Blood Biospecimen Recommendations for Research on Stroke Outcomes and Recovery

The impact of trait-associated genetic variants on stroke risk is by now a well-established area of research that has continued to accelerate since the introduction of genome-wide technologies. More recently, the field has seen an increasing interest in the biology of stroke recovery. Studies designed to evaluate stroke recovery have unique needs that differ from those in studies of stroke risk and acute stroke outcomes. Here we outline the essential considerations for researchers aiming to develop or contribute to blood biomarker research on stroke recovery. Our recommendations incorporate the latest evidence and technologies that have emerged since the prior International Stroke Genetics Consortium Global Alliance recommendations were published in 2015. Nominated contributors with expertise in stroke recovery and genomics met over the course of 9 months and defined the scope of topics, discussed current practice and standards, and revised the recommendations to reflect consensus achieved through 2 rounds of anonymized surveys. Our writing group defined an updated and expanded set of recommendations applicable to a range of research priorities including (1) elucidating the biology of stroke recovery, (2) determining genetic variations associated with good versus poor stroke outcomes and recovery, (3) identifying druggable (or otherwise therapeutically actionable) gene or protein targets for enhanced recovery, and (4) identifying blood biomarkers that can predict stroke outcomes and recovery. The resulting work offers comprehensive guidance on essential preanalytical considerations for blood biomarker studies, encompassing blood collection timing, specimen processing and storage procedures, and regulatory aspects such as informed consent and data sharing. These guidelines will enable the consistent collection of human data on recovery biology at scale, providing the foundational evidence necessary to drive subsequent clinical translation.