery disease.

Our faculty have led the country in population and community-based research, as well. The Northern Manhattan Study, a landmark epidemiological effort, was established in 1990, and has contributed to groundbreaking knowledge of stroke risk in minority populations. This study and other Columbia epidemiological studies of stroke risk factors in children and adults have continued to move the field forward in the investigation of novel stroke risk factors and stroke genetics.

Areas of Research

  • Blood-brain barrier biology
  • CNS and retina vascular biology
  • Dynamic imaging of the CNS vasculature
  • Models of psychiatric disorders
  • Neuroimmunology
  • Relationship between infection, inflammation and stroke
  • Stroke epidemiology

Studies

Stroke Prevention

  • Population-based assessment of stroke risk factors
  • Northern Manhattan Study: Mitchell Elkind, Joshua Willey, Jose Gutierrez
  • Cardiovascular Health Study: Mitchell Elkind, Joshua Willey, Jose Gutierrez
  • California Teachers Study: Mitchell Elkind, Jose Gutierrez
  • Stroke, Frailty and Successful Aging: Joshua Willey
  • Hip-Hop Public Health: utilizing youth in stroke care in the community: Olajide Williams
  • Engaging Religious Institutions for Dissemination of Stroke Information in the Community: Olajide Williams
  • Practice-based trial of home BP telemonitoring among minority stroke survivors: Olajide Williams
  • Antiplatelet versus anticoagulation for stroke prevention in patients with cancer: Randolph Marshall
  • Follow-up for the medical arm of the unruptured brain arteriovenous population from the ARUBA trial: JP Mohr
  • Stroke in left ventricular assist devices: Joshua Willey
  • AtRial Cardiopathy and Antithrombotic Drugs In prevention After cryptogenic stroke (ARCADIA): Mitchell Elkind

Stroke Pathophysiology

  • Blood Flow and Cognition: the impact of cerebral hemodynamics on cognitive function in carotid artery disease: Randolph Marshall
  • Vascular remodeling, a pathological study of the development of atherosclerosis and dolichoectasia: Jose Gutierrez
  • HIV infection and stroke: Jose Gutierrez
  • The impact of cardiac disease on cognitive dysfunction: MaryKay Pavol
  • Genetics control of the Blood Brain Barrier in ischemia: Dritan Agalliu
  • Genetics of collateral formation in acute ischemia: Randolph Marshall
  • Risk of Paradoxical Embolism (RoPE) Study: Mitchell Elkind
  • Vertebrobasilar Flow Evaluation and Risk of Transient Ischemic Attack & Stroke (VERITAS): Mitchell Elkind
  • Traffic pollution and cerebrovascular disease in the Northern Manhattan Study: Mitchell Elkind
  • Vasculopathy and Infection in Pediatric Stroke: Mitchell Elkind
  • Mechanisms of Early Recurrence in Intracranial Atherosclerotic Disease (MyRIAD): Mitchell Elkind

Stroke Recovery

  • The effect of a novel pharmacological agent on neuroplasticity after stroke: Randolph Marshall
  • Application of procedural Memory Strategies to Rehabilitation (MAStR): MaryKay Pavol
  • Follow-up for the interventional arm of the unruptured brain arteriovenous population from the ARUBA trial: JP Mohr

Acute Stroke

  • High dose statins for neuroprotection in acute stroke: Mitchell Elkind
  • Sliding scale versus standard administration of insulin in acute stroke: Neuro-ICU collaboration with Jan Claassen
  • Aspirin monotherapy versus Aspirin and Clopidogrel for minor stroke and TIA (POINT trial): Joshua Willey
  • Aspirin versus Ticagrelor for minor stroke and TIA (SOCRATES trial): Joshua Willey
  • Tissue plasminogen activator for minor stroke (PRISMS trial): Joshua Willey
  • Hypothermia for Neuroprotection in acute stroke: Neuro-ICU collaboration with Jan Claassen
  • Desferoxamine for treatment of Intracranial Hemorrhage: Neuro-ICU collaboration with Jan Claassen
  • Intravenous Natalizumab for Reducing Infarct Volume in Acute Ischemic Stroke (ACTION): Mitchell Elkind

Outcomes Research

  • Healthcare Cost Utilization Project Analyses: Mitchell Elkind
  • Get With The Guidelines – STROKE: Joshua Willey
  • SPARCS (HOSPTALIZATIONS IN New York STATE): Joshua Willey, Mitchell Elkind
  • National Health and Nutrition Examination Survey (NHANES): Jose Gutierrez
  • Outcome predictors after cardiac arrest: Sachin Agarwal
  • Modeling hemorrhage risk for brain vascular anomalies: retrospective comparison of annual hemorrhage rates for brain arteriovenous malformations and cavernous angiomas: JP Mohr