2014 Thomas Willis Award Lecture: sex, stroke, and innovation.

Abstract

Innovation is a form of purposeful discovery behavior that exploits the unexpected, utilizes imagination, and provides one avenue of new solutions to complex human health needs. It is through this lens that two examples are described in which innovative approaches have been used to dissect the complexities of stroke pathophysiology. The first example focuses on one of the most fundamental genetic factors relevant to the brain and ischemic injury: biological sex. Much might be gained by understanding the details of sex-specific pathobiology, if the field is to develop therapies that work well in patients of both sexes. The second example surrounds brain-spleen cell cycling after stroke which is fundamental to our evolving understanding that stroke is a systemic disease, rather than solely a lesion of the brain. While much work remains, it is now apparent that brain-spleen cell cycling is temporally specific, varies in intensity, and involves cell players that are of much wider lineages than originally believed. In the future, it is likely that innovation will need to turn to “big data”, particularly if our field is to tackle the daunting questions that most greatly matter to unraveling brain injury. The huge availability and growth rate of biomedical data, handled in a shared but coherent environment, offers an opportunity to further vitalize stroke research.