Tag Archives: brain

The Changing Field of Stroke Medication

Strokes are the fifth leading cause of deaths in North America. If one is fortunate enough to survive a stroke, the rehabilitation process is long and painful depending on the amount of damage done to the brain. There are two types of strokes – ischemic and hemorrhagic. Ischemic strokes are the result of a clot forming in an artery and preventing blood flow, whereas hemorrhagic strokes are the result of an artery bursting and and the brain literally bleeding out.

Many researchers have worked towards improving and developing treatments to reduce the amount of brain damage a patient suffers during a stroke. One of the events that takes place during a stroke is called excitotoxicity, where brain cells literally excite themselves to death.

Receptors like NMDA as well as calcium are key culprits in causing damage to brain tissue. NMDA is a protein that is present on nerve cells and binds to the neurotransmitter glutamate. When a stroke occurs, nerve cells release large amounts of glutamate which bind to these NMDA receptors. The binding of glutamate to an NMDA receptor causes it to open. Calcium which is present in excess on the outside of the nerve cell, enters the cell. The calcium alongside with glutamate go on to wreck havoc in the nerve cell ultimately leading to its death. 

Courtesy of Khashayar.

Dr. Nicolas Weilinger investigated what happens at a cellular level during a stroke and the mechanism which works to damage brain cells. While researching, Dr. Weilinger discovered a new signalling pathway that had broad reaching implications for brain physiology and pathology.

YouTube Preview Image Courtesy of Harnoor Shoker

The findings of this study are important because current treatments in place to protect the brain during and after a stroke are not as effective as they should be. One of the main findings of Dr. Weilinger’s paper was that another channel much bigger than NMDA called pannexin gets activated during a stroke. Pannexin is physically connected to the NMDA receptor so when the NMDA receptor opens it signals pannexin to open as well. The opening of another channel therefore allows more calcium and glutamate to enter at an even faster pace. Using this information, a new drug was designed that would prevent the NMDA receptor from communicating with pannexin – in other words it would block the physical connection between the two proteins.

The wider implications of Weilinger’s paper is to hopefully improve stroke treatment. Future research into Dr. Weilinger’s findings could potentially be the first step in discovering a new drug type that can be used to reduce brain damage suffered during a stroke.

**We would like to thank Dr. Nicholas Weillinger for his time and the SCIE 300 team for guiding us and providing feedback.**

Harnoor, Khashayar, Matthew.

Special K to treat the Blues

Ketamine is a drug that was developed in 1962 and is commonly used as an anesthetic during surgical procedures in humans as well as in animals. However, like most drugs, ketamine made its way into the party scene during the 90s due to it’s hallucinogenic as well as dissociative effects (alter a person’s perception of reality). Furthermore, it also became notorious for being a date rape drug and was eventually classified as a Schedule III drug.

A vial containing ketamine.

A vial containing ketamine. Courtesy of Wikimedia Commons

In an interesting turn of events, ketamine is now undergoing clinical trials for its potential use in the treatment of depression. Depression itself is a debilitating condition with approximately 121 million people globally affected by it. The same drug that was being used as a date rape drug is now being used to treat depression?!

Yes! Ketamine therapy is being used to treat patients with severe major depression who don’t respond to traditional antidepressant medication. The treatment consists of giving a low dose of ketamine to the patient. The most common way to administer ketamine is by injecting it or by intranasal (smelling it) use. The positive effects in mood can be seen within 24 hours and can last up to ten days. This is one of the biggest advantages of using ketamine because the effects are noticeable immediately compared to traditional antidepressants which can take up to several months to work.

A typical neuron. Courtesy of Wikimedia Commons

A typical neuron. Courtesy of Wikimedia Commons

Depression is a multi-faceted disorder with several causes, one of them being a reduction in synaptic connections – the area between two neurons. For example, picture a neuron being a tree during spring, with many branches and leaves. When depression comes along, that tree now looks shrivelled up with bare branches and no leaves. Introduce a bit of Special K at low doses, and it converts our sad looking tree into a healthy tree once again. In other words, the synaptic connections are restored. The exact mechanism behind this is still unknown and being investigated.

Like with any other treatment, ketamine therapy also has a few side effects. When patients are first given a dose of ketamine they experience dissociative effects which are only temporary. Another down side of ketamine treatment is cost. The effects of ketamine treatment are short lived so patients often have to get regular infusions and since insurance does not cover the cost of treatment, it can get expensive; a single dose can cost anywhere from $525 to $800.

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Courtesy of The Doctors

Furthermore, many opponents are concerned about the possibility of patients developing an addiction to ketamine. The dose used in clinical trials is well below the dose used by recreational users so it is very unlikely for the patient to develop an addiction. The future of ketamine therapy in treating depression looks promising and further studies should explore the long term effects of it before it becomes a standard in treating depression cases that don’t respond to traditional therapy.

Harnoor Shoker

The causes, symptoms and treatment of Stroke

Did you know that stroke is the fourth leading cause of death in Canada?

Stroke occurs when cells do not receive enough oxygen and nutrients, thus blood supply to the brain is interrupted or reduced. It most likely affects a person if they have a personal or family history of stroke, overweight, aged 55 or more, does not exercise much, drink heavily, or use illicit drugs. There are three main kinds of stroke: ischemic stroke, hemorrhagic stroke and Transient Ischemic Attack (TIA).

Illustration of ischemic stroke: Wikimedia commons by National Heart Lung and Blood Institute (NIH)

Illustration of ischemic stroke: Wikimedia commons by National Heart Lung and Blood Institute (NIH)

Ischemic stroke is the most common kind of stroke – at least 88% of strokes occurred are this type. As you can see from the image to the left, ischemic stroke happens due to the blockage or narrowing down of arteries that connect to the brain, resulting in low blood flow to the brain. The blockage is caused by blood clots, which can form in the arteries or even further away before the blood enters the narrower part of arteries within the brain.

Illustration of hemorrhagic stroke: Wikimedia commons by National Heart Lung and Blood Institute (NIH)

Illustration of hemorrhagic stroke: Wikimedia commons by National Heart Lung and Blood Institute (NIH)

On the other hand, hemorrhagic stroke is less common than Ischemic stroke. Although, only 15% consists of hemorrhagic stroke, 40% of the death occurs due to this type of stroke. As you can see from the image to the right, it takes place when a blood vessel ruptures causing blood to accumulate in the tissue surrounding the rupture. Pressure on the brain is produced as a result, as well as loss of blood to certain areas.

Transient Ischemic Attack is very different from the other two types of stroke. The flow of blood to the brain is only disrupted for a short period of time. However, it is similar to Ischemic stroke due to the fact that it is often caused by blood clots. This type of stroke serves as a warning signs for future strokes, indicating that there is a partially blocked artery or clot source in heart. Over one third of the people who experience this have a major stroke within a year, and between 10-15% will have a major stroke within three months.

Some symptoms of stroke include confusion, trouble with speaking and understanding, headache, possibly with altered consciousness or vomiting, numbness of the face, arm or leg at one side of the body, trouble with seeing in one or both eyes, trouble with walking, dizziness and lack of coordination.

When should you see the doctor? An easy way to tell if a person has any of the signs or symptoms of a stroke is by remembering the acronym FAST:

F – face drooping

A – arm weakness

S -speech difficulty

T- time to call 911

Call 911 or your local emergency number immediately as soon as you feel the symptoms. Every minute counts, as the potential for brain damage increases, the longer you wait.

Stroke must be treated within 4.5 hours after the events start. There are different types of treatment for each type of stroke. If you are having an ischemic stroke, a drug called tissue plasminogen activator (TPA) is given to break up the blood clot. Aspirin or other blood thinners are also given to the patient before surgery.

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-Shayini Kanageswaran