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 high dose statins for neuroprotection in acute stroke, an international study of surgery versus medical management of unruptured brain arteriovenous malformations, and the use of educational interventions in the Emergency Department to reduce the rates of stroke recurrence.  

In the area of stroke recovery we are testing novel pharmaceutical agents and robotics to improve stroke motor deficits. Other investigators have initiated novel community education efforts working with school-age children to recognize signs of stroke in their family members, and another new project using arterial specimens and advanced imaging techniques to investigate the pathophysiology of arterial disease.

Our group is also involved in national, multi-center trials of intra-arterial stents and brain cooling for acute stroke, and the use of surgery versus 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.

Our community-based research has also resulted in a highly effective stroke prevention program targeting school-age children in underserved populations who are learning to recognize and act on stroke signs in their relatives and neighbors, thus helping to reduce the burden of stroke in those communities.

In the laboratory, our division is investigating the underlying mechanisms of blood flow in the brain and the pathophysiology of vascular remodeling that contributes to stroke risk. Our investigators use advanced imaging methods, cerebral ultrasound, and neuropathological techniques to understand how the brain reorganizes after injury, and how brain arteries remodel in response to atherosclerotic stress factors.

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