About this trial
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 criteria
This trial does not accept healthy volunteersQualifiers
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).
Disqualifiers
Primary intracerebral hemorrhage- as evidenced by blood on head CT or MRI.
Previous neurological disease (e.g., dementia, multiple sclerosis, prior symptomatic stroke). Incidental asymptomatic lacunar strokes found on imaging will not be excluded as prior disease.
Uncorrected hearing or visual loss.
Large vessel occlusion.
Trial population
Participants will be recruited from those recently hospitalized with minor stroke at Johns Hopkins Bayview Medical Center (see inclusion criteria). Controls will include friends, family, and other volunteers of similar age meeting Inclusion Criteria.
Trial design
Case-control
Prospective
Treatments tested in this trial
Magnetoencephalography (MEG)
Diagnostic testParticipants will undergo MEG at the University of Maryland (College Park) to measure cerebral activity while performing a visual naming task. The Montreal Cognitive Assessment (MOCA) will also be administered.
Treatment groups
Trial outcomes
Primary outcomes
Cerebral Activity Measured Using Magnetoencephalography (MEG)
Global patterns of cerebral activity as well as individual brain areas important for cognitive processing will be analyzed for differences with respect to amplitude, latency, and frequency.
Cerebral Activity Measured Using Magnetoencephalography (MEG)
Global patterns of cerebral activity as well as individual brain areas important for cognitive processing will be analyzed for differences with respect to amplitude, latency, and frequency.
Cerebral Activity Measured Using Magnetoencephalography (MEG)
Global patterns of cerebral activity as well as individual brain areas important for cognitive processing will be analyzed for differences with respect to amplitude, latency, and frequency.
Reaction Time
Reaction times will be recorded and compared during the visual naming task
Secondary outcomes
MOCA
Scores on the MOCA will be compared between those with minor stroke and controls
MOCA
Scores on the MOCA will be compared between those with minor stroke and controls
MOCA
Scores on the MOCA will be compared between those with minor stroke and controls
Sponsors and contacts
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Johns Hopkins University
Lead sponsor
University of Maryland, College Park
Collaborator
American Heart Association
Collaborator