James Simpkins on Stroke

Dana Alliance member James Simpkins, Ph.D., is working on novel treatments that could limit the damage and/or improve recovery from stroke. As a professor and the director of the Center for Basic & Translational Stroke Research at West Virginia University, he operates in a state that has a high rate of stroke. In recognition of Stroke Awareness Month, we asked Simpkins a few questions.james simpkins wvu

Why does West Virginia have a high incidence of stroke?

West Virginians have a very sedate lifestyle. They rank 49th nationally, per person, in exercise. They have a comparatively poor diet, high smoking and drinking rates, and rank in the bottom four or five in states in obesity, heart disease, hypertension, etc.

Also, the folks who show up to a hospital with a stroke often have really severe strokes, likely in part because of the geography of West Virginia. We’re completely within Appalachia, so it’s not uncommon for a 40-mile trip from a person’s home to a hospital to take an hour and a half or two hours. That puts those people close to if not outside the window for tissue plasminogen activator treatment.

What is the best advice you can give for someone who has already suffered a stroke?

Physical rehabilitation is critical to try to rewire the brain to achieve maximum possible recovery of function. Amazing things are possible. We’ve had folks who have lost 10 percent of their brain to a stroke, but recovered much of their function. It teaches us that the brain is very plastic. Areas that normally don’t subserve particular functions can take over those functions.

Lifestyle issues that led to the stroke need to be addressed. You can tell people, ‘Look, you’re 70 pounds overweight, your blood pressure’s through the roof, you smoke—you’re a candidate for a heart attack or stroke, and it’s going to happen pretty soon,’ and often that does not affect their behavior. It’s the heart attack or stroke that actually affects their behavior.

Is there any way to predict a stroke is coming?

The only things we know now is that if you have transient ischemic attacks or you’ve had a stroke, then you’re part of a population that is more likely to have stroke. Other than that, we don’t have any reliable biomarkers that predict stroke or tell us a stroke will happen at a certain time. Those are obviously desperately needed. There are dozens of groups looking for genetic markers, including ours.

Can you tell me about your research?

We’ve settled in on the search for molecules that enhance the capacity of mitochondria. Our working hypothesis is that every day we throw blood clots, every day those blood clots get into the cerebral vascular circulation and transiently cut off blood flow. These don’t always cause strokes because the brain has a capacity to supply energy when there’s a deprivation of oxygen to the brain. We think if we can increase mitochondrial function we would be able to prevent strokes, reduce the severity of strokes, or enhance recovery from strokes.

We started looking at microRNAs. They regulate a variety of proteins that are important for stroke outcomes and occurrences. They are critical for maintaining the blood-brain barrier and preventing clotting mechanisms from happening, resolving clots, and mitochondrial function. We discovered that circulating levels of microRNAs are much higher than those that we find in the brain. We’re looking at specific microRNAs as biomarkers of stroke or as affecters of mitochondrial function.

Anything else?

I know Dana is very much involved in the mission of inspiring the next generation. Liz Engler-Chiurazzi, a post-doctoral fellow in my lab, is involved with the West Virginia University Neuroscience Club. They’ve been going to schools and boys and girls clubs to get kids involved in understanding the brain. They have some hands-on activities that are really neat. It’s been a fun and rewarding activity for them.

–Andrew Kahn

One response

  1. Hello,
    My name is Confidence, and I am an MD, practicing in Nigeria. I can relate to what Dr Simpkins has said about stroke and the effects of delayed hospital presentation. At my center, we often don’t get to see these patients until days after the fact, which puts them way outside the therapeutic window. Recently, we have noticed a higher incidence of stroke, which has been associated with changes in lifestyle, the higher incidence of diabetes, undiagnosed hypertension and persistent lack of compliance with medications, in diagnosed cases.
    This has really been a great challenge to the medical personnel.

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