Imaging the Network: Using MEG to Determine the Pathophysiology Underlying Post-Stroke Cognitive Impairment

Status: Recruiting
Location: See location...
Intervention Type: Diagnostic test
Study Type: Observational
SUMMARY

This is a study using magnetoencephalography (MEG) to look at recovery in those with minor stroke. The investigators know that these individuals report difficulties in attention, concentration, multi-tasking, energy level, and processing speed that appear to be independent of lesion size or location. The underlying pathophysiology is unclear; however, anecdotally, many individuals are significantly improved by 6 months post-stroke. One hypothesis is that a single lesion, regardless of size, may disrupt the classic neural networks required for cognitive function. The investigators are currently collecting data to better characterize these difficulties and stroke patients' recovery as part of a previously approved recovery study. In this sub-study, the investigators propose to add MEG at 1 and 6 months in a subset of individuals with small: 1) subcortical, and 2) cortical lesions. The investigators will partner with colleagues at the University of Maryland (College Park), who are well experienced with MEG to conduct this research. In addition a control population of age-similar individuals will be recruited for comparison. Cerebral activation patterns of individuals with stroke versus controls will be compared, both across patients with stroke at a given time point, and within subjects from 1 to 6 months to determine the association of abnormal activation with cognitive dysfunction and recovery. \*\*The investigators have recently extended follow-up by adding an additional assessment at 12 months and will enroll additional participants (up to 40 patients with minor stroke, 15 age-similar controls).

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Maximum Age: 100
View:

• Adults (≥18 years) admitted to Bayview Medical Center Neurology.

• Evidence of acute ischemic stroke (CT or MRI)- lacunar stroke or branch occlusion (M3/A3/P3 or smaller) OR NIHSS ≤ 8 on admission.

• Competent speaker of English (by self or family report) prior to stroke.

• Return for follow-up 4-6 weeks post event (+/- 4 wks).

• Cognitive deficits present on initial testing.\*\* unique to MEG study

• Willing to travel to the University of Maryland twice for MEG.\*\* unique to MEG study

• Fully independent functionally and able to travel to the University of Maryland unassisted.\*\* unique to MEG study

Locations
United States
Maryland
Johns Hopkins Bayview Medical Center
RECRUITING
Baltimore
Contact Information
Primary
Elisabeth B Marsh, MD
ebmarsh@jhmi.edu
410-550-8703
Time Frame
Start Date: 2018-07-01
Estimated Completion Date: 2026-06-30
Participants
Target number of participants: 55
Treatments
Minor Stroke
We will enroll a cohort of 15 adult patients previously admitted to Johns Hopkins Bayview Medical Center with small/minor acute ischemic stroke visible on neuroimaging. Patients will follow-up in clinic 4-6 weeks following hospital discharge. To be eligible for the study, patients must have a minor stroke, defined as NIH Stroke Scale score at follow-up of less than or equal to 8, modified Rankin score of 0-2, be competent speakers of English, and have no prior history of stroke, dementia, or untreated psychiatric disease. Those with proximal large vessel (M1) or branch (M2) occlusions will be excluded.~\*Based on preliminary results we have expanded our trial and will continue to recruit up to 40 patients with minor stroke.
Controls
For comparison, we will recruit a group of age-similar controls (n=15) without neurologic disease or prior clinical history of stroke.
Related Therapeutic Areas
Sponsors
Collaborators: University of Maryland, College Park, American Heart Association
Leads: Johns Hopkins University

This content was sourced from clinicaltrials.gov