Larry Bruce Goldstein, MD

Adjunct Professor of Neurology
Director of the Duke Stroke Center
Campus mail 201A Bryan Res Bldg, Durham, NC 27710
Phone (919) 684-3801
Email address golds004@mc.duke.edu

General Research Focus: Cerebrovascular Disease/Stroke. Research efforts have involved several aspects of cerebrovascular disease. In the laboratory, work has centered on developing an understanding of the mechanisms underlying pharmacological modulation of motor recovery after injury to the cerebral cortex and has led to several clinical studies in patients with stroke and traumatic brain injury. Research in stroke has also focused on health policy issues related to the use of carotid endarterectomy and optimization of stroke prevention strategies. Research involving new therapies for acute stroke has been carried out through clinical trials. Current focus is on identifying genes associated with small-vessel type stroke.

Specific Approaches: Laboratory Research: Studies of recovery after sensorimotor cortex injury have focused on measurement of neurobehavioral recovery as influenced by systemically administered drugs modulating the activities of specific central neurotransmitters. This work has involved behavioral measures, stereotactic lesioning, basic neurochemistry, cerebral microdialysis, and immunocytochemistry. Health Policy Research: Work has focused on clinical health policy related to cerebrovascular disease carried out in conjunction with the Center for Clinical Health Policy Research. These studies have centered on the utilization of carotid endarterectomy and the optimization of secondary and tertiary stroke prevention with an emphasis on outcome measures.

Clinical Trials: Principal investigator at Duke for several stroke acute treatment trials including studies of GM1-ganglioside and several neuroprotective drugs including CGS-19755 (Selfotel), Eliprodil, and a glycine receptor anatagonist. Principal or co-investigator at Duke for several stroke prevention trials including the NIH-supported study of carotid angioplasty and stenting as compared with carotid endarterectomy (CREST), RESPECT (PFO closure), PROfESS (antiplatelet drugs and angiotensin receptor blocker). In addition, principal investigator for NIH-supported studies related to poststroke recovery and steering committee for SPARCL (statin for secondary stroke prevention).

Special Expertise: Effects of drugs on recovery after stroke and brain injury
Neuroplasticity and behavioral recovery after brain injury
Stroke trial design and outcomes measures
Carotid endarterectomy/ angioplasty-stenting
Stroke prevention (primary and secondary)
Stroke-related health policy and outcomes

Key Words: Neurorehabilitation, stroke, cerebrovascular disease, neurobehavior, carotid endarterectomy, angioplasty, health services, prevention, outcomes

Education and Training

  • Fellow in Neurology, Medicine, Duke University, 1985 - 1987
  • Resident in Neurology, Medicine, Mount Sinai School of Medicine, 1982 - 1985
  • Intern in Medicine, Medicine, Mount Sinai School of Medicine, 1981 - 1982
  • M.D., Mount Sinai School of Medicine, 1981

Publications

Ganz, P, Amarenco, P, Goldstein, LB, Sillesen, H, Bao, W, Preston, GM, Welch, KMA, and SPARCL Steering Committee, . "Association of Osteopontin, Neopterin, and Myeloperoxidase With Stroke Risk in Patients With Prior Stroke or Transient Ischemic Attacks: Results of an Analysis of 13 Biomarkers From the Stroke Prevention by Aggressive Reduction in Cholesterol Levels Trial." Stroke 48, no. 12 (December 2017): 3223-3231.

PMID
29114094
Full Text

Gaist, D, Goldstein, LB, Cea Soriano, L, and García Rodríguez, LA. "Statins and the Risk of Intracerebral Hemorrhage in Patients With Previous Ischemic Stroke or Transient Ischemic Attack." Stroke 48, no. 12 (December 2017): 3245-3251.

PMID
29070714
Full Text

Murphy, RR, Al Sawaf, A, Rose, DR, Goldstein, LB, and Smith, CD. "Clinical Reasoning: Two see or not two see—Is it really double vision?." Neurology 89, no. 6 (August 8, 2017): e56-e60.

Full Text

Kaddumukasa, MN, Katabira, E, Sajatovic, M, Pundik, S, Kaddumukasa, M, and Goldstein, LB. "Influence of Dietary Salt Knowledge, Perceptions, and Beliefs on Consumption Choices after Stroke in Uganda." Journal of Stroke and Cerebrovascular Diseases (August 2017).

Full Text

Ly, H, Verma, N, Wu, F, Liu, M, Saatman, KE, Nelson, PT, Slevin, JT, Goldstein, LB, Biessels, GJ, and Despa, F. "Brain microvascular injury and white matter disease provoked by diabetes-associated hyperamylinemia." Annals of neurology 82, no. 2 (August 2017): 208-222.

PMID
28696548
Full Text

El Husseini, N, Goldstein, LB, Peterson, ED, Zhao, X, Olson, DM, Williams, JW, Bushnell, C, and Laskowitz, DT. "Depression Status Is Associated with Functional Decline Over 1-Year Following Acute Stroke." Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association 26, no. 7 (July 2017): 1393-1399.

PMID
28389192
Full Text

Kaddumukasa, MN, and Goldstein, LB. "Author response: Influence of sodium consumption and associated knowledge on poststroke hypertension in Uganda." Neurology 88, no. 11 (March 14, 2017): 1103.3-1103.

Full Text

Goldstein, LB. "Adverse Effects of Statins." JAMA 317, no. 10 (March 2017): 1079-. (Letter)

PMID
28291885
Full Text

El Husseini, N, Fonarow, GC, Smith, EE, Ju, C, Schwamm, LH, Hernandez, AF, Schulte, PJ, Xian, Y, and Goldstein, LB. "Renal Dysfunction Is Associated With Poststroke Discharge Disposition and In-Hospital Mortality: Findings From Get With The Guidelines-Stroke." Stroke 48, no. 2 (February 2017): 327-334.

PMID
28034963
Full Text

Aroor, S, Singh, R, and Goldstein, LB. "BE-FAST (Balance, Eyes, Face, Arm, Speech, Time): Reducing the Proportion of Strokes Missed Using the FAST Mnemonic." Stroke 48, no. 2 (February 2017): 479-481.

PMID
28082668
Full Text

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