December 15, 2017

Pictured: Dr. Alexander Thiel, left, of McGill University, and Dr. Jodi Edwards, right, of the Ottawa Heart Institute, chaired the CanStim Consensus Conference, which brought together 18 leading researchers from across Canada as part of a national clinical trials network to study the effect of brain stimulation on stroke recovery.

 

Researchers from across Canada came together in Montreal in late November for a lively two-day conference to establish the Canadian Platform for Trials in Non-Invasive Brain Stimulation (CanStim), an ambitious project to create a national multicentre network for clinical trials to study the effect of brain stimulation on stroke recovery.

CanStim was the highest-ranked catalyst grant awarded by CaSTOR (Canadian Stroke Trials for Optimized Results), a joint initiative of the Canadian Stroke Consortium and the Heart & Stroke Foundation Canadian Partnership for Stroke Recovery (CPSR).

Led by stroke neurologist Dr. Alexander Thiel of McGill University and Dr. Jodi Edwards, Director of the Brain and Heart Nexus Research Program at the University of Ottawa Heart Institute, 18 researchers convened to examine the state of the literature, engaging in breakout sessions to brainstorm the development of stimulation and therapy protocols, examine optimal therapeutic doses, identify who could be targeted to participate in a trial, and select appropriate outcome measures, imaging and database requirements.

At the two-day consensus conference, researchers also heard presentations on four key consensus themes from Dr. Adam Kirton of the University of Calgary on outcome measures used in his work with children living with stroke, Dr. Shaun Boe of Dalhousie University on current best practices for rehabilitation interventions, Dr. Thiel on selecting patient populations and Dr. Edwards on optimizing stimulation parameters.

CPSR’s Katie Lafferty facilitated a priority-setting exercise where participants voted to achieve consensus on what they considered to be critical elements of a brain stimulation trial protocol.

Participants had high agreement on a majority of consensus elements identified for each theme. They discussed next steps for CanStim as a national platform and a plan to pilot the CanStim Protocol in a feasibility study in spring 2018. The group finalized a feasibility questionnaire for circulation to all sites and formed a CanStim Writing Committee for reporting of the CanStim Consensus Results and Protocol, which will be submitted for publication in early 2018.

The consensus protocol targeting the use of transcranial magnetic stimulation for recovery of motor function is among the first nation-wide efforts to build clinical trial capacity in stroke recovery research. If successful, CanStim may offer a platform to test other brain stimulation modalities and protocols for the treatment of post-stroke deficits in the future.

“The CanStim Consensus conference was an essential first step towards the use of brain stimulation technologies as adjunct rehabilitative therapies for people living with stroke in Canada,” Dr. Edwards said. “What we learned from this process was the degree of complexity involved in translating this innovative technology to clinical use for a heterogenous disease such as stroke, but our hope is that CanStim will offer a platform to provide the clinical trial data necessary to advance these therapies from the laboratory to the rehabilitation clinic.”