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Women’s Imaging of Stroke Hemodynamics Study (WISHeS)
This study addresses the women’s health issue of cerebrovascular disease through a multi-institutional retrospective study accompanied by a prospective aim. The number of deaths due to stroke in Texas is higher than the national average and is increasing. Stroke is the third leading cause of death for women (in comparison, stroke is the fifth leading cause of death for men). Each year, 55,000 more women than men have strokes. Because in general women live longer than men, stroke will have a more negative impact on their lives.
Due to this, more women will: Live alone when they have a stroke, be more likely to live in a long-term health care facility after a stroke, have a worse recovery after stroke. Women may report symptoms that are different from common symptoms. These unique symptoms create a problem as they are often not recognized as a stroke and treatment is often delayed. This is an important problem because most effective stroke treatments are only available if the stroke is recognized and diagnosed within hours of the first symptoms.
Neuroimaging can provide cerebral vascular measures that predict outcome from stroke. The Women’s Imaging of Stroke Hemodynamics Study (WISHeS) project is the first of its kind to determine candidate sex differences in cerebrovascular and hemodynamic predictors of stroke. The data obtained will provide the basis for a prospective observational trial examining these differences and their effect on stroke outcomes. If sex differences are confirmed in treatment responses or time windows related to vascular or hemodynamic differences, this LSSC-funded study will be the cornerstone to future clinical trials as well as changes in practice for treating men and women.
Active and enrolling. The Women’s Imaging of Stroke Hemodynamics study (WISHeS) will use neuroimaging to examine cerebrovascular and hemodynamic predictors of stroke outcome to understand how they are different in women. The multi-institutional retrospective aspect of WISHeS has enrolled 162 patients from the LSSC Hub Coordinating center. Enrollment is planned for at least one other Hub (UT Southwestern Medical Center and Spoke hospital (St. Joseph Regional Health Center, Bryan). Currently, 162 stroke patients are enrolled for this retrospective aim. A prospective trial at the coordinating Hub will further explore the sex differences in neuroimaging and common risk factors as well as information regarding hormonal therapy and parity. The protocols are outlined and case report forms are in development.
Plans for 2019 – 2020
Enrollment of LSSC Hubs and Spokes will continue for the retrospective review of sex differences in imaging and clinical parameters. An image repository will be curated including all imaging data to be used as a basis for hypothesis generation and further development of personalized stroke protocols. Statistical analyses of these established databases will follow in parallel with enrollment in the prospective aim at the coordinating LSSC Hub site. The resulting data will be presented at national conferences and a manuscript will be prepared to communicate the findings. The findings will be used as a basis to leverage additional external funding support from sources such as the NIH and AHA.