The field of stroke has recently undergone rapid evolution. Patients who may have died from their strokes just 10 years ago now often survive, and this is driven largely by neurologists, neurosurgeons and interventional radiologists’ adoption of better thrombectomy protocols and the development of new technologies.

But survival isn’t the only goal, says Johns Hopkins Department of Neurology Director Justin McArthur. Now in its fourth year, Johns Hopkins’ Sheikh Khalifa Stroke Institute is making great strides in helping stroke patients prevent and overcome neurological deficits that can deeply affect quality of life. The institute today funds numerous projects through collaboration with Johns Hopkins’ departments of medicine, neurology, physical medicine and rehabilitation, and radiology, as well as nursing, along with other colleagues within the institution and the United Arab Emirates.

“We don’t want patients who survived an acute ischemic stroke to live with a permanent deficit,” McArthur says. “We want them to survive and thrive.”

Through its three Centers of Excellence, explains Johns Hopkins neurologist Argye Hillis, the institute’s programs and research are addressing unmet needs in stroke research and care that could have large impacts on patients’ outcomes. For example, the Center of Excellence in Stroke Detection and Treatment, which Hillis directs, is using artificial intelligence to search for markers in the genome that impact stroke risk as well as recovery. Among the first systematic genetic and precision medicine programs in the world specifically geared toward stroke, the endeavor could eventually lead to new personalized approaches to mitigate stroke risk and encourage healing after a stroke takes place.

This center is also using artificial intelligence to examine diagnostic images routinely collected from stroke patients — research that will eventually help doctors determine which patients are good candidates for thrombectomies past the currently recommended window of three to four hours.

“With the power of big data,” Hillis says, “we can eventually identify which patients may still be helped by treatment, potentially saving their lives and more function.”

Research and technologies developed through the other centers in the institute — the Kata Center for Neuro Restorative Technology and Design and the Center for Excellence in Stroke Recovery and Rehabilitation — are already serving patients to improve functional outcomes. For example, the institute has funded several projects that take advantage of the “fourth hour” — extra time beyond the typical three hours a day that stroke patients receive intensive physical, occupational and speech therapy. Patients spend the additional time using digital technologies to aid recovery.

For example, those treated in the stroke centers at The Johns Hopkins Hospital and Johns Hopkins Bayview Medical Center often use gaming apps that encourage use of their weaker arms and hands. Recently, the institute funded the setup of a “super room” within the hospital’s stroke unit. The space is filled with equipment for such technologies, facilitating therapy for patients who aren’t yet stable enough to receive it elsewhere. The institute has also funded 20 portable gaming units that help discharged patients perform this innovative therapy at home.

“With these technologies,” Hillis says, “we’re helping people return to work, live independently, and communicate with their spouses and children. They’re not just living; they’re living as high a quality of life as possible.”