Pediatric cerebrovascular disease
The Calgary Pediatric Stroke Program
Stroke and cerebrovascular disease are a common and increasingly recognized cause of acquired brain injury in newborns and children. The Calgary Pediatric Stroke Program (CPSP) provides children with cerebrovascular disease and their families with state-of-the-art diagnosis, treatment, education, and family support while providing the opportunity to participate in leading clinical research initiatives. Established at the Alberta Children's Hospital in 2007, the CPSP has enrolled >300 children with provincial initiatives expanding to >1000 families by 2011.
Areas of clinical research activity focus on stroke in the fetus and newborn, a leading cause of cerebral palsy. Active projects include: clinical, prothrombotic, genetic, and biomarker risk profiles; epidemiology of perinatal stroke syndromes; placental disease in perinatal stroke; advanced neuroimaging to predict stroke outcomes; developmental neurorehabilitation; and the measurement and modulation of brain plasticity systems after perinatal stroke. Ongoing provincial collaborations are creating the largest population-based sample of perinatal stroke ever studied through the Alberta Perinatal Stroke Project (APSP). The rigorous collection of these children will facilitate the development of multidisciplinary institutional clinical and applied technology research programs. The PLASTIC CHAMPS clinical trial, funded by HSFA, is exploring the efficacy and neurophysiological effects of combined brain stimulation and constraint therapy in children with weakness after perinatal stroke.
In 2009, we established the ACH Pediatric Transcranial Magnetic Stimulation (TMS) Laboratory, the first facility of its kind in Canada. TMS technology has the remarkable capacity to measure and "map" how a child's brain recovers from stroke and also possesses therapeutic potential whereby repetitive TMS may help guide a child's brain development toward better function. In 2010, we established the ACH Neuroimaging Analysis Centre where advanced technologies such as functional MRI, DTI, volumetrics and others are being developed to better understand stroke and other neurological disorders of childhood. The CPSP is an enrolling site in the International Pediatric Stroke Study (IPSS), a global research initiative in childhood stroke now spanning >100 centres in 35 countries. We currently participate in 3 NIH-funded multicentre pediatric stroke studies. The CPSP team is also conducting quality improvement research to better understand the educational and support needs of pediatric stroke families.