Silent Stroke Clinical Trial
— ACCURATE-2Official title:
Association Between Gait Features Assessed by Artificial Intelligent System and Cognitive Function Decline in the Patients of Silent Cerebrovascular Disease: A Multicenter Prospective Cohort Study
This study is a multi-center prospective cohort study. We will continuously recruit subjects
with silent cerebrovascular disease aged 60 to 85 years from Shanghai and Guizhou. Data
including demographic characteristics, medical history, other concomitant diseases,
neurological function assessments, laboratory examinations, imaging examinations, and other
clinical data and health economics survey responses will be collected from all subjects.
At baseline, all subjects will undergo gait assessment using the intelligent system and
cognitive function scale assessment by clinicians. According to the intelligent gait results,
the subjects will be divided into normal and abnormal gait groups. All subjects will be
observed naturally for 1 year, and all medical behaviors will be recorded. All subjects will
be interviewed by telephone for the occurrence of vascular events and changes in medical
behaviors at half a year after enrollment and followed up at 1 year after enrollment,
including gait evaluation using the intelligent system and cognitive function scale
evaluation by clinicians. During the follow-up period, patients can visit the hospital for
follow-up at any time when their condition changes.
Status | Not yet recruiting |
Enrollment | 1600 |
Est. completion date | December 31, 2021 |
Est. primary completion date | October 31, 2021 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 60 Years to 85 Years |
Eligibility |
Inclusion Criteria: 1. Aged between 60 and 85 years. 2. Diagnosed with silent cerebrovascular disease/silent stroke, which is consistent with the 2016 statement issued by the American Heart Association (AHA) and American Stroke Association (ASA): 1. No previous clear history of stroke and no clinical symptoms or mild clinical symptoms that fail to attract clinical attention; 2. Cranial MRI showing at least one of the following within 5 years: lacunar infarct of vascular origin; white matter hyperintensity of vascular origin; cerebral microbleeds; 3. Consciousness and ability to complete cognitive assessment 4. Ability to stand and walk independently and complete gait assessment without assistance from others. 5. Ability to sign the informed consent. Exclusion Criteria: 1. Intracranial lesions that have been clearly diagnosed as demyelination disease, white matter dystrophy, intracranial space-occupying lesions, or autoimmune encephalitis. 2. Gait disorder that has been diagnosed as Parkinson's disease, normal cranial hydrocephalus, an otogenic disease, subacute combined degeneration, peripheral neuropathy, osteoarthritis, or lumbar disease. 3. Cognitive disorders that have been diagnosed, such as Alzheimer's disease, frontotemporal dementia, Lewy body dementia, etc. 4. Severe neurological diseases such as previous cerebral trauma, epilepsy, and myelopathy, etc. 5. Severe cardiovascular complications and intolerance to the assessment 6. Severe visual or hearing impairment, aphasia, cognitive disorder, gait disorder, etc., that results in the inability to cooperate for cognitive and gait assessment 7. Refusal to participate in the study 8. Other anomalies that could not be included in the exclusion criteria, but are considered inappropriate to be included in this study. |
Country | Name | City | State |
---|---|---|---|
n/a |
Lead Sponsor | Collaborator |
---|---|
Shanghai Zhongshan Hospital | Fudan University, The Affiliated Hospital Of Guizhou Medical University |
Brickman AM, Provenzano FA, Muraskin J, Manly JJ, Blum S, Apa Z, Stern Y, Brown TR, Luchsinger JA, Mayeux R. Regional white matter hyperintensity volume, not hippocampal atrophy, predicts incident Alzheimer disease in the community. Arch Neurol. 2012 Dec;69(12):1621-7. doi: 10.1001/archneurol.2012.1527. — View Citation
de Laat KF, van Norden AG, Gons RA, van Oudheusden LJ, van Uden IW, Bloem BR, Zwiers MP, de Leeuw FE. Gait in elderly with cerebral small vessel disease. Stroke. 2010 Aug;41(8):1652-8. doi: 10.1161/STROKEAHA.110.583229. Epub 2010 Jun 24. — View Citation
Debette S, Markus HS. The clinical importance of white matter hyperintensities on brain magnetic resonance imaging: systematic review and meta-analysis. BMJ. 2010 Jul 26;341:c3666. doi: 10.1136/bmj.c3666. Review. — View Citation
Dumurgier J, Artaud F, Touraine C, Rouaud O, Tavernier B, Dufouil C, Singh-Manoux A, Tzourio C, Elbaz A. Gait Speed and Decline in Gait Speed as Predictors of Incident Dementia. J Gerontol A Biol Sci Med Sci. 2017 May 1;72(5):655-661. doi: 10.1093/gerona/ — View Citation
Feigin VL, Forouzanfar MH, Krishnamurthi R, Mensah GA, Connor M, Bennett DA, Moran AE, Sacco RL, Anderson L, Truelsen T, O'Donnell M, Venketasubramanian N, Barker-Collo S, Lawes CM, Wang W, Shinohara Y, Witt E, Ezzati M, Naghavi M, Murray C; Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010) and the GBD Stroke Experts Group. Global and regional burden of stroke during 1990-2010: findings from the Global Burden of Disease Study 2010. Lancet. 2014 Jan 18;383(9913):245-54. Review. Erratum in: Lancet. 2014 Jan 18;383(9913):218. — View Citation
Kim BJ, Lee SH. Prognostic Impact of Cerebral Small Vessel Disease on Stroke Outcome. J Stroke. 2015 May;17(2):101-10. doi: 10.5853/jos.2015.17.2.101. Epub 2015 May 29. Review. — View Citation
Kim YJ, Kwon HK, Lee JM, Cho H, Kim HJ, Park HK, Jung NY, San Lee J, Lee J, Jang YK, Kim ST, Lee KH, Choe YS, Kim YJ, Na DL, Seo SW. Gray and white matter changes linking cerebral small vessel disease to gait disturbances. Neurology. 2016 Mar 29;86(13):1199-207. doi: 10.1212/WNL.0000000000002516. Epub 2016 Mar 2. — View Citation
Leary MC, Saver JL. Annual incidence of first silent stroke in the United States: a preliminary estimate. Cerebrovasc Dis. 2003;16(3):280-5. — View Citation
Maillard P, Carmichael O, Fletcher E, Reed B, Mungas D, DeCarli C. Coevolution of white matter hyperintensities and cognition in the elderly. Neurology. 2012 Jul 31;79(5):442-8. doi: 10.1212/WNL.0b013e3182617136. Epub 2012 Jul 18. — View Citation
Montero-Odasso MM, Sarquis-Adamson Y, Speechley M, Borrie MJ, Hachinski VC, Wells J, Riccio PM, Schapira M, Sejdic E, Camicioli RM, Bartha R, McIlroy WE, Muir-Hunter S. Association of Dual-Task Gait With Incident Dementia in Mild Cognitive Impairment: Results From the Gait and Brain Study. JAMA Neurol. 2017 Jul 1;74(7):857-865. doi: 10.1001/jamaneurol.2017.0643. Erratum in: JAMA Neurol. 2017 Nov 1;74(11):1381. — View Citation
Murray ME, Senjem ML, Petersen RC, Hollman JH, Preboske GM, Weigand SD, Knopman DS, Ferman TJ, Dickson DW, Jack CR Jr. Functional impact of white matter hyperintensities in cognitively normal elderly subjects. Arch Neurol. 2010 Nov;67(11):1379-85. doi: 10.1001/archneurol.2010.280. — View Citation
Poels MM, Steyerberg EW, Wieberdink RG, Hofman A, Koudstaal PJ, Ikram MA, Breteler MM. Assessment of cerebral small vessel disease predicts individual stroke risk. J Neurol Neurosurg Psychiatry. 2012 Dec;83(12):1174-9. doi: 10.1136/jnnp-2012-302381. Epub 2012 Aug 23. — View Citation
Sachdev PS, Wen W, Christensen H, Jorm AF. White matter hyperintensities are related to physical disability and poor motor function. J Neurol Neurosurg Psychiatry. 2005 Mar;76(3):362-7. — View Citation
Smith EE, Saposnik G, Biessels GJ, Doubal FN, Fornage M, Gorelick PB, Greenberg SM, Higashida RT, Kasner SE, Seshadri S; American Heart Association Stroke Council; Council on Cardiovascular Radiology and Intervention; Council on Functional Genomics and Translational Biology; and Council on Hypertension. Prevention of Stroke in Patients With Silent Cerebrovascular Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2017 Feb;48(2):e44-e71. doi: 10.1161/STR.0000000000000116. Epub 2016 Dec 15. Review. — View Citation
Verghese J, Lipton RB, Hall CB, Kuslansky G, Katz MJ, Buschke H. Abnormality of gait as a predictor of non-Alzheimer's dementia. N Engl J Med. 2002 Nov 28;347(22):1761-8. — View Citation
Vermeer SE, Hollander M, van Dijk EJ, Hofman A, Koudstaal PJ, Breteler MM; Rotterdam Scan Study. Silent brain infarcts and white matter lesions increase stroke risk in the general population: the Rotterdam Scan Study. Stroke. 2003 May;34(5):1126-9. Epub 2003 Apr 10. — View Citation
Vermeer SE, Longstreth WT Jr, Koudstaal PJ. Silent brain infarcts: a systematic review. Lancet Neurol. 2007 Jul;6(7):611-9. Review. — View Citation
Wakefield DB, Moscufo N, Guttmann CR, Kuchel GA, Kaplan RF, Pearlson G, Wolfson L. White matter hyperintensities predict functional decline in voiding, mobility, and cognition in older adults. J Am Geriatr Soc. 2010 Feb;58(2):275-81. doi: 10.1111/j.1532-5415.2009.02699.x. Epub 2010 Jan 26. — View Citation
Wardlaw JM, Smith EE, Biessels GJ, Cordonnier C, Fazekas F, Frayne R, Lindley RI, O'Brien JT, Barkhof F, Benavente OR, Black SE, Brayne C, Breteler M, Chabriat H, Decarli C, de Leeuw FE, Doubal F, Duering M, Fox NC, Greenberg S, Hachinski V, Kilimann I, Mok V, Oostenbrugge Rv, Pantoni L, Speck O, Stephan BC, Teipel S, Viswanathan A, Werring D, Chen C, Smith C, van Buchem M, Norrving B, Gorelick PB, Dichgans M; STandards for ReportIng Vascular changes on nEuroimaging (STRIVE v1). Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegeneration. Lancet Neurol. 2013 Aug;12(8):822-38. doi: 10.1016/S1474-4422(13)70124-8. — View Citation
* Note: There are 19 references in all — Click here to view all references
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Change in cognitive assessment scale score(MMSE) | It will be assessed by the Mini-Mental state examination (MMSE), which is scored 0-30. | 1 year | |
Secondary | Change in cognitive assessment scale score(MoCA) | It will be assessed by the Montreal cognitive assessment (MoCA), which is scored 0-30. | 1 year | |
Secondary | the prevalence of gait disorders | the prevalence of gait disorders, according to the intelligent assessment | baseline | |
Secondary | the prevalence of cognitive disorder | the prevalence of cognitive disorder, according to the MMSE | baseline | |
Secondary | the incidence of vascular events | the incidence of vascular events, including Cardiovascular and cerebrovascular events | 1 year | |
Secondary | the incidence of fall incidence | the incidence of fall incidence | 1 year |
Status | Clinical Trial | Phase | |
---|---|---|---|
Recruiting |
NCT04449523 -
Incidence of Silent Atrial Fibrillation in Patients With Clinically Silent Brain Ischemic Lesions
|
||
Completed |
NCT00831259 -
Risk of Stroke in Pulmonary Embolism With a Patent Foramen Ovale (PFO)
|
N/A | |
Recruiting |
NCT05369195 -
Cerebral Protection in Transcatheter Left Atrial Appendage Occlusion
|
N/A | |
Active, not recruiting |
NCT04808778 -
Stroke Prevention in Young Adults With Sickle Cell Anemia
|
||
Completed |
NCT04241289 -
Detection and Neurological Impact of Cerebrovascular Events in Cardiac Surgery Patients
|
||
Recruiting |
NCT05685069 -
Prevalence of Attributable Etiology and Modifiable Stroke Risk Factors in Patients With Covert Brain Infarctions
|
||
Not yet recruiting |
NCT04457908 -
The Effectiveness and Cost Effectiveness of Intelligent Assessment of Gait Disorder in Silent Cerebrovascular Disease
|
N/A | |
Completed |
NCT04734587 -
Evaluation of Brain Damage Due to Coronary Angioplasty in Percutaneous Intervention Patients
|
||
Completed |
NCT03104556 -
Silent sTROke duriNG MitraClip Implantation
|