New Neurons: The Future of Regenerative Therapy-Scott Douglas Simon, MD, FAANS Video

Video Transcription

Welcome to New Neurons, the Future of Regenerative Therapy. My name is Scott Simon, and I'm an associate professor of neurosurgery at Penn State Hershey,  where I specialize in cerebrovascular and endovascular neurosurgery. I have nothing to disclose.  When we talk about the creation of new neurons, we first have to consider how the neurons that had been there were destroyed.  So to infarction, we have a primary injury caused by energy failure that creates an acidotic  environment, releases excitatory neurotransmitter, which can be toxic, free radical release,  which is also toxic, and this leads to necrosis, apoptosis, and eventual removal of the damaged cells.  On top of this, there's secondary degeneration of partially injured neurons, and then there's transneural degeneration across neural networks.  So even if you have a local stroke, the damage can be quite extensive throughout the brain and even spinal cord.  The key point is that each step represents a very hostile environment to cell growth, and this has made recovery very challenging.  The clinical therapies for stroke, which is the leading cause of disability in the United States, focus mostly on avoiding damage.  There have been over 1,000 trials of different therapies aimed at every aspect of the injury  cascade that I've laid out in the previous slide, and none of these have shown any decrease in the rate of disability.  There was great promise for mechanical thrombectomy, and in fact, it helps a very large number of patients, and that fact can't be denied.  Nonetheless, the most recent meta-analysis of pooled trial data by the Hermes authors  showed that mechanical thrombectomy has demonstrated 20% of candidates will have no or minor disability as judged by modified Rankin scale of 0 to 2.  Of course, this is a marked improvement over the 10% in the control group, but it still means that 80% of those patients who qualify for a thrombectomy will end up being disabled  or die. The bottom line is that new therapies are needed to restore function. I hope you'll enjoy our esteemed list of speakers in describing how they are approaching this problem.

Video Summary

In this video, Associate Professor Scott Simon from Penn State Hershey discusses the challenges in regenerating new neurons to treat stroke. He explains the primary and secondary injuries that occur during stroke, leading to the destruction of neurons. Current clinical therapies focus on preventing damage, but none have been successful in reducing disability rates. Mechanical thrombectomy has shown promise, but still leaves 80% of patients disabled or deceased. Simon emphasizes the need for new therapies to restore function. The video also mentions an upcoming discussion with experts on their approaches to this problem.

Keywords

regenerating new neurons

stroke challenges

primary and secondary injuries

clinical therapies

mechanical thrombectomy