Method for Diagnosing to Enable Treatment of Overwhelmed Myelin Lipid Processing in the Brain After Stroke

This invention addresses and provides a solution to secondary neurodegeneration post-stroke. It was discovered that foam cells form within primary infarcts and areas of secondary neurodegeneration after stroke. This invention provides for a method of noninvasive imaging and assessment of fatty acid oxidation in the brain after stroke using radionuclide and magnetic resonance-based imaging currently used to measure myocardial fatty acid oxidation in cardiometabolic disease. This is intended as a means of diagnosing, treating, and monitoring inflammation and preventing secondary neurodegeneration in the brain in the days, weeks, and months after stroke. The invention can be used as a companion diagnostic for reducing inflammation, and thus foam cells, using drugs such as cyclodextrin.

Background:
The researchers recently discovered that foam cells form after stroke due to the sheer amount of lipid rich myelin debris generated by stroke overwhelming the lipid processing capability of resident and infiltrating myeloid cells. They also recently discovered that fatty acid oxidation is substantially elevated within these cells in the days, weeks, and months after stroke. This is significant because fatty acid oxidation only occurs at very low levels in the healthy brain. Foam cells are dysfunctional immune cells derived from the myeloid cell lineage that are maladaptive for stroke recovery. A promising approach for enhancing stroke recovery and lowering the risk of post-stroke dementia, for which there are presently no therapies, is to target foam cell development and reduction.  

Applications: 

• Imaging foam cells in the brain after stroke for diagnosis, monitoring, and treatment
• Companion diagnostic with treatment using appropriate anti-inflammatory compounds, including cyclodextrin

Advantages: 

• Stroke assessment
• Secondary neurodegeneration prevention
• Targeted post stroke treatment