Focus on research: Dr Karen Doyle, Curam

Dr Karen Doyle, Curam
Dr Karen Doyle, Curam

Developing new devices for combating the effects of stroke

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20 August 2019 | 0

Dr Karen Doyle is a senior lecturer in physiology and principal investigator at Curam, the SFI-funded centre for research into medical devices. She is the founder of Galway Neuroscience Centre. Dr Doyle’s research involves studying novel strategies to protect brain tissue from damage. In this interview she talks about her work on understanding the characteristics of the blood clots that cause strokes and finding new ways to combat them.

Your experience in neuroscience stretches back to the 1980s. What do you consider the biggest milestones in that time?

I first studied the brain in the late 1980s during my BSc degree in UCD, and I was very struck by how little was known about how the brain works, in comparison to the rest of the body. The brain was very definitely a bit of a black box.

Technological improvements in neuroimaging have helped us to understand the brain much better. We can see in to the living brain now and look for evidence of disease. More recently, functional brain scans have allowed us to observe which brain regions are involved in performing all sorts of activities and tasks.

There have also been major developments in our understanding of the neurochemistry of the brain. We are still finding new neurotransmitters and modulators that are important to normal brain function – currently the number is over 100.

Another key advance is the evolving recognition of the importance of glial cells in the brain. Until relatively recently, glial cells were considered to be nothing more than simple caretakers of neurons. Now, we know that they are very important to brain function, and have an array of transmitters in their own right: the gliotransmitters.

Your current work looks at strokes. What attracted you to that area?

Despite huge investment into researching disorders of the brain, a major disappointment has been the lack of development of a really effective neuroprotective drug.

Fifteen-million people suffer stroke each year worldwide. About 85% of strokes are caused by a blockage in a cerebral blood vessel by a blood clot. It is estimated that 2 million brain cells die every minute the brain is deprived of blood flow, so it’s really important to find effective treatments that work quickly. With no neuroprotective drug to protect the cells from dying, we need another approach, so I got interested in the clots that cause the strokes.

In 2015, clinical trials showed that a new surgical technique called mechanical thrombectomy can improve outcome for stroke patients. Neuroradiologists in stroke centres throughout the world have started to adopt this technique, retrieving blood clots from the brain. They do this either by aspirating the clot, or by capturing it in a new type of medical device called a stent retriever. Of course, that clot is now being removed from the brain has also meant that the clots that cause strokes are available for us to study.

What we are finding is that not all blood clots are alike – the composition of clots varies quite considerably and some are much more difficult to remove by thrombectomy than others. We are working with clinical, academic and medical device industry colleagues to advance the design of stent retrievers to efficiently retrieve even very difficult to remove clots.

Into the future, our discoveries could also lead to the development of predictive and diagnostic tests and maybe future drug treatments that may have use in stroke prevention.

Your work attracted the interest of a documentary maker. How did you find the experience?

I was definitely out of my comfort zone at the thought of filming, but I am delighted with the end product. The film, A Tiny Spark, was directed by Niamh Heery and produced by Caroline Kealy from Swansong films. They were fantastic to work with, and the film is a wonderful blend of the stories of stroke survivors, Rebecca, Trevor and Helen and the science behind our research.

It shows Dr John Thornton, head of neuroradiology in Beaumont Hospital describing the mechanical thrombectomy procedure, and highlights how we hope our work will improve stroke treatment.

Everyone is interested in how their brain works, and most of us know someone who has suffered a stroke. Thanks to the effective FAST (face, arms, speech, time) campaign on TV, I think people already know quite a bit about the symptoms of stroke. This documentary will help us to heighten awareness about stroke even more and to let people know that there is real hope for the future in treating stroke.

As a pioneer in your field, do you feel you are missing out on a collaborative element?

Luckily, no. A large international network of collaborators work with me on this project. A network of clinicians across Europe send us the clots that they remove by mechanical thrombectomy for analysis.

My group also works closely with collaborators in the Mayo Clinic (USA) and Cerenovus, who are a Galway-based thrombectomy medical device company. The mix of clinicians, scientists and engineers working together with a common aim on this project is one of its biggest strengths.

What areas of neuroscience are you most excited about right now?

I am so excited about our work at the moment, because I know that it will have a hugely positive impact on stroke patient survival and quality of life, in the near future. Being able to have a positive impact in the short term really is so exciting, and very unusual in neuroscience research.

We still need to find a safe effective neuroprotective drug, and also neuro-regenerative therapies would be fantastic. That is still a dream at the moment, but it is becoming apparent that there are marked similarities in the way cells in the brain die, irrespective of why they die, be it because of a stroke, or Alzheimer’s disease, or some other condition.

I am excited that we finally know enough to be able to see that, which will help us to simplify the issues, and hopefully help us find a neuroprotective treatment in the not too distant future.

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