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NCT07513428
The primary objective of this observational study is to investigate alterations in PrPc levels in peripheral blood during acute cerebral infarction, as well as the correlation between these changes and both disease severity and prognosis. Additionally, it aims to explore the association between peripheral blood PrPc and T-cell-mediated inflammatory responses in acute cerebral infarction. Key research questions addressed include: how PrPc concentrations in peripheral blood change during acute cerebral infarction, and whether such variations correlate with clinical severity and patient outcomes. No interventions were administered in this study, and all patients received standard diagnostic and therapeutic care without disruption. Fasting venous blood samples were collected on the morning following hospital admission, and follow-up assessments using the modified Rankin Scale (mRS) were conducted at 90 days post-onset.
NCT06935279
This study is a prospective, multicenter cohort study conducted in western China. The registry study is primarily conducted at the Department of Neurosurgery, Tangdu Hospital, with participation from the Departments of Neurosurgery at Xi'an Medical University Second Affiliated Hospital, Hanzhong Central Hospital, Hanzhong 3201 Hospital, Baoji People's Hospital, and Pucheng County People's Hospital. The study population consists of patients aged 18 to 90 years undergoing carotid endarterectomy. Patients meeting all inclusion criteria and none of the exclusion criteria may be considered for enrollment after demonstrating informed consent to participate in this registry study and agreeing to sign the informed consent form. All patients enrolled in this study underwent a comprehensive standardized assessment by a multidisciplinary team (including neurology, neurosurgery, laboratory medicine, endocrinology, ultrasound, and other practitioners). The assessment included examinations of neurological, neuropsychological, and psychiatric conditions; endocrine disorders; and hematological indicators. Bacterial species identification was performed using 16S rDNA sequencing, with further validation via transmission electron microscopy. Included patients will undergo routine surgical treatment and follow-up visits as recommended by physicians, with corresponding clinical practice data accurately recorded. Data generated during patient clinical visits will be documented, including preoperative assessment, preoperative care, operating room care, anesthesia management, intraoperative procedures, postoperative medical management, postoperative nursing care, and follow-up information. Inclusion Criteria 1. Patients with clinically diagnosed moderate-to-severe carotid artery stenosis; 2. Age 18 years ≤ age ≤ 90 years; 3. Patients undergoing carotid endarterectomy (CEA) treatment; 4. Preoperative modified Rankin Scale (mRS) score for stroke patients: 0-2; 5. Preoperative NIHSS score for stroke patients: 0-20; 6. Glasgow Coma Scale (GCS) score of 8-15 at hospital admission; 7. No fever or evidence of infection at admission; 8. Informed consent obtained from the subject or legal representative; 9. Good compliance with follow-up requirements. Exclusion Criteria 1. Brain tumors (with mass effect); 2. Patient's Glasgow Coma Scale (GCS) score \<8; 3. Refractory hypertension (defined as sustained systolic blood pressure \>185 mmHg or diastolic blood pressure \>110 mmHg) unresponsive to medical therapy 4. History of severe infection within the past three months; 5. Severe or acute heart failure; 6. Acute myocardial infarction or severe arrhythmia; 7. Undergone solid organ surgery or biopsy within the past month; 8. Active bleeding or recent bleeding (gastrointestinal, urinary tract, etc.) within the past month; 9. Currently undergoing hemodialysis or peritoneal dialysis; known severe renal impairment (glomerular filtration rate \<220 mmol/L \[2.5 mg/dL\]); 10. Concurrent malignancy, severe cardiopulmonary disease, or other conditions rendering the patient unable to tolerate surgery; 11. Participation in other interventional clinical studies that may affect outcome assessment; 12. Severe hepatic dysfunction; 13. Other conditions deemed by the investigator as unsuitable for study participation or posing significant risk to the patient (e.g., inability to understand and/or comply with study procedures and/or follow-up due to psychiatric, cognitive, or emotional disorders); 14. Current use of immunosuppressive agents or undergoing immunotherapy. 15. Severe chest or abdominal trauma requiring surgical intervention, or severe traumatic brain injury; 16. Infectious diseases such as syphilis, HIV/AIDS, hepatitis, or tuberculosis; 17. Patients concurrently diagnosed with hypertension and diabetes mellitus. Research Projects and Content 1. Assess bacterial species within carotid plaques to preliminarily identify correlations between bacterial types and different plaque pathologies; 2. Detect plaque bacteria associated with adverse postoperative outcomes (cerebral infarction, carotid restenosis, mortality), identify risk bacteria linked to poor outcomes, and conduct preliminary functional analysis. 3. Analyze clinical data to assess the correlation between postoperative adverse events and bacteria within high-risk plaques, adjusting for confounding factors including age, gender, body mass index, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, creatinine, diabetes, and hypertension to enhance the reliability of research findings.
NCT03288090
Cerebral infarction is a type of stroke that can lead to sometimes disabling sequelae. Among these sequelae, fatigue is frequently reported by patients. It is therefore important for doctors to understand why patients suffer from fatigue after cerebral infarction and to determine whether treatments given for the cerebral infarction may have an impact on this fatigue. The aim of this research was to study the frequency of fatigue after cerebral infarction, the associated factors, in particular the impact of treatments administered in the acute phase.
NCT06757764
Currently, aspirin plus clopidogrel is considered as a standard acute treatment of ischemic stroke, based on results of CHANCE and POINT trial. However, still a considerable portion of patients showed early stroke recurrence, especially in those with stroke due to large artery atherosclerosis. Cilostazol may have benefit in reducing early stroke recurrence of neurologic deterioriation. The post-hoc analysis of CSPS.com showed that use of cilostazol after 15 days of stroke was effective for preventing subsequent stroke. The effect of adding cilostazol was more effective in those with large artery atherosclerosis and those receiving clopidogrel than aspirin.
NCT06548971
Stroke is the second leading cause of death worldwide, and ischemic stroke is the most frequent type. Intravenous thrombolysis with recombinant tissue plasminogen activator within 4.5 hours of symptom onset is the most effective therapy for patients with acute ischemic stroke. However, ischemic stroke progression and early reocclusion are not an uncommon phenomenon in patients after intravenous thrombolysis, resulting in neurological deterioration, which is associated with unfavorable functional outcomes. The underlying mechanism mainly involves the augmented platelet activation, triggered by the activated coagulation cascade during thrombolysis, which peaks within 2 hours of initiating rt-PA administration. Therefore, early antiplatelet therapy following intravenous thrombolysis represents a promising therapeutic approach to prevent neurological deterioration and improve the functional outcome of patients treated with intravenous thrombolysis. Currently, guidelines recommend initiating antiplatelet therapy 24 hours after intravenous thrombolysis due to the potential risk of increased bleeding. The safety and efficacy of early antiplatelet treatment following intravenous thrombolysis in patients with acute ischemic stroke remain clear. The study aims to test the hypothesis that in patients with acute ischemic stroke treated with intravenous thrombolysis, early administration of oral aspirin will improve functional outcomes without increasing the risk of intracranial hemorrhage.
NCT07140406
Objective: To explore the clinical efficacy of different needling strategies with moxibustion needles on upper limb function in post-stroke patients. Method: 105 patients with upper limb dysfunction after stroke were randomly divided into an extensor treatment group, a flexor treatment group, and a control group, with 35 patients in each group. Patients in the extensor treatment group were treated with extensor group moxibustion, patients in the flexor treatment group were treated with flexor group moxibustion, and patients in the control group were treated with conventional moxibustion. Observe the upper limb movement trajectory, surface electromyographic signals (sEMG) of extensor and flexor muscle groups, MAS scale scores, and FMA-UE scores of two groups of patients under specific tasks detected by a three-dimensional motion capture system before and after treatment, and determine the clinical efficacy. Result: Moxibustion therapy with moxibustion is helpful in improving upper limb dysfunction in stroke patients, safe and reliable, and worthy of application. The efficacy of needling the flexor muscle group with moxibustion is better than that of needling the extensor muscle group and conventional acupuncture, providing certain evidence and guidance for the selection of moxibustion sites in clinical practice.
NCT07121088
The objective of this observational study is to understand the long-term effects of traditional Chinese medicine (TCM) intervention on patients with cerebral infarction onset within \<48 hours and comorbid diabetes. The primary question it aims to address is: Can long-term TCM intervention for the treatment of ischemic cerebrovascular disease comorbid with diabetes improve patients' neurological deficits and self-care ability? Participants receiving TCM intervention (universal treatment combined with syndrome-specific treatment) as part of routine cerebrovascular disease management will undergo follow-up assessments at 30 days, 90 days, 6 months, and 12 months within 1 year to evaluate neurological status (e.g., mRS score, NIHSS score) and quality of life indicators.
NCT06712004
BCAIS-I is a single-center, randomized, double-blind, dose-response controlled clinical Trial, to preliminarily explore the efficacy of two different maintenance doses of bevifibatide citrate injection in improving 90-day neurological outcomes and the incidence of symptomatic intracranial hemorrhage in patients with acute ischemic stroke without large or medium-sized vessel occlusion, aiming to identify a dosing regimen that maintains therapeutic efficacy while minimizing the rates of symptomatic intracranial hemorrhage and serious adverse events, thereby providing dosing evidence for future large-scale randomized controlled trials.
NCT03186456
The purposes of the study is to determine the safety and efficacy of treating acute ischemic stroke patients with human umbilical cord mesenchymal stem cells (hUC-MSC).
NCT06834750
1. To observe the inducing and promoting effect of kinesio taping technique on the recovery of upper limb function in early-stage stroke patients. 2. To compare the different effects of kinesio tape and sports white tape on the induction and promotion of limb function in patients. 3. To verify that kinesio taping technique is a safe and promotable technical means for stroke patients.
NCT03358810
This is a randomized, sham-controlled, patient masked, outcome assessor-blinded study to assess a Pharyngeal Electrical Stimulation (PES) Catheter for treatment of oropharyngeal dysphagia following a stroke.
NCT06708065
This study investigates the effectiveness of combining Armeo Power robotic therapy with conventional rehabilitation techniques to improve upper limb motor function in patients with hemiplegia caused by supratentorial cerebral infarction (a type of stroke). The study aims to evaluate how robotic-assisted therapy can enhance recovery by measuring motor function improvements over three weeks of treatment. Participants will undergo standard physical and occupational therapy alongside Armeo Power training, with results compared to those receiving only standard rehabilitation. The findings aim to provide valuable insights into advanced therapeutic options for stroke rehabilitation.
NCT03741400
The Virtual Reality Glove for Hand and Arm Rehabilitation (vREHAB) trial is a randomized, controlled, phase 3 trial aiming to evaluate the safety, usability, and efficacy of a virtual reality biofeedback system (Neofect RAPAEL Smart Glove) to promote recovery of distal arm and hand function in the acute and subacute period after stroke, as compared to standard of care therapy. The aims of the study is to demonstrate: 1. the effect of Smart Glove use on functional recovery, in addition to standard of care rehabilitation therapy. 2. the feasibility of increasing the dose of rehabilitation in acute stroke patients with the Smart Glove. 3. the effect of Smart Glove use on quality of life.
NCT06486792
Patients who have recently had an ischemic stroke with no clear cause might have undetected atrial fibrillation (AF) that isn't caught during their initial hospital stay. After discharge, these patients are typically monitored for AF using devices like Holter monitors or implantable loop recorders. Treatment options during this period include anticoagulants or aspirin. Anticoagulants are more effective in preventing recurrent strokes if AF is present, offering an 80% risk reduction compared to aspirin's 20%. If AF is detected, anticoagulant treatment continues; if not, patients may switch to aspirin after 6-12 months. Despite the clinical rationale for using anticoagulants during this search period, their benefit-risk ratio compared to aspirin has not been fully evaluated.
NCT06456437
Post-ischemic adaptation is a physical brain protective treatment strategy in which an ischemic event in an organ or tissue is treated and blood flow is restored, and an ischemic stimulus is given to local tissues to induce the production of anti-ischemic damage factors and reduce the damage associated with reperfusion therapy . Relevant basic studies have confirmed that post-ischemic adaptation can reduce infarct volume and promote neurological function recovery in animal models of cerebral infarction. Therefore, it may be beneficial to the recovery of neurological function in patients with acute ischemic stroke undergoing mechanical thrombus extraction. Based on the above background, the use of a balloon to repeatedly dilate-contract at the original occlusion site after revascularization to block and restore arterial flow may be an effective cerebroprotective treatment for patients with large-vessel occlusion who undergo thrombolysis. However, can this approach be safely used in patients with acute ischemic stroke treated with thrombolysis? What is the protocol for the length of time patients can tolerate post-ischemic adaptation? The application of this method in the treatment of acute ischemic stroke will be explored in this study.
NCT05173051
In a prospective, quantitative explorative study, the risk of aspiration and penetration when swallowing solid pills (placebo) compared to a crushed placebo pill will be evaluated during a routine Fiberoptic Endoscopic Evaluation of Swallowing (FEES). The study design is thus a quasi-experimental study design with repeated measurements in the sense of a pre-posttest. Each patient undergoes a baseline examination (routine procedure) followed by the intervention (administration of three different solid pills and a crushed pill).
NCT03534466
There have been many studies on the use of running training in older children to improve gait development in children with cerebral palsy. The aim of our study was to conduct early treadmill training in infants who were highly suspected of cerebral palsy and to follow up on their long-term gait development.
NCT03886675
Vascular brain infarction (VBI) occurs in 67% of patients undergoing TEVAR. Overt stroke occurs in 13% of these patients and 88% of patients suffer from neurocognitive impairment. Cerebral air embolisation during the stent-graft deployment phase of TEVAR may be a cause of VBI. Standard treatment to de-air stent-grafts is through the use of a saline flush. This study aims to investigate whether carbon-dioxide or saline is the better fluid to de-air TEVAR stent-grafts prior to insertion in to the patient and compare VBI rate in the carbon-dioxide group and saline group.
NCT04093336
This is a placebo controlled, randomized, double blinded study including Phase 1 and Phase 2. Phase I study is a safety assessment and Phase 2 study is incline to assess effectiveness of MSCs. Potential subjects must be screened and consented before enrolled. The primary objective of this study is to determine the effects of early intravenous infusion of allogeneic human umbilical cord mesenchymal stem cells (HucMSCs or MSCs used in the following section) for patients with acute ischemic stroke. Eligible patients will receive a single dose of MSCs or placebo within 24 hours after stroke. Patients will be followed for 2 years post infusion for safety and efficacy (change in neurological symptoms and quality of life). Assessments will occur during transplantation and at 3,7, 14 days and1,3, 6, 12, 18 and 24 months after infusions of stem cells.
NCT03281590
This is a single institutional registry database for the patients with stroke and cerebrovascular diseases. Stroke is the fifth leading cause of death in the United States. Despite extensive research, most of the patients die or suffer from varying degree of post-stroke disabilities due to neurologic deficits. This registry aims to understand the disease and examine the disease dynamics in the local community.