Molecular biomarkers in stroke recovery: Consensus-based core recommendations from the fourth Stroke Recovery and Rehabilitation Roundtable

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RATIONALE: The 2017 Stroke Recovery and Rehabilitation Roundtable (SRRR) consensus statement on biomarkers identified genetic and blood biomarkers as a developmental priority for stroke recovery and rehabilitation. While progress has been made, this nascent field still lags behind other medical disciplines. Further development is critical because molecular biomarkers hold great promise to provide key insights into the neurobiological mechanisms of both spontaneous and treatment-induced stroke recovery. Such insights could lead to effective recovery biotherapeutics and help optimize the timing and delivery of therapies.MethodsA multidisciplinary taskforce of international experts with expertise in omics and stroke recovery identified and prioritized key focus areas. Consensus opinion was developed across 15 virtual meetings, 2 rounds of anonymous polling and a 2-day in-person meeting. Key recommendations were iteratively refined until full consensus was achieved by all taskforce members.ResultsOur main recommendation is that there is a critical need for large-scale, multi-center, discovery-based omics studies to identify molecular targets in stroke recovery. To help achieve this goal we suggest ways to harmonize future studies including timepoints for data collection, outcome measures, and biospecimen selection. In addition, we address the limitations of current candidate biomarkers, translational challenges, emerging technologies, biomarker response to interventions, multi-site collaboration, and ethical concerns.ConclusionsThere is a great need for collaborative efforts by the international neurorehabilitation community to collect and harmonize molecular biomarker data. The resulting discoveries will be foundational to precision neurorehabilitation and the development of recovery biotherapeutics to enhance recovery for stroke survivors.

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