The New South Wales (NSW) State Brain Clot Bank, in Sydney, is aiming to collect over 1400 specimens from donors at the hi-tech facility over the next four years.
Researchers will focus on cryptogenic stroke – those caused by a blood clot of unknown origin.
These make up between 30 and 40 per cent of all patients whose stroke was caused by a blood clot and can be difficult to treat since the cause is not known.
Chief investigator Dr Sonu Bhaskar told the Sydney Morning Herald: “The whole platform has been designed with a single ambition or mission – to improve the outcomes of patients with stroke in NSW, Australia and then globally.
“We can potentially make a dent in at least knowing where the clots are coming from, and whether that has potential in clinical decision-making.”
Associate professor Murray Killingsworth, NSW Health Pathology’s principal scientist, added: “[Using] amazing analytical systems which can break these clots down into an almost single-molecule level, we can understand what’s exactly making up the clot, where it came from and how it’s interacting with normal tissue in the brain. We’re very proud to say this will be a fully open-access digital resource which will be available to anyone in the world.
“Traditionally a lot of researchers are very protective of their data, and we both believe by throwing this open to everyone we’re going to get the best input from the rest of the world.”
Meanwhile, Australian stroke survivors are to receive broader access to Botox (botulinum toxin type A) treatment, potentially saving them thousands of dollars.
From this month they can access Botox to treat involuntary muscle movements (spasticity) in their lower limbs, via the Pharmaceutical Benefits Scheme (PBS). People affected by spinal cord and traumatic brain injuries could also benefit from the treatment.
More than 475,000 Australians are living with the effects of stroke, with around a third (38 per cent) suffering spasticity within 12 months of their stroke. Eight out of 10 of people with spinal cord injury will also reportedly have spasticity.
The new inclusion of Botox injections on the PBS is aimed at better supporting the management of their symptoms, quality of life and reducing the burden of such conditions.
Spasticity resulting from injury to the central nervous system causes tightening or stiffness in muscles which can lead to jerking, twisting and involuntary contraction of the limbs, poor motor control, weakness and fatigue.
In Australia it is currently treated by a team of rehabilitation specialists including rehabilitation physicians or neurologists, allied health professionals and nurses.
Botox injections are administered through intramuscular injections which contain the muscle relaxant obtained from the bacterium Clostridium botulinum. They work by temporarily relaxing the overactive or contracting muscles.
Professor John Olver, director of the Rehabilitation, Mental Health and Chronic Pain Clinical Institute at Victoria’s Epworth clinic, said: “Being able to do basic day-to-day tasks like wear shoes and socks correctly, go to the bathroom without assistance, or walk without pain, have the potential to make an enormous improvement to their quality of life.
“Providing broader access to further treatment options is a critical commitment we need to make to this community living day to day with the devastation of neurological injury. We also need to consider the impact to their families and carers.
“It’s very important for anyone with focal spasticity of the lower limbs to seek the advice from their regular healthcare professional – their GP or physiotherapist who can consider referral to a rehabilitation physician or neurologist to discuss appropriate treatment options.”
Michelle Sharkey, CEO of the Australia-based Stroke Recovery Association said the PBS listing was a welcome step to assist and restore further physical function to those recovering from stroke, brain injury and other debilitating conditions.
“We commend the government for recognising the burden of lower limb spasticity on those who are already battling to recover from conditions like stroke and brain injury. It is imperative we ensure we make every proven approach available to give these patients every opportunity to maximise their rehabilitation and quality of life.”
Treatment of lower limb spasticity should be tailored to each individual based on the size, number and location of muscles involved, the severity of spasticity, presence of local muscle weakness, and the patient’s response to previous treatment. Clinical changes in muscle tone generally occurs within two weeks following treatment, with the peak effect seen in four to six weeks.
Most side effects that have been reported in patients being treated with Botox injection for focal spasticity were mild to moderate and got better without needing medical attention.
Side effects reported include: pain in the affected limb, changes in ease of movement of the muscle, increased sensitivity to touch or pain, headache, muscular weakness, pain at the injection site, fever, flu-like illness, joint pain, swelling of the extremities such as the hands and feet and bruising under the skin.
Less common side effects include: weakness or a loss of energy, skin problems, nausea, ‘pins & needles’, itching, rash, pain and lack of coordination.
In the UK, Botox to treat leg and arm spasticity has been available on the NHS for several years.