National Institute of Neurological Disorders

NfNDS rt-PA Study Group. Tissue plasminogen activator for acute ischemic stroke. The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. N EnglJMed 1995 333 1581-1587. 

This section will review the phase III clinical trials of IV thrombolytic agents for acute ischemic stroke, organized by the type of agent and the time window from stroke onset to study drug delivery (Table 3.1). The 1995 National Institute of Neurological Disorders and Stroke (NINDS) rt-PA trial is presented first because it showed that IV rt-PA, given within 3 hours of stroke onset, reduced stroke-related disability. This trial was the basis for the United States Food and Drug Administration (FDA) approval for rt-PA for use in acute ischemic stroke. 

Dr. Smith is supported by grant funding from the National Institute of Neurological Disorders and Stroke (K23 NS-046327). 

Kwiatkowski TG, Libman RB, Frankel M, Tilley BC, Morgenstem LB, Lu M, Broderick JP, Lewandowski CA, Marler JR, Levine SR, Brott T. Effects of tissue plasminogen activator for acute ischemic stroke at one year. National Institute of Neurological Disorders and Stroke Recombinant Tissue Plasminogen Activator Stroke Study Group. New England Journal of Medicine. 1999 340 1781-1787. 

The severity of the neurological deficit at the time of stroke onset is a major predictor of stroke outcome. In an analysis of the placebo-treated patients in the National Institute of Neurological Disorders and Stroke (NINDS) recombinant tissue-plasminogen activator (rt-PA) study, the best acute predictor of a poor outcome at 1 year was an National Institute of Health Stroke Scale (NIHSS) score >17 for patients over 70 years. These criteria had a high specificity (98%), but sensitivity was only 31%. The low sensitivity of the acute NIHSS score alone in predicting... 

Walter J. Koroshetz, MD National Institute of Health, National Institute of Neurologic Disorders and Stroke... 

Alteplase (rt-PA Activase) is an IV thrombolytic (fibrinolytic) that was approved for acute stroke treatment in 1996 based on the results of the National Institute of Neurological Disorders and Stroke (NINDS) rt-PA Stroke Trial.10 The current American Stroke Association guidelines include alteplase as the only Food and Drug Administration (FDA) approved acute treatment for ischemic stroke and strongly encourage early diagnosis and treatment of appropriate patients.11... 

Information from the US National Institute of Neurological Disorders and Stroke www.ninds.nih.gov/health and medical/disorders/parkinsons disease.htm... 

NINDS National Institute of Neurological Disorders and Stroke... 

Purpose The mission of the National Institute of Neurological Disorders and Stroke (NINDS) Office of Translational Research is to facilitate the pre-clinical discovery and development of new therapeutic interventions for neurological disorders. The Office supports pre-clinical projects from the discovery of candidate therapeutics through IND and Investigational Device Exemption (IDE) applications to the FDA. This is accomplished through both access to NINDS contract resources and direct funding mechanisms. 

Chopp, M., Chan, P. H., Hsu, C. Y., Cheung, M. E. and Jacobs, T. P. DNA damage and repair in central nervous system injury National Institute of Neurological Disorders and Stroke Workshop Summary. Stroke 27 363-369,1996. 

Chief of Section on Enzymes Laboratory of Neurochemistry National Institute of Neurological Disorders and Stoke National Insiitutes of Health Bethesda, Maryland... 

National Institute of Neurological Disorders and Stroke National Institutes of Health 5625 Fishers Lane, Room 4S-30, MSC 9407 Bethesda, Maryland 20892... 

National Institutes of Neurological Disorders and Stroke, NINDS Attention Deficit-Hyperactivity Disorder Information Page, National Institutes of Health. Available online. URL http //www.ninds.nih.gov/disorders/adhd/adhd.htm. Updated June 6, 2008. 

Dr. Mitler was supported by research grant number NS37571 and GCRC grant number RR00833 while he conducted the research discussed in this chapter while at the Scripps Research Institute he is now at the National Institute of Neurological Disorders and Stroke (NINDS). The author wishes to thank Dr. Michael Bonnet for his careful evaluation. Thanks are due Janet Molsberry for her help in manuscript preparation. 

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