Stroke Recovery Program
The Stanford Stroke Recovery Program is dedicated to improving the function and quality of life of stroke survivors. Based at Stanford University, the Program is uniquely positioned to bridge the barriers between neuroscience, engineering, and clinical research, to develop new therapies for stroke survivors. With grant funding from the Stanford Neuroscience Institute, the Program has brought together world-renowned scientists from a wide variety of disciplines, including stroke neurology, neurosurgery, neuroscience, mechanical, electrical, and bio-engineering, systems and molecular neuroscience, imaging/radiology, neuroimmunology, and genetics.
Our multi-disciplinary team of scientists is constantly innovating to develop new treatments that will improve gait, arm function and cognition after stroke. The medical innovations developed in our laboratories span a wide array, including immune-modulating therapies, stem-cell therapies, non-invasive brain stimulation (TMS), and medical devices developed by Stanford engineers. Being located in the center of Silicon Valley, the worlds most well-known hub for technological innovation, the Program has also established ties with multiple start-up companies that have developed innovative technologies to help patients recover from stroke. Our highly-experienced group of clinical scientists conducts trials to tests how effective these new treatments are at improving the symptoms of stroke survivors.
In addition to advancing research in the field of stroke recovery, we have a strong clinical neurologic rehabilitation program that serves stroke patients from the San Francisco Bay Area and beyond. A multi-disciplinary team of physiatrists, stroke neurologists, stroke nurses, physical therapists, occupational therapists, speech therapists, neuropsychologists, and social workers works together to provide the best care possible for our patients. The outpatient neurological rehabilitation program is based at Stanford Healthcare's state-of-the-art Neuroscience Health Center. The center, designed with the patient in mind, has an expansive gym with specialty equipment for patients with neurological impairments, spacious exam rooms, and convenient parking in the adjacent parking structure. The center is also home to the Neuroscience Supportive Care Program, which provides a variety of free support groups, classes, workshops, personal one-on-one consultations and services that are open to all patients and families in the community regardless of where they receive their stroke care.
Stroke Patient Care
Stanford Health Care’s nationally-recognized Comprehensive Stroke Program provides comprehensive care and treatment for stroke.
Greg Albers, MD
Professor of Neurology and Neurological Sciences
Dr. Albers has been the Director of the Stanford Stroke Center since its inception in 1992. He is a leader in the clinical care of stroke patients as well as cerebrovascular research and education. Dr. Albers has published over 300 articles in the medical literature and has been the principal investigator of more than 70 clinical studies. He has chaired multiple consensus panels that have published national and international guidelines for stroke treatment and prevention. Under his guidance, the Stroke Center has trained more than 40 clinical stroke specialists; many of these individuals are directing stroke centers at academic institutions thoughout the country.
Martin Angst, MD
Professor of Anesthesia
The Angst Laboratory’s transformative research efforts focus on immune health in the context of surgery and trauma. In a broader sense, their work is pertinent to clinical conditions that are governed by an acute inflammatory response. The aim of studying immunity in patients suffering from acute inflammatory conditions such as surgery is to identify immune phenotypes that will predict clinical outcomes, discover maladaptive mechanisms that result in adverse outcomes, and devise immune-modulatory strategies that will improve outcomes. Mass cytometry (CyTOF), proteomics, and functional ex-vivo immune assays are the major molecular tools used for the systems-based functional exploration of the circulating immune system.
Nima Agheepour, MD
Instructor, Anesthesiology, Perioperative and Pain Medicine
Dr. Aghaeepour is an expert in analysis of multi-dimensional data sets with training in computer science, artificial intelligence, and machine learning. His research focuses on developing analytical pipelines from highly complex datasets, with the goal of distilling biological meaning and producing direct clinical impact.
Marion Buckwalter, MD, PhD
Associate Professor of Neurology and Neurological Sciences, and Neurosurgery
Dr. Buckwalter is a stroke clinician and basic scientist, and her laboratory focuses on how inflammation after stroke affects outcomes. They utilize complementary mouse models of stroke, and use transgenic, viral, and pharmacological techniques to alter inflammatory gene expression and assess the effect on outcome. Her lab also utilizes human samples from ongoing clinical studies at the Stanford Stroke Center.
Howard Y. Chang MD, PhD
Professor of Dermatology
Dr. Chang is Director of the Center for Personal Dynamic Regulomes and Professor of Dermatology at Stanford University School of Medicine. Chang earned a Ph.D. in Biology from MIT, M.D. from Harvard Medical School, and completed Dermatology residency and postdoctoral training at Stanford University. His research addresses how large sets of genes are turned on or off together, which is important in normal development, cancer, and aging. Chang discovered a new class of genes, termed long noncoding RNAs, can control gene activity throughout the genome, illuminating a new layer of biological regulation. He has invented new methods for defining the shapes of RNA and DNA genome-wide. The long term goal of his research is to decipher the regulatory information in the genome to benefit human health.
Scott L. Delp, PhD
James H. Clark Professor, Schools of Engineering and Medicine
Dr. Delp and his collaborators use their expertise in biomechanics, computer science, imaging, robotics, and neuroscience to analyze muscle function, study human movement, design medical technologies, and optimize human performance. His team has measured the movement dynamics of thousands of individuals with movement disorders, and has developed realistic computer simulations to gain insight into the causes of abnormal movement and design methods to improve movement through surgery or robotic assistance.
Lauren Drag, PhD
Clinical Instructor (Affiliated), Neurology & Neurological Sciences
Lauren Drag, PhD, is a Clinical Instructor (Affiliated) in the Department of Neurology and Neurological Sciences at Stanford University School of Medicine. She received her bachelor’s degree from Pomona College and a Ph.D. in clinical psychology from the University of Arizona. She completed a clinical internship in neuropsychology at the VA Ann Arbor Medical Center and a two-year post-doctoral fellowship in neuropsychology at the University of Michigan Healthcare System. Prior to coming to Stanford, she was a researcher at the VA Palo Alto Medical Center and served as Director of the Neuropsychology Area of Emphasis at Palo Alto University. Dr. Drag’s research interests are in cognitive aging and traumatic brain injury.
Amit Etkin, MD, PhD
Assistant Professor of Psychiatry
Amit Etkin is a human systems neuroscientist and psychiatrist. His interest is in using advanced functional neuroimaging tools to define causal neural circuit pathways in the brain in health and disease. To do this, he combines external perturbation of brain circuitry using transcranial magnetic stimulation (TMS) while imaging the consequences with concurrent fMRI or EEG. This allows them to define what the causal consequences are in the brain of inducing activation in any particular region in accessible cortical regions. He hopes to apply these methods to stroke patients in the acute phase and recovery in order to define systems-level plasticity and opportunities for novel neural circuit-directed interventions.
Robert Fisher, MD, PhD
Maslah Saul MD Professor of Neurology & Neurological Sciences
Director of Stanford Comprehensive Epilepsy Program
Dr. Fisher received his M.D. and Ph.D. from Stanford, and trained at Johns Hopkins where he remained as faculty. He served time as Chair of Neurology at Barrow Neurological Institute in Phoenix, before returning to Stanford in 2000. He has had a leading role in the testing of devices that can detect or treat seizures, including deep brain stimulation, focal drug infusion, seizure notification accelerometers and biosensor. He also collaborates with laboratory researchers studying mechanisms of epilepsy. He has been named in Best Doctors of America for 16 consecutive years. He is a past-president of the American Epilepsy Society, prior Editor-in-Chief of the world's main epilepsy journal, Epilepsia, and past Editor of epilepsy.com, the most visited website about epilepsy. He has published numerous articles and books about epilepsy.
Kara Flavin, MD
Clinical Assistant Professor of Orthopaedic Surgery
Dr. Kara Flavin is a Clinical Assistant Professor of Orthopedics in the division of Physical Medicine and Rehabilitation at Stanford University. She specializes in the comprehensive rehabilitation of neurologic disorders and her practice is located within the Stanford Neurology Clinic. Her research interests include stroke recovery, spasticity management, and pressure ulcer treatment and prevention.
Paul George, MD, PhD
Assistant Professor, Neurology and Neurological Sciences
Dr. George joined the Stanford Stroke Center in 2012 to complete his Vascular Neurology fellowship and has remained as an Assistant Professor. His clinical and research interests are centered on acute stroke and stroke recovery. He cares for hemorrhagic and ischemic stroke patients in the inpatient and outpatient settings. His research focuses on the application of novel biotechnologies to improve healing after stroke. Currently, limited treatment options are available for stroke patients outside of the acute timeframe. His lab works on combining stem cell therapeutics and novel polymers to enhance and improve stroke recovery. His work also utilizes biomedical methods to better understand the mechanisms of neural repair after injury.
Rona Giffard, MD, PhD
Professor of Anesthesiology
Dr. Giffard is an anesthesiologist and basic scientist. Her laboratory is very interested in both acute response to stroke, and factors that affect delayed plasticity, including effects of inflammation on neurogenesis, and the role of organelle interaction and the chaperone network in both acute response and plasticity.
Brice Gaudilliere, PhD
Clinical Instructor, Anesthesiology, Perioperative and Pain Medicine
Postdoctoral Research Fellow, Anesthesiology and Pain Medicine
Our group studies how the human immune system responds to acute physiological perturbations, such as surgical trauma. Using high parameter single cell technologies (CyTOF) and proteomics approaches for the deep immune profiling of patients undergoing surgery, our research aims at identifying immune mechanisms (cell subsets and associated signaling pathways) that critically determine a patient's ability to heal and recover from surgical trauma.
Sarah Heilshorn, PhD
Associate Professor of Materials Science and Engineering
Dr. Heilshorn is a materials scientist and bioengineer whose laboratory specializes in interfacing novel biomaterials and microfluidic devices with mammalian cells. Specific areas of interest include microfluidic devices to study neuronal chemotaxis and neurite guidance within gradients, synthetic matrices for three-dimensional neural cultures, and injectable hydrogels to deliver cells, proteins, and drugs to the central nervous system.
Karen G. Hirsch, MD
Assistant Professor of Neurology and Neurological Sciences
Dr. Karen G. Hirsch is a neurocritical care physician. She cares for critically ill patients with neurologic disorders in the intensive care unit and for patients with cerebrovascular disease in the inpatient stroke unit. Dr. Hirsch’s research focuses on novel imaging techniques such as functional brain imaging in patients with cardiac arrest and traumatic brain injury. She also studies methods of non-invasive measurement of cerebral blood flow, oxygenation, and cerebrovascular autoregulation and how these parameters might be targeted to improve outcome in patients with neurologic injury.
Hadi Hosseini, PhD
Instructor, Psychiatry and Behavioral Sciences - Center for Interdisciplinary Brain Sciences Research
Hadi Hosseini is a computational/cognitive neuroscientist investigating large-scale structural and functional brain networks in various neurological and psychiatric conditions using multimodal neuroimaging, graph theoretical and multivariate pattern analyses techniques. He is also developing novel near-infrared spectroscopy (NIRS)-based neurofeedback interventions for targeted enhancement of executive functions. As the Associate Director of the NIRS Lab at CIBSR, one of his interests is to employ NIRS as a potential cost-effective biomarker for monitoring functional stroke recovery.
John Huguenard, PhD
Professor of Neurology and Neurological Sciences
The Huguenard Lab focuses on 2 stroke-related questions. 1) What are the changes in cortical microcircuits that occur in peri-infarct regions that promote functional recovery, specifically with a focus on GABA receptors and a potential new therapeutic approach. 2) What are the changes in regions distal to the stroke, yet connected to the peri-infarct region, such as the thalamus that contribute to adaptive (functional recovery) and/or maladaptive (post-stroke epilepsy) circuit changes. Relatedly, are there specific subcircuits implicated in epilepsy that could be focally targeted for novel therapies.
Michelle L. James, PhD
Instructor, Radiology and Neurology & Neurological Sciences
My research is focused on developing and evaluating molecular imaging agents for visualizing neurological diseases in living subjects.
In particular, I am interested in imaging neuroinflammation, microglial activation, neurodegeneration, cognitive decline, and neurogenesis using positron emission tomography (PET). Non-invasive PET imaging of these biochemical processes in living, intact, subjects may lead to an enhanced understanding of a range of brain disorders (including Alzheimer’s disease, multiple sclerosis, and brain injury), ultimately generating effective diagnostic techniques and treatment strategies.
My Ph.D. was focused on the design and development of novel PET radioligands for imaging the translocator protein (18kDa) (TSPO). Since TSPO expression reflects microglial activation and neuroinflammation, radioligands for this protein may act as valuable tools for detecting regions of active brain disease before clinical signs manifest. These radioligands may also be used to track disease progression and monitor response to novel therapeutics.
Calvin Kuo, MD, PhD
Professor of Medicine (Hematology)
Dr. Kuo is trained in Internal Medicine and researches new strategies to stimulate new blood vessel growth as well as how to stop blood vessel leakage after stroke. His research team is studying new classes of receptors on brain blood vessels that can be manipulated for these purposes, as well as new hormones that could be used therapeutically for stroke treatment.
Maarten Lansberg, MD, PhD
Associate Professor of Neurology and Neurological Sciences
Dr. Lansberg's research focuses on clinical trials in stroke treatment and recovery. He has extensive experience with the design and conduct of clinical stroke trials. His team is currently conducting an NIH funded cohort study of endovascular stroke treatment. In addition, they are participating in multiple other NIH and industry-sponsored clinical stroke trials. They were recently awarded an infrastructure grant from the NIH to become a Regional Coordinating Center for the NINDS Clinical Stroke Trial Network.
Sarah Lee, MD
Clinical Assistant Professor, Neurology and Neurological Sciences
Dr. Lee completed her pediatric neurology residency at Stanford in 2015 then joined the Stanford Stroke Center as a vascular neurology fellow. Following her fellowship she began a faculty position at Stroke Center as an Assistant Professor. Dr. Lee is board-certified in neurology with special qualification in child neurology, and attends on both the adult stroke service as well as the pediatric neurology service. Dr. Lee is the Associate Director of the Stroke Center’s Telestroke Program. Her primary clinical and research focus involves optimizing diagnosis, treatment, and rehabilitation for pediatric and young adult stroke patients. Additional areas of interest include venous sinus thrombosis, inflammatory and non-inflammatory vasculopathies, stroke in pregnancy, and hypercoagulable state.
Jennifer McNab, PhD
Assistant Professor of Radiology
Jennifer McNab is a magnetic resonance imaging (MRI) physicist and her laboratory focuses on the development of clinical biomarkers of stroke recovery on 3T and 7T human MRI scanners. The scope of this research involves engineering new MRI contrast mechanisms, strategic encoding and reconstruction schemes, physiological monitoring, brain tissue modeling and validation.
Christina Mijalski, MD
Clinical Assistant Professor, Neurology & Neurological Sciences
Christina Mijalski Sells is a board-certified neurologist who joined the Stanford Stroke Center in August of 2016. She completed the Partners Vascular Neurology fellowship at Harvard Medical School after residency at Brown University. She also holds a Master of Public Health from the University of California, Los Angeles. Currently, her clinical and research interests include telemedicine, stroke in women, and healthcare delivery systems. Dr. Mijalski Sells is developing the telestroke program at Stanford that will extend the delivery of acute stroke care throughout Northern and Central California.
Michael Moseley, PhD
Professor of Radiology
Michael Moseley is a neuroradiologist and scientist. His primary current research interests are centered on developing MR methods to detect the earliest effects of experimental and clinical cerebrovascular diseases using functional neuroimaging (DWI, PWI, and fMRI). His early papers in 1990 were the first to suggest that DWI and contrast-enhanced PWI are useful for detection of early cerebral ischemia and in tumor depiction. He also helped publish the first papers on blood pool contrast agents in 1985 and was the first to show in 1989 that mapping white matter fiber orientation using diffusion MR imaging is a novel measure of neuroimaging and now later as a means of mapping clinical cognitive performance in events such as stroke.
Allison Okamura, PhD
Associate Professor of Mechanical Engineering (and by courtesy, Computer Science)
Dr. Okamura's laboratory develops medical robots and haptic human-machine interfaces. Their interests include minimally invasive surgery/ percutaneous interventions and robots to enable neuroscience research/rehabilitation. Their devices and models of human motor control are used in the assessment and enhancement of human sensorimotor capabilities. Current they are working on movement control in isometric environments aims to create new methods for rehabilitating chronic stroke patients.
David Prince, MD
Professor of Neurology and Neurological Sciences
Dr. Prince is a neurologist and basic neuroscientist. His work focuses on cellular and circuit abnormalities following focal cortical injuries and novel agents that may prevent maladaptive changes in neuronal and circuit structure and function. We use combinations of electrophysiological, anatomical and pharmacological approaches.
Mehrdad Shamloo, PhD
Associate Professor of Neurosurgery and Comparative Medicine
The ultimate goal of the Shamloo Laboratory is to elucidate the pathological processes underlying malfunction of the nervous system following injury and stroke. They are using automated behavioral and functional methods in experimental and transgenic rodent models in conjunction with small molecule therapeutic approaches in order to manipulate the loss of function following ischemic brain injury. Their therapeutic targets are adrenergic receptors, lysosome proteases (cathepsins) and activity dependent transcription factor (Npas4).
Gary K. Steinberg, MD, PhD
Professor of Neurosurgery
Dr. Steinberg is a neurosurgeon and basic and clinical scientist. His research involves investigating the molecular and cellular mechanisms of cerebral injury after ischemia, developing neuroprotective agents including hypothermia to reduce stroke damage, employing novel approaches such as stem cell transplantation and optogenetic stimulation to enhance functional recovery after stroke, and elucidating the genetic basis for intracranial aneurysms, vascular malformations and moyamoya disease.
Lawrence Steinman, MD
Professor of Neurology and Neurological Sciences
Dr. Steinman’s research focuses on what provokes relapses and remissions in MS and the nature of the genes that serve as a brake on brain inflammation in his quest for a vaccine against multiple sclerosis. He has taken several therapies from the bench to the bedside, including work directly related to the development of natalizumab, and two experimental therapies, statins and DNA vaccines, are in trials. He received the John M. Dystel Prize in 2004, and the Charcot Award for Lifetime Achievement in 2011. He is a member of the Institute of Medicine of the National Academies of Science. A graduate of Harvard School of Medicine, Dr. Steinman has been on the Stanford faculty since 1980. He served as Chair of the Immunology Program from 2002 to 2011.
Courtney Wusthoff, MD MS
Neurology Director, LPCH NeuroNICU Assistant Professor of Neurology & Neurological Sciences and by courtesy, Pediatrics- Neonatal and Developmental Medicine
Dr. Wisthoff is a neonatal neurologist and neurophysiologist at Lucile Packard Children's Hospital Stanford. As neurology director of our Neuro Neonatal Intensive Care Unit, and in her clinical research, she investigates markers of early brain injury, and how they can identify candidates for neuroprotective treatments. She is particularly interested in how seizures may be a modifiable risk factor for later consequences after neonatal brain injury.
Greg Zaharchuk, MD
Associate Professor of Radiology
Dr. Zaharchuk's research focuses on improved functional imaging of the brain following stroke, using both MRI and CT methods. In particular, his group in collaboration with many others from the Departments of Neurology and Neurosurgery have focused on developing improved methods for assessing quantitative blood flow and oxygenation measurement in the brain, for identifying and quantifying the impact of collateral blood flow, and for measuring cerebrovascular reserve in the brain following a vasodilatory challenge (“brain stress test”). His research spans from basic MR sequence development to clinical-translational application of these techniques to stroke patients.
Heng Zhao, PhD
Associate Professor of Neurosurgery
The Zhao lab studies the protective effects of ischemic postconditioning and the underlying protective mechanisms against stroke. His lab is also interested in clarifying the roles of T lymphocytes in brain injury induced by stroke, as well as the differential roles of blood-derived macrophages and brain resident microglia in acute brain injury after stroke.
The Stanford Stroke Center is recognized as a world leader in clinical stroke research. The physicians at the Stanford Stroke Center are always exploring new ways to diagnose and treat stroke. Our stroke recovery trials are designed to improve our understanding of how the brain recovers after stroke and to tests new treatments aimed at improving the lives of stroke survivors. Your participation in these trials will help us develop new rehabilitation therapies for future stroke victims. We are currently recruiting patients for the following trials:
Memory and other cognitive problems are common after stroke but the exact mechanisms of these problems is not well understood. In the StrokeCog study we follow stroke patients for several years during which we assess cognitive function every year. We also obtain a blood sample every year which we examine for the presence of markers of inflammation to determine if inflammation causes cognitive decline after stroke. Substudies are available for interested participants to look more deeply for neuroinflammation using cerebrospinal fluid and PET scans. StrokeCog is a study funded by the Stanford Neuroscience Institute.
The Neofect Smart Glove study tests the feasibility of the Neofect Smart Glove as an effective, home-based hand rehabilitation tool for recovering stroke victims. The Neofect Smart Glove system consists of the wearable Smart Glove with which participants use to interact with a tablet pre-loaded with games and activities. Using the system, participants will be asked to use the Smart Glove for an hour a day for five days a week over the course of 8 weeks. We will be evaluating participant's satisfaction of the system as a rehabilitation tool as well as monitoring progress to see if participants have improvement in their hand function.
StrokeCoach: A novel approach to home-based rehabilitation
StrokeCoach is an application for post-stroke rehabilitation geared to improve arm weakness. It uses the Apple Watch to provide patients with daily assessment of movements and progress of the weak arm to better follow their recovery. StrokeCoach also offers the patients with daily exercises created by our rehabilitation team. The exercies the degree of impairment of the patient using the application. With this study, we want to assess if StrokeCoach can be use to supplement therapy of stroke patients and see if it is a realiable way to assess recovery after stroke.
We will provide our participant with an AppleWatch and support during the duration of the study. We are looking for patients having suffered a stroke in the past and who currently have arm weakness.
StrokeCoach is an application that created by a Stanford multidisciplinary team of stroke and rehabilitation physician, occupational therapist engieneers, computer scientists and biology students.
Even after rehabilitation, many stroke survivors walk abnormally, with one leg taking a longer step than the other, resulting in a limp. This lack of symmetry in walking is correlated with decreased balance and slower walking speeds. We are investigating different learning techniques with motion capture that allows us to accurately track each step and give real-time feedback to promote walking more symmetrically.
Proprioception is a person's sense of their own body in space, without having to rely on vision. For example, proprioception is how we know whether our arm is raised or lowered without looking at it. In this study, we use a robotic support to assess arm proprioception. Stroke survivors will move and identify the location of their supported arm so that we can model the effects of proprioception on movement control. These models can be used in the future to influence the design of new rehabilitation technologies.
After a stroke, individuals frequently have difficulty lifting their arms due to muscle weakness, stiffness, or a loss of control of individual muscles. Several devices exist to help rehabilitate those experiencing these problems, but they are expensive, cumbersome, and complicated. We are developing inexpensive, unintrusive, and simple devices and testing their effectiveness for providing portable assistance for rehabilitation after stroke.
The ACTIsSIMA (“Allogeneic Cell Therapy for Ischemic Stroke to Improve Motor Abilities”) trial studies if an injection of stem-cells into the brain increases arm strength in patients with persistent arm weakness up to 5 years after their stroke. Patients who participate in the study are randomized to receive active treatment (an injection of stem-cells into the brain) or a sham surgery during which nothing is injected into the brain. Details of the study are at clinicaltrials.gov.
The Collins biomechatronics lab develops wearable robots and exoskeletons that improve mobility for individuals whose strength and coordination have been affected by stroke, amputation, or aging. Using these devices it may be possible to restore function or even enhance performance beyond typical human limits.
The Shamloo lab studies normal and pathological brain function with the long-term goal to discover novel therapeutic approaches for neurologic disorders such as stroke, Alzheimer’s disease (AD), and autism. The lab has focused its efforts on characterizing genes and proteins that are involved in neuroprotective or neurodegenerative pathways.
Stroke Patient Care
Stanford Health Care’s nationally-recognized Comprehensive Stroke Program provides comprehensive care and treatment for stroke.