Stroke

A new breakthrough in the understanding of the neurological basis of chronic brain dysfunction following stroke

                           

Chronic neurological dysfunction produced by stroke and traumatic brain injury has long been thought to be irreversible. A new scientific discovery by the INR, as documented in the medical literature (article 1; article 2), now promises to change current thinking about the potential for recovery of function, even years after the acute event.

The INR is pleased to make this new therapeutic approach available for selected patients. Individual results vary, not all patients respond. Treatment is an innovative off-label patented invention of the INR. Additional doses may be needed for optimal benefit, please see the Terms of Use. These unprecedented clinical results rely upon the Institute’s patented drug delivery technology (multiple issued and pending U.S. and international patents, including U.S. patents 6419944, 6537549, 7214658, 7629311, 8119127, and 8236306, assigned to TACT IP, LLC and Australian patent 758,523), as published in the scientific literature and documented in independent news stories. 

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See a list of Dr. Tobinick’s scientific publications, including links to find and download these articles.

For more scientific information, please see:

• Selective TNF Inhibition for Chronic Stroke and Traumatic Brain Injury – An Observational Study Involving 629 Consecutive Patients ..., Edward Tobinick MD, Nancy M. Kim, et al. CNS Drugs. 2012 26(12): pp.1051-70.
• PSE for Post-Stroke Neurological and Cognitive Dysfunction: Scientific Rationale and Current Evidence. Ignatowski TA, Spengler RN, Dhandapani KM, Folkersma H, Butterworth RF, Tobinick E. CNS Drugs August 2014, 28(8):679-697, published online 27 May 2014. (Download full-text PDF). 
• PSE for Traumatic Brain Injury. Tobinick E, Rodriguez H, Kinssies R, Kim N. Chapter 7, pp.109-29, in New Therapeutics for Traumatic Brain Injury, KA Heidenreich, editor. Academic Press. 2017. (LINK).
• Perispinal Delivery of CNS Drugs. Edward Tobinick MD. CNS Drugs. 2016;30(6):469-80. (full-text PDF).
• Treatment of traumatic brain injury with anti-inflammatory drugs. Bergold Peter J. Experimental Neurology 275 (Pt 3) (2016) 367-380.
• A Neurologist’s Guide to TNF Biology .... Ian Clark and B Vissel. Neural Plasticity. 2015;358263. (full-text PDF).
• Immediate neurological recovery following PSE years after brain injury. Tobinick E, Rodriguez-Romanacce H, Levine A, Ignatowski TA, Spengler RN. Clin Drug Investig, 2014;34(5):361-6.
• Studies of selective TNF inhibitors in the treatment of brain injury from stroke and trauma: a review of evidence to date. Tuttolomondo A, Pecoraro R, Pinto A. Drug Design, Development and Therapy. 2014;8:2221-2239. (full text PDF).
• Rapid improvement of chronic stroke deficits after PSE: three consecutive cases. Edward Tobinick MD. CNS Drugs. 2011 Feb 1; 25(2):145-155.

Consultation for Stroke at the INR

This treatment is not for acute stroke. Consultation with an INR medical provider after hospital discharge is encouraged, even if the stroke has occurred years before. Please call the INR in Florida at +1 (561) 353-9707 for further information.

Scientific References (clicking on title will access the scientific abstract and full-text of the article)

1.Feuerstein GZ, Liu T, Barone FC: Cytokines, inflammation, and brain injury: role of tumor necrosis factor-alpha. Cerebrovasc Brain Metab Rev 1994, 6:341-360.

2.Barone FC, Arvin B, White RF, Miller A, Webb CL, Willette RN, Lysko PG, Feuerstein GZ: Tumor necrosis factor-alpha. A mediator of focal ischemic brain injury. Stroke 1997, 28:1233-1244.

3.Nawashiro H, Martin D, Hallenbeck JM: Neuroprotective effects of TNF binding protein in focal cerebral ischemia. Brain Res 1997, 778:265-271.

4.Pappata S, Levasseur M, Gunn RN, Myers R, Crouzel C, Syrota A, Jones T, Kreutzberg GW, Banati RB: Thalamic microglial activation in ischemic stroke detected in vivo by PET and [11C]PK1195. Neurology 2000, 55:1052-1054.

5.Zaremba J: Contribution of tumor necrosis factor alpha to the pathogenesis of stroke. Folia Morphol (Warsz) 2000, 59:137-143.

6.Zaremba J, Losy J: Early TNF-alpha levels correlate with ischaemic stroke severity. Acta Neurol Scand 2001, 104:288-295.

7.Zaremba J, Skrobanski P, Losy J: Tumour necrosis factor-alpha is increased in the cerebrospinal fluid and serum of ischaemic stroke patients and correlates with the volume of evolving brain infarct. Biomed Pharmacother 2001, 55:258-263.

8.Gerhard A, Schwarz J, Myers R, Wise R, Banati RB: Evolution of microglial activation in patients after ischemic stroke: a [11C](R)-PK11195 PET study. Neuroimage 2005, 24:591-595.

9.Tobinick E: Perispinal etanercept for neuroinflammatory disorders. Drug Discov Today 2009, 14:168-177.

10.Chio CC, Lin JW, Chang MW, Wang CC, Yang CZ, Chang CP: Therapeutic evaluation of etanercept in a model of traumatic brain injury. J Neurochem 2010, 115:921-929.

11.Tobinick E: Perispinal etanercept: a new therapeutic paradigm in neurology. Expert Rev Neurother 2010, 10:985-1002.

12.Esposito E, Cuzzocrea S: Anti-TNF therapy in the injured spinal cord. Trends Pharmacol Sci 2011, 32:107-115.

13.Tobinick E: Rapid improvement of chronic stroke deficits after perispinal etanercept: three consecutive cases. CNS Drugs 2011, 25:145-155.

14.Tobinick E: Deciphering the physiology underlying the rapid clinical effects of perispinal etanercept in Alzheimer’s disease. Curr Alzheimer Res 2012, 9:99-109. (Download free full-text PDF).

15.Tobinick E, Kim NM, Reyzin G, Rodriguez-Romanacce H, Depuy V: Selective TNF Inhibition for Chronic Stroke and Traumatic Brain Injury : An Observational Study Involving 629 Consecutive Patients Treated with Perispinal Etanercept. CNS Drugs 2012, 26:1051-1070.

16.King MD, Alleyne CH, Jr., Dhandapani KM: TNF-alpha receptor antagonist, R-7050, improves neurological outcomes following intracerebral hemorrhage in mice. Neurosci Lett 2013, 542:92-96.

17.Lei B, Dawson HN, Roulhac-Wilson B, Wang H, Laskowitz DT, James ML: Tumor necrosis factor alpha antagonism improves neurological recovery in murine intracerebral hemorrhage. J Neuroinflammation 2013, 10:103.

18.Works MG, Koenig JB, Sapolsky RM: Soluble TNF receptor 1-secreting ex vivo-derived dendritic cells reduce injury after stroke. J Cereb Blood Flow Metab 2013.

19.Faingold CL: Chapter 7: Network Control Mechanisms: Cellular Inputs, Neuroactive Substances, and Synaptic Changes. In Neuronal Networks in Brain Function, CNS Disorders, and Therapeutics. Edited by Faingold CL, Blumenfeld H: Elsevier; 2014

20.Siniscalchi A, Gallelli L, Malferrari G, Pirritano D, Serra R, Santangelo E, De Sarro G: Cerebral stroke injury: the role of cytokines and brain inflammation. J Basic Clin Physiol Pharmacol 2014.

Additional information:

• A published news story, Florida Doctor Gives Stroke Patients a New Shot at Mobility, Independence. 
• Additional information about Edward Tobinick, M.D., including medical office, background, license, medical training.
• Edward Tobinick – Google Scholar
• On Overcoming Barriers to Application of Neuroinflammation Research – Edward L. Tobinick