Using MEG to Evaluate Recovery After Minor Stroke

Imaging the Network: Using MEG to Determine the Pathophysiology Underlying Post-Stroke Cognitive Impairment

This study is testing how well people recover their thinking skills after a minor stroke by using special brain scans at 1 and 6 months after the stroke.

Quick facts

• Study type: Observational
• Enrollment: 55 (estimated)
• Ages: 18 Years to 100 Years
• Sex: All
• Sponsor: Johns Hopkins University (other)
• Locations: 1 site (Baltimore, Maryland)
• Trial ID: NCT04188522 on ClinicalTrials.gov

What this trial studies

This observational study investigates cognitive recovery in patients who have experienced a minor stroke using magnetoencephalography (MEG). Participants will undergo MEG testing at 1 and 6 months post-stroke to assess brain activity during cognitive tasks related to executive function, attention, and multi-tasking. The study aims to better understand the cognitive difficulties faced by stroke survivors, which may not correlate with the size or location of brain lesions. The research will involve collaboration with the University of Maryland to enhance data collection and analysis.

Who should consider this trial

Good fit: Ideal candidates are adults aged 18 and older who have experienced a minor ischemic stroke and exhibit cognitive deficits.

Not a fit: Patients with primary intracerebral hemorrhage or significant prior neurological diseases may not benefit from this study.

Why it matters

Potential benefit: If successful, this study could lead to improved understanding and management of cognitive recovery in stroke patients.

How similar studies have performed: While the use of MEG in stroke recovery is a novel approach, similar studies have shown promise in understanding cognitive deficits post-stroke.

Eligibility criteria

Inclusion Criteria:

1. Adults (≥18 years) admitted to Bayview Medical Center Neurology.
2. Evidence of acute ischemic stroke (CT or MRI)- lacunar stroke or branch occlusion (M3/A3/P3 or smaller) OR NIHSS ≤ 8 on admission.
3. Competent speaker of English (by self or family report) prior to stroke.
4. Return for follow-up 4-6 weeks post event (+/- 4 wks).
5. Cognitive deficits present on initial testing.\*\* unique to MEG study
6. Willing to travel to the University of Maryland twice for MEG.\*\* unique to MEG study
7. Fully independent functionally and able to travel to the University of Maryland unassisted.\*\* unique to MEG study

Exclusion Criteria:

1. Primary intracerebral hemorrhage- as evidenced by blood on head CT or MRI.
2. 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.
3. Uncorrected hearing or visual loss.
4. Large vessel occlusion.
5. Presence of any of the following that would lead to significant artifact on MEG: cardiac pacemaker, intracranial clips, metal implants, or external clips within 10mm of the head, metal in the eyes.\*\* unique to MEG study
6. Claustrophobia, obesity, and/or any other reason leading to difficulty staying in the MEG for up to 1 hour.\*\* unique to MEG study
7. For controls- clinical history of stroke or other neurological dysfunction (seizure, multiple sclerosis, etc.); psychiatric disease

Where this trial is running

Baltimore, Maryland

• Johns Hopkins Bayview Medical Center — Baltimore, Maryland, United States (RECRUITING)

Study contacts

• Principal investigator: Elisabeth B Marsh, MD — Johns Hopkins School of Medicine
• Study coordinator: Elisabeth B Marsh, MD

Conditions: Stroke, Stroke Sequelae, Stroke/Brain Attack