Network advances understanding of sex and gender differences in stroke prevention, care and recovery

When it comes to stroke, sex and gender matter. “We have known for many years that women experience different stroke risk factors, interactions with the health system, diagnoses, treatments, and outcomes,” says Dr. Amy Yu, an Associate Professor at the University of Toronto and stroke neurologist at Sunnybrook Research Institute.

Until now, most stroke research studies (like those in other medical disciplines) have largely involved men.

And yet, cisgender men don’t have menstrual periods or get pregnant or take oral contraceptives or go through menopause. Men don’t experience some health conditions – migraines, for example – at the same rate as women. Stroke looks different in men and women.

“As a funding agency, we have a responsibility to support these considerations in the work we enable —we must all acknowledge that sex and gender differences exist.” – Brain Canada CEO and President Dr. Viviane Poupon

That’s why StrokeGoRed, a pan-Canadian network of research excellence, funded through a $5-million grant from Brain Canada, Heart & Stroke and the Government of Canada, is preparing to launch a series of sex and gender studies to understand the differences in stroke, and to ensure more women participate along with men.

“As a funding agency, we have a responsibility to support these considerations in the work we enable —we must all acknowledge that sex and gender differences exist,” says Brain Canada CEO and President Dr. Viviane Poupon.

“The field of neuroscience is one of the most advanced in its understanding and application of sex and gender science,” says CIHR Institute of Gender and Health Scientific Director, Dr. Angela Kaida. “The StrokeGoRed team’s research will not only be lifesaving and life-changing for women experiencing stroke, but will also offer precedent-setting examples of how science becomes more rigorous, personalized and inclusive with sex and gender.”

“We know that sex differences are relevant to all aspects of health and disease, so we can no longer accept clinical trials with primarily male participants and hope that they’ll adequately represent women. It’s essential for both to be included in all research where possible, and studies like StrokeGoRed are critical to closing that gap.” – Julia Segal Program Manager Brain Canada

“There are many reasons why women have been under-represented in research,” Dr. Yu says. For example, women are often caregivers, and reluctant to step away from family roles even while recovering from stroke. The StrokeGoRed team hopes to get more women involved by using a patient-centred approach.

Dr. Amy Yu

“We know that sex differences are relevant to all aspects of health and disease, so we can no longer accept clinical trials with primarily male participants and hope that they’ll adequately represent women. It’s essential for both to be included in all research where possible, and studies like StrokeGoRed are critical to closing that gap;” states Julia Segal Program Manager Brain Canada.

Dr. Yu has assembled a team of more than 50 collaborators across Canada who aim to fill gaps and answer big questions around the best ways to prevent stroke, care for mild and large strokes, the efficacy of different therapies, and variations in recovery.

She is particularly excited about plans to study some unknowns, identified by people with lived experience, “that really matter to patients”, including post-stroke cognitive changes, sleep and mood disturbances, as well as the challenges around returning to work.

The end goal is to develop individualized approaches to improve care and restore lives.

StrokeGoRed will also roll out an education and training program to bring more people to the field of stroke and generate more interest in sex and gender research. “Capacity building is critical,” Dr. Yu explains. Databases of research information, built from the StrokeGoRed studies and housed at Sunnybrook, will be made available to students and early-career scientists.

And, the network will work with an Indigenous scholar from Manitoba to build trust and reciprocity with First Nations communities to understand their needs, concerns and priorities. StrokeGoRed wants to develop education programs in these communities by engaging local students who will become future health professionals or researchers. “This is something that’s really important to me,” Dr. Yu says.

The name StrokeGoRed is a nod to Heart & Stroke’s red-themed health equity campaigns (the red-dress campaign and others) and also stands for Stroke in Women: Growing Opportunities to Realize optimal Evaluation, Diagnosis, and outcomes.

“I really hope to advance the needle on our knowledge of stroke,” Dr. Yu says.

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