ISC 2026 | Reflecting on the past 50 years of stroke research and looking to the future

I’ve been fortunate to live in what I call the golden age of stroke. Because when I started, there was no treatment for acute stroke. There was only a couple of treatments for prevention, aspirin, and just beginning to know that treating your blood pressure can make a difference. There was nothing for stroke recovery. So in 50 years, we’ve gone from zero to 60, so to speak, in terms of speed. We have a revolution in how we treat acute stroke, both using drugs as well as devices that remove clots. We also have developing treatments for intracerebral hemorrhage, both surgery, as well as we talked about FASTEST today and some of the promise there. But the point is, that probably has a limit to what we can do biologically. There’s been no new treatments for acute MI for probably 15, 20 years. And I think we’re getting close to that with stroke, probably 10, 15 years or so. And we’re going to just reach a threshold. It’s hard to get past because of biology. I think prevention, similarly, we can make some, I think, improvements, particularly if we can change our behaviors. But I really think the future, the next century, is about recovery after stroke. And that’s really exciting. It’ll be beyond my career. But I do think we’re learning how the brain cells really talk to one another. And once you know that, you can start to make connections with the damaged brain that helps the body start to do things it couldn’t do before, like walk and talk. We may be even able to figure out how to make new brain cells with connections, but that’s scientifically really challenging. That may be even beyond the next 30, 40 years. But I do think we’re going to have a lot of changes with stroke recovery, and we’ll have advances in acute prevention, but I think we’re going to sort of plateau out probably in about 15 years or so.

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