Brain recovery after MCA reopening is studied with PET/MR

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This prospective observational study uses integrated PET/MR imaging to examine how cerebral perfusion, metabolic activity, and functional connectivity change after recanalization of a non-acute atherosclerotic MCA occlusion. Imaging is performed at predefined time points and analyzed alongside vascular status and neurological or cognitive outcomes. The goal is to understand perfusion–metabolism recoupling and network recovery to better interpret tissue-level recovery beyond just reopening the artery. The study will relate imaging findings to clinical status and treatment decisions. Participants are adults aged 18–80 undergoing endovascular recanalization with atherosclerotic occlusion of the M1 MCA segment.

Why it matters

Who can join: the full rules

Inclusion Criteria:

1. Aged 18-80 years, regardless of sex.
2. Symptomatic non-acute middle cerebral artery (MCA) occlusion, with an interval of ≥4 weeks between the most recent ischemic event or imaging confirmation of occlusion and the recanalization procedure.
3. Occlusion involving the M1 segment of the MCA, confirmed by computed tomography angiography (CTA), magnetic resonance angiography (MRA), or digital subtraction angiography (DSA).
4. Occlusion presumed to be of atherosclerotic origin.
5. Persistence of at least one of the following despite guideline-directed medical therapy: recurrent transient ischemic attacks (TIAs), minor ischemic stroke, symptoms attributable to cerebral hypoperfusion, watershed infarction, or imaging evidence of cerebral hypoperfusion or metabolic abnormalities.
6. Preoperative PET/MR images of sufficient quality for quantitative analysis.
7. Clinically scheduled to undergo endovascular recanalization.
8. Provision of written informed consent by the patient or their legally authorized representative.

Exclusion Criteria:

1. Acute large-territory cerebral infarction involving more than one-third of the MCA territory.
2. Extensive encephalomalacia within the affected vascular territory that precludes reliable assessment of cortical regions of interest (ROIs).
3. Non-atherosclerotic causes of MCA occlusion, including moyamoya disease, arterial dissection, central nervous system vasculitis, or cardioembolism.
4. Severe bilateral intracranial arterial occlusive disease that precludes reliable calculation of hemispheric asymmetry indices.
5. Structural lesions involving the cerebellum or brainstem that may interfere with metabolic analysis using the cerebellum as a reference region.
6. Contraindications to MRI (e.g., incompatible cardiac pacemakers, metallic foreign bodies, or severe claustrophobia) or PET imaging.
7. Severe head motion or imaging artifacts that render PET/MR, arterial spin labeling (ASL), or blood oxygen level-dependent (BOLD) imaging data unsuitable for analysis.
8. Poor glycemic control (fasting blood glucose \>11.1 mmol/L) that may compromise the quality of 18F-fluorodeoxyglucose (18F-FDG) PET imaging.

Where it's running

• The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital
  Jinan, Shandong, China Recruiting

Study contacts

• Principal investigator: Ju Han, MD — The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital
• Study coordinator: Ju Han, MD
• Email: hanjujack@163.com
• Phone: 86+13791120710

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.