Evaluating brain metabolism in minor strokes with large vessel occlusion

Magnetic Resonance Spectroscopic Imaging Evaluation for Understanding Acute Minor Stroke With Large Vessel Occlusion Evolution Study

This study is trying to see how brain metabolism changes in people with minor strokes caused by large blood vessel blockages to help predict their recovery and guide treatment.

Quick facts

• Study type: Observational
• Enrollment: 75 (estimated)
• Ages: 18 Years to 100 Years
• Sex: All
• Sponsor: Shanghai 6th People's Hospital (Academic / other)
• Locations: 1 site (Shanghai, Shanghai Municipality)
• Trial ID: NCT06457217 on ClinicalTrials.gov

What this trial studies

This observational study aims to investigate the evolution of acute minor strokes caused by large vessel occlusion using magnetic resonance spectroscopic imaging (MRSI). It focuses on identifying neurometabolic predictors of early neurological deterioration and functional outcomes, as well as examining the dynamic changes of neurotransmitters and neurometabolites over time. Patients diagnosed with acute mild ischemic stroke will undergo MRSI scans at various stages: acute (within 24 hours), subacute (5-7 days), and chronic (90 days). The study seeks to understand how these metabolic changes correlate with neurological outcomes, potentially guiding treatment decisions for at-risk patients.

Who should consider this trial

Good fit: Ideal candidates are adults over 18 years old diagnosed with acute mild ischemic stroke due to large vessel occlusion within 24 hours of symptom onset.

Not a fit: Patients with significant pre-existing neurological impairment or those unable to undergo MRI may not benefit from this study.

Why it matters

Potential benefit: If successful, this study could lead to improved identification of patients at risk for neurological deterioration, allowing for timely interventions.

How similar studies have performed: While the approach of using MRSI in stroke evaluation is established, the specific focus on minor strokes with large vessel occlusion is relatively novel.

Eligibility criteria

Inclusion Criteria:

1. Adult (age ≥ 18 years) patients presenting with symptoms consistent with acute ischemic stroke due to occlusion of the intracranial internal carotid artery and/or M1 or M2 segment of the middle cerebral artery;
2. Patients with mild symptoms at admission (National Institutes of Health Stroke Scale (NIHSS)\<6);
3. Baseline multimodal-CT imaging, including NCCT, CTA and CTP, performed at the trial-site hospital;
4. Time from symptom onset or last known normal to enrollment is less than 24 hours;
5. Patient or legal representative willing to comply with protocol requirements and data collection procedures, understand and sign informed consent.

Exclusion Criteria:

1. A pre-incident mRS ≥ 1 point before onset;
2. Previous clear history of cerebral infarction, cerebral hemorrhage, brain tumor and other diseases that affect cerebral metabolism;
3. Intolerance or non-cooperation with magnetic resonance examination;
4. Severe cardiac, hepatic, renal impairment or other systemic serious advanced diseases;
5. Pregnancy or lactation;
6. Life expectancy is less than 3 months;
7. Other conditions that, in the opinion of the investigator, are not suitable for participation in this study or may pose a significant risk to the patient (such as inability to understand and/or comply with study procedures and/or follow-up due to psychiatric disorders, cognitive or emotional disorders).

Where this trial is running

Shanghai, Shanghai Municipality

• Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine — Shanghai, Shanghai Municipality, China (Recruiting)

Study contacts

• Principal investigator: Li Cao, phD — Shanghai Jiao Tong University Affiliated Sixth People's Hospital
• Study coordinator: Li Cao, phD

Conditions Acute Ischemic Stroke; Magnetic resonance spectroscopic imaging; Clinical Deterioration; Neurotransmitter; Neurometabolite; Metabolic network connectivity