Validation of 3D Stroke Models to Differentiate Stroke Subtypes and Predict Source in Acute Ischaemic Stroke
Stroke is a common condition which results in significant disability for patients. There are different causes of stroke, but around one quarter are as a result of clots or other material from the heart lodging in blood vessels in the brain, stopping the blood supply to that area. Atrial fibrillation is a common cause of blood clots which go to the brain and can be easily treated with blood thinning medications, which significantly reduce the risk of further strokes. However, at the moment, atrial fibrillation is difficult to identify, and heart monitoring can be needed for up to one year. This significantly delays starting blood thinning medications and leaves patients at risk of stroke during this time. Therefore, better ways of picking up strokes caused by atrial fibrillation are needed. One such method may be to use brain scans which are routinely taken at the time a patient presents with an acute stroke. By using mathematical models to work out the source of stroke, we may be able to determine which strokes are caused by atrial fibrillation at the time the patient presents with their stroke. This would reduce the number of investigations patients under-go, saving money for the NHS, and reducing the number of tests patients have. Therefore, the aim of this project is to create an anonymised database of brain scans from patients who have presented to hospital with a stroke to develop and test these recently developed models to see if they can accurately identify which strokes are caused by atrial fibrillation, and which ones are not. This project has the potential to improve patient outcomes by reducing treatment delays and improving the accuracy of the diagnosis of the stroke source.
NCT05055960 — Stroke
Status: Active, not recruiting
http://inclinicaltrials.com/stroke/NCT05055960/
Stroke School - Cross-sectorial Physical Exercise for Patients With Minor Stroke or Non-disabling Stroke
In a randomized controlled trial the effect of 12 weeks of cross-sectorial physical exercise combined with patient education and individual follow-up session is investigated in patients with minor stroke or non-disabling stroke.
NCT04945174 — Transient Ischemic Attack
Status: Recruiting
http://inclinicaltrials.com/transient-ischemic-attack/NCT04945174/
STROKE-CARD REGISTRY: Extension of Standard Care in Patients With Ischemic STROKE and Transient Ischemic Attack
Stroke is the second leading cause of death and one of the main contributors to disability. Patients who survive the acute phase of ischemic stroke and those with transient ischemic attack (TIA) are at high risk of subsequent vascular events. Importantly, recurrent strokes are associated with a higher social and economic impact, higher case fatality, and worse clinical outcome than first-ever strokes. The burden of post-stroke complications, residual deficits, and inadequate medical and psychosocial care all contribute to long-term disability and reduced quality of life in these patients. The Department of Neurology of the Medical University Innsbruck undertook the STROKE-CARD trial (NCT02156778) between 2014 and 2018 with follow-up until 2019 to evaluate the efficacy of the Post-Stroke disease-management program STROKE-CARD care. After implementation of STROKE-CARD care, the investigators aim to document the quality of post-stroke care and compare outcome parameters to historical cohorts and the change over time. Furthermore the investigators aim to gain a large data-resource for future research of biomarkers, disease mechanisms, prognosis and imaging mechanisms for R&D.
NCT04582825 — Ischemic Stroke
Status: Recruiting
http://inclinicaltrials.com/ischemic-stroke/NCT04582825/
Randomized, Double-blind, Placebo-controlled Study of the Effect of Cerebrolysin® (EVER Neuro Pharma GmbH, Austria) at the Level of Paresis of the Upper Limb When Used in Complex Therapy of Acute Ischemic Stroke
The aim of the present clinical phase IV study is to estimate the influence of Cerebrolysin in combination with standard therapy on the dynamics of recovery of the paretic upper limb in patients with acute ischemic stroke. Each patient participates in the study for 176-190 days (approximately 6 months). The estimated duration of the study is 2 years.
NCT02581371 — Ischemic Stroke
Status: Recruiting
http://inclinicaltrials.com/ischemic-stroke/NCT02581371/
Autoimmune Phenomena After Acute Stroke - the Role of Stroke-induced Immunodepression
The damage of the brain parenchyma, as well as the stroke-induced dysfunction of the blood-brain-barrier can make previously hidden CNS antigens "visible", and can thus lead to the development of autoimmune mechanisms. It seems plausible that stroke-associated immunodepression influences the development and the phenotype of these autoreactive immune responses. This study will investigate whether cerebral ischemia leads to changes in the immune response, in particular to the development and/or proliferation of autoreactive effector T-cells and/or regulatory T-cells. Furthermore, the association between the severity and the phenotype of this autoimmune response and the clinical course, i.e. prognosis and mortality, will be investigated.
NCT01082783 — Stroke
Status: Completed
http://inclinicaltrials.com/stroke/NCT01082783/
"Mobile Stroke-Unit" for Reduction of the Response Time in Ischemic Stroke
Stroke, the most common cause of permanent disability, the second most common cause of dementia and third most common cause of death, has tremendous socio-economic consequences. Currently, systemic thrombolysis with the tissue plasminogen activator represents the only causal and approved treatment for acute ischemic stroke. However, the chances to save the brain tissue by a thrombolytic therapy exponentially decrease with proceeding time after onset of symptoms. In most cases, the beginning of the thrombolysis therapy is delayed by a variety of factors, like delivery to the hospital, re-examinations and delay of blood analysis or of CT scans. Due to this, a thrombolytic therapy is possible only in a minority of the stroke patients (2-5 %). The aim of this study is to investigate whether a "Mobile Stroke Unit", a rescue car with an integrated CT scanner, necessary for essential diagnostics, contributes to a better stroke management by saving precious time until a therapeutic decision is made. The trial is planned as a monocentric, randomised prospective trial.
NCT00792220 — Stroke
Status: Completed
http://inclinicaltrials.com/stroke/NCT00792220/
An Individualized Video-based Stroke Education Platform for Stroke Survivors and Caregivers
The goal of this multicenter randomized trial is to evaluate the impact of a personalized video-based stroke education platform on patient-centered and health system-centered outcomes. The main questions this study aims to address are: 1. Does a personalized, video-based educational platform improve stroke knowledge? 2. Does a personalized, video-based educational platform reduce post-discharge health system utilization? 3. Do different strategies of nudging improve engagement with educational material after hospital discharge? In order to determine the effect of this personalized stroke education strategy, researchers will compare subjects who receive standard stroke education with those who receive the personalized stroke education platform in addition to standard standard education. Patient knowledge will be assessed 90-days after discharge. Study participants will include both stroke patients and caregivers, who will: 1. Receive standard education during the stroke hospitalization 2. Complete a survey on the day of hospital discharge to assess their baseline knowledge. 3. Half of the subjects will be randomly assigned to also receive access to the personalized stroke education platform on the day of discharge. 4. All subjects will complete two follow-up study visits (7 and 90 days after discharge) in order to complete surveys.
NCT06442631 — Stroke, Acute
Status: Not yet recruiting
http://inclinicaltrials.com/stroke-acute/NCT06442631/
Plaque Characteristics From Vessel Wall Magnetic Resonance Imaging Predict Recurrent Stroke in Ischemic Stroke Patients Due to Middle Cerebral Artery Stenosis
The epidemiology of TOAST classification in Asian patients seems to differ due to the higher rates of large-artery atherosclerosis. The complex pathology of atherosclerosis could lead to recurrent stroke, including shear stress on the endothelium, disturbance of the flow, occlusion at the origin of the perforating artery, and other complications (plaque inflammation, plaque hemorrhage, plaque rupture) that could lead to stroke and recurrent stroke. Therefore, The exact determination of the etiology of stroke due to atherosclerosis is the most critical factor for treatment and prognostic. On the other hand, HR-MRI could be a useful imaging modality to evaluate the characteristics of plaque in stroke patients due to atherosclerosis stenosis, which will help us find out the etiology of stroke. Previous studies have demonstrated its prognosis value in predicting recurrent stroke in the same vascular territory. The investigators hypothesize that with an appropriate evaluation, HR-MRI could help to predict recurrent stroke in the same vascular territory in patients with high-risk plaque characteristics on HR-MRI. These findings could contribute to individual treatment according to etiology. The investigators intend to conduct a study to determine the correlation between plaque characteristics and recurrent stroke in the same vascular territory in ischemic stroke patients due to middle cerebral artery stenosis.
NCT06404242 — Stroke, Ischemic
Status: Recruiting
http://inclinicaltrials.com/stroke-ischemic/NCT06404242/
Circadian Based Acupressure Therapy on Post-stroke Fatigue, Depression, and Sleep Disturbances in Ischemic stroke Patients Undergoing Rehabilitation
Post-stroke fatigue (PSF) was defined as 'a subjective feeling of physical and/or mental exhaustion that is unrelated to exertion and does not typically improve with rest'. About 25~85% of first stoke patients had PSF in the first year. Literature review from animal studies suggested the mechanism of post-stroke fatigue may be due to prolonged production of inflammatory cytokines process after stroke. Acupuncture therapy which regulates the inflammatory process may have the potential to ameliorate fatigue symptoms alone with sleep disturbance after stroke. Acupressure which stimulating the same acupoints by manually pressure may make it easy to perform in anytime and anywhere. The effect of circadian based acupressure application on post-stroke fatigue and sleep disturbances need be further examined. The purpose of this two-year study is to (1) explore the distribution of inflammatory cytokines (blood and urine IL-1β, IL-6, TNF-α, IL-8) and post-stroke fatigue and sleep, and (2) examine the effect of circadian-based acupressure application on the inflammatory cytokines (urine and blood IL-1β, IL-6, TNF-α, IL-8), and post-stroke symptoms fatigue and sleep) in ischemic stroke patients with post-stroke fatigue during rehabilitation. Ischemic stroke patients (N=240) will be assessed from the rehabilitation wards. Patients with fatigue (FAS>=24) at assessment (n=78) will be further randomly assigned to the circadian based acupressure application group (AA), or the routine care control group (RC) for 2 weeks. Data of inflammatory cytokines (of IL-1β, IL-6, TNF-α, IL-8), post-stroke fatigue (Fatigue assessment scale), and sleep (Pittsburg Sleep Quality Index and consumer tracker) will be collected. Descriptive statistics, t-test, repeated measure ANOVA, linear/logistic regression or appropriate nonparametric equivalent will be used to compare pre-post differences and to compare differences between groups. Study results will provide information about the mechanism and effect of acupressure application on inflammation and post-stroke fatigue and sleep disturbances in ischemic stroke patients.
NCT06401837 — Ischemic Stroke
Status: Recruiting
http://inclinicaltrials.com/ischemic-stroke/NCT06401837/
Statins in Acute Ischemic Stroke(Role of Statins in Reperfusion in Acute Stroke )
Strokes is amajor cause of death and disabilities in different countried
NCT06371495 — Stroke, Acute
Status: Not yet recruiting
http://inclinicaltrials.com/stroke-acute/NCT06371495/