Director, Duke Stroke Center

Department / Division:
Medicine / Neurology

Address:
DUMC 3651
Durham, NC 27710

Appointment Telephone:
919-668-7600

Office Telephone:
919-684-3801

Fax Telephone:
919-684-6514

• MD, Mount Sinai School of Medicine of New York University, 1981

• Neurology, Mt. Sinai Medical Center (New York), 1981-1985

• Cerebrovascular Research, Duke University Medical Center, 1985-1987

• Board Certifications, Neurology and Vascular Neurology

Clinical Interests:
Stroke, cerebrovascular disease, TIAs, general neurology

Research Interests:
General Research Focus: Cerebrovascular Disease. 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.

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

Representative Publications:
Smith Hammond CA, Goldstein LB. Cough and aspiration of food and liquids due to oral-pharyngeal dysphagia: ACCP evidence-based clinical practice guidelines. Chest. 2006 Jan;129(1 Suppl):154S-168S. (2006) Abstract

Sacco RL, Adams R, Albers G, Alberts MJ, Benavente O, Furie K, Goldstein LB, Gorelick P, Halperin J, Harbaugh R, Johnston SC, Katzan I, Kelly-Hayes M, Kenton EJ, Marks M, Schwamm LH, Tomsick T, , , . Guidelines for prevention of stroke in patients with ischemic stroke or transient ischemic attack: a statement for healthcare professionals from the American Heart Association/American Stroke Association Council on Stroke: co-sponsored by the Council on Cardiovascular Radiology and Intervention: the American Academy of Neurology affirms the value of this guideline. Circulation. 2006 Mar 14;113(10):e409-49. (2006) Abstract

Goldstein LB. Neurotransmitters and motor activity: effects on functional recovery after brain injury. NeuroRx. 2006 Oct;3(4):451-7. (2006) Abstract

Goldstein LB. Improving the clinical diagnosis of stroke. Stroke. 2006 Mar;37(3):754-5. (2006) Abstract

Goldstein LB, Adams R, Alberts MJ, Appel LJ, Brass LM, Bushnell CD, Culebras A, DeGraba TJ, Gorelick PB, Guyton JR, Hart RG, Howard G, Kelly-Hayes M, Nixon JV, Sacco RL, , . Primary prevention of ischemic stroke: a guideline from the American Heart Association/American Stroke Association Stroke Council: cosponsored by the Atherosclerotic Peripheral Vascular Disease Interdisciplinary Working Group; Cardiovascular Nursing Council; Clinical Cardiology Council; Nutrition, Physical Activity, and Metabolism Council; and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation. 2006 Jun 20;113(24):e873-923. (2006) Abstract

Bushnell CD, Hurn P, Colton C, Miller VM, del Zoppo G, Elkind MS, Stern B, Herrington D, Ford-Lynch G, Gorelick P, James A, Brown CM, Choi E, Bray P, Newby LK, Goldstein LB, Simpkins J. Advancing the study of stroke in women: summary and recommendations for future research from an NINDS-Sponsored Multidisciplinary Working Group. Stroke. 2006 Sep;37(9):2387-99. (2006) Abstract

Bushnell CD, Griffin J, Newby LK, Goldstein LB, Mahaffey KW, Graffagnino CA, Harrington RA, White HD, Simes RJ, Califf RM, Topol EJ, Easton JD. Statin use and sex-specific stroke outcomes in patients with vascular disease. Stroke. 2006 Jun;37(6):1427-31. (2006) Abstract

Amarenco P, Bogousslavsky J, Callahan A 3rd, Goldstein LB, Hennerici M, Rudolph AE, Sillesen H, Simunovic L, Szarek M, Welch KM, Zivin JA, . High-dose atorvastatin after stroke or transient ischemic attack. N Engl J Med. 2006 Aug 10;355(6):549-59. (2006) Abstract

Goldstein LB, Simel DL. Is this patient having a stroke? JAMA. 2005 May 18;293(19):2391-402. (2005) Abstract

Camilo O, Goldstein LB. Non-atherosclerotic vascular disease in the young. J Thromb Thrombolysis. 2005 Oct;20(2):93-103. (2005) Abstract

Camilo O, Goldstein LB. Lower stroke-related mortality in counties with stroke centers: North Carolina Stroke Facilities Survey. Neurology. 2005 Feb 22;64(4):762-3. (2005) Abstract

Adams H, Adams R, Del Zoppo G, Goldstein LB, , . Guidelines for the early management of patients with ischemic stroke: 2005 guidelines update a scientific statement from the Stroke Council of the American Heart Association/American Stroke Association. Stroke. 2005 Apr;36(4):916-23. (2005) Abstract

Rothwell PM, Goldstein LB. Carotid endarterectomy for asymptomatic carotid stenosis: asymptomatic carotid surgery trial. Stroke. 2004 Oct;35(10):2425-7. (2004) Abstract

Goldstein LB. Neuroprotective therapy for acute ischaemic stroke: down, but not out. Lancet. 2004 Feb 7;363(9407):414-5. (2004) Abstract

Goldstein LB. Blood pressure management in patients with acute ischemic stroke. Hypertension. 2004 Feb;43(2):137-41. (2004) Abstract

Goldstein LB, Samsa GP, Matchar DB, Horner RD. Charlson Index comorbidity adjustment for ischemic stroke outcome studies. Stroke. 2004 Aug;35(8):1941-5. (2004) Abstract

Camilo O, Goldstein LB. Seizures and epilepsy after ischemic stroke. Stroke. 2004 Jul;35(7):1769-75. (2004) Abstract

Bushnell CD, Newby LK, Goldstein LB, Lin F, Yaffe K, Simon JA. Statin use and stroke outcomes in the Heart and Estrogen-Progestin Replacement Study (HERS). Neurology. 2004 Mar 23;62(6):968-70. (2004) Abstract

Bushnell CD, Goldstein LB. Risk of ischemic stroke with tamoxifen treatment for breast cancer: a meta-analysis. Neurology. 2004 Oct 12;63(7):1230-3. (2004) Abstract

Marler JR, Goldstein LB. Medicine. Stroke--tPA and the clinic. Science. 2003 Sep 19;301(5640):1677. (2003) Abstract

Goldstein LB. Neuropharmacology of TBI-induced plasticity. Brain Inj. 2003 Aug;17(8):685-94. (2003) Abstract

Goldstein LB. Model of recovery of locomotor ability after sensorimotor cortex injury in rats. ILAR J. 2003;44(2):125-9. (2003) Abstract

Goldstein LB. Extracranial carotid artery stenosis. Stroke. 2003 Nov;34(11):2767-73. (2003) Abstract

Goldstein LB. Editorial comment--Prenatal influences on stroke mortality in England and Wales. Stroke. 2003 Jul;34(7):1602-3. (2003) Abstract

Goldstein LB. Editorial comment--Advertising strategies to increase the public knowledge of the warning signs of stroke. Stroke. 2003 Aug;34(8):1968-9. (2003) Abstract

Goldstein LB. Amphetamines and related drugs in motor recovery after stroke. Phys Med Rehabil Clin N Am. 2003 Feb;14(1 Suppl):S125-34, x. (2003) Abstract

Goldstein LB, Matchar DB, Hoff-Lindquist J, Samsa GP, Horner RD. Veterans Administration Acute Stroke (VASt) Study: lack of race/ethnic-based differences in utilization of stroke-related procedures or services. Stroke. 2003 Apr;34(4):999-1004. (2003) Abstract

Goldstein LB, Matchar DB, Hoff-Lindquist J, Samsa GP, Horner RD. VA Stroke Study: neurologist care is associated with increased testing but improved outcomes. Neurology. 2003 Sep 23;61(6):792-6. (2003) Abstract

Bushnell C, Goldstein LB. Screening for hypercoagulable syndromes following stroke. Curr Atheroscler Rep. 2003 Jul;5(4):291-8. (2003) Abstract

Anderson DJ, Goldstein LB, Wilkinson WE, Corey GR, Cabell CH, Sanders LL, Sexton DJ. Stroke location, characterization, severity, and outcome in mitral vs aortic valve endocarditis. Neurology. 2003 Nov 25;61(10):1341-6. (2003) Abstract

Adams HP Jr, Adams RJ, Brott T, del Zoppo GJ, Furlan A, Goldstein LB, Grubb RL, Higashida R, Kidwell C, Kwiatkowski TG, Marler JR, Hademenos GJ, . Guidelines for the early management of patients with ischemic stroke: A scientific statement from the Stroke Council of the American Stroke Association. Stroke. 2003 Apr;34(4):1056-83. (2003) Abstract

Johnston DC, Goldstein LB. Utility of noninvasive studies in the evaluation of patients with carotid artery disease. Curr Neurol Neurosci Rep. 2002 Jan;2(1):25-30. (2002) Abstract

Johnston DC, Eastwood JD, Nguyen T, Goldstein LB. Contrast-enhanced magnetic resonance angiography of carotid arteries: utility in routine clinical practice. Stroke. 2002 Dec;33(12):2834-8. (2002) Abstract

Goldstein LB, Bullman S. Differential effects of haloperidol and clozapine on motor recovery after sensorimotor cortex injury in rats. Neurorehabil Neural Repair. 2002 Dec;16(4):321-5. (2002) Abstract

Coull BM, Williams LS, Goldstein LB, Meschia JF, Heitzman D, Chaturvedi S, Johnston KC, Starkman S, Morgenstern LB, Wilterdink JL, Levine SR, Saver JL, , . Anticoagulants and antiplatelet agents in acute ischemic stroke: report of the Joint Stroke Guideline Development Committee of the American Academy of Neurology and the American Stroke Association (a division of the American Heart Association). Neurology. 2002 Jul 9;59(1):13-22. (2002) Abstract

Bushnell CD, Goldstein LB. Physician knowledge and practices in the evaluation of coagulopathies in stroke patients. Stroke. 2002 Apr;33(4):948-53. (2002) Abstract

Bushnell CD, Goldstein LB. Homocysteine testing in patients with acute ischemic stroke. Neurology. 2002 Nov 26;59(10):1541-6. (2002) Abstract

Smith Hammond CA, Goldstein LB, Zajac DJ, Gray L, Davenport PW, Bolser DC. Assessment of aspiration risk in stroke patients with quantification of voluntary cough. Neurology. 2001 Feb 27;56(4):502-6. (2001) Abstract

Johnston DC, Goldstein LB. Clinical carotid endarterectomy decision making: noninvasive vascular imaging versus angiography. Neurology. 2001 Apr 24;56(8):1009-15. (2001) Abstract

Johnston DC, Chapman KM, Goldstein LB. Low rate of complications of cerebral angiography in routine clinical practice. Neurology. 2001 Dec 11;57(11):2012-4. (2001) Abstract

Goldstein LB. Medical therapy for acute ischemic stroke. Curr Atheroscler Rep. 2001 Jul;3(4):299-306. (2001) Abstract

Goldstein LB, Jones MR, Matchar DB, Edwards LJ, Hoff J, Chilukuri V, Armstrong SB, Horner RD. Improving the reliability of stroke subgroup classification using the Trial of ORG 10172 in Acute Stroke Treatment (TOAST) criteria. Stroke. 2001 May;32(5):1091-8. (2001) Abstract

Goldstein LB, Edwards MG, Wood DP. Delay between stroke onset and emergency department evaluation. Neuroepidemiology. 2001 Aug;20(3):196-200. (2001) Abstract

Bushnell CD, Siddiqi Z, Goldstein LB. Improving patient selection for coagulopathy testing in the setting of acute ischemic stroke. Neurology. 2001 Oct 9;57(7):1333-5. (2001) Abstract

Bushnell CD, Samsa GP, Goldstein LB. Hormone replacement therapy and ischemic stroke severity in women: a case-control study. Neurology. 2001 May 22;56(10):1304-7. (2001) Abstract

Bushnell CD, Johnston DC, Goldstein LB. Retrospective assessment of initial stroke severity: comparison of the NIH Stroke Scale and the Canadian Neurological Scale. Stroke. 2001 Mar;32(3):656-60. (2001) Abstract

Bushnell C, Siddiqi Z, Morgenlander JC, Goldstein LB. Use of specialized coagulation testing in the evaluation of patients with acute ischemic stroke. Neurology. 2001 Mar 13;56(5):624-7. (2001) Abstract

Albers GW, Goldstein LB, Hall D, Lesko LM, . Aptiganel hydrochloride in acute ischemic stroke: a randomized controlled trial. JAMA. 2001 Dec 5;286(21):2673-82. (2001) Abstract

Samsa GP, Matchar DB, Goldstein LB, Bonito AJ, Lux LJ, Witter DM, Bian J. Quality of anticoagulation management among patients with atrial fibrillation: results of a review of medical records from 2 communities. Arch Intern Med. 2000 Apr 10;160(7):967-73. (2000) Abstract

Goldstein LB. Should antihypertensive therapies be given to patients with acute ischemic stroke? Drug Saf. 2000 Jan;22(1):13-8. (2000) Abstract

Goldstein LB. Rehabilitation and Recovery After Stroke. Curr Treat Options Neurol. 2000 Jul;2(4):319-328. (2000) Abstract

Goldstein LB. Novel risk factors for stroke: homocysteine, inflammation, and infection. Curr Atheroscler Rep. 2000 Mar;2(2):110-4. (2000) Abstract

Goldstein LB. Effects of amphetamines and small related molecules on recovery after stroke in animals and man. Neuropharmacology. 2000 Mar 3;39(5):852-9. (2000) Abstract

Goldstein LB, Vitek MP, Dawson H, Bullman S. Expression of the apolipoprotein E gene does not affect motor recovery after sensorimotor cortex injury in the mouse. Neuroscience. 2000;99(4):705-10. (2000) Abstract

Goldstein LB, Howard G. Stroke in patients with asymptomatic internal-carotid-artery stenosis. N Engl J Med. 2000 Nov 9;343(19):1420; discussion 1421. (2000) Abstract

Goldstein LB, Hey LA, Laney R. North Carolina stroke prevention and treatment facilities survey. Statewide availability of programs and services. Stroke. 2000 Jan;31(1):66-70. (2000) Abstract

Goldstein LB, Bian J, Samsa GP, Bonito AJ, Lux LJ, Matchar DB. New transient ischemic attack and stroke: outpatient management by primary care physicians. Arch Intern Med. 2000 Oct 23;160(19):2941-6. (2000) Abstract

Bushnell CD, Goldstein LB. Diagnostic testing for coagulopathies in patients with ischemic stroke. Stroke. 2000 Dec;31(12):3067-78. (2000) Abstract