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NCT07036406
The goal of this clinical trial is to compare the effectiveness of traditional Semantic Feature Analysis (SFA) treatment to a modified SFA protocol that includes Metacognitive Strategy Training (SFA+MST) for adults with acquired aphasia. The main questions it aims to answer are: * What are the comparative outcomes in picture naming accuracy and strategy use during picture naming following 2 months of traditional SFA versus SFA + MST in adults with acquired aphasia? * What are the comparative outcomes in percent of informative content and rate of informative content during spontaneous speech production following 2 months of traditional SFA versus SFA + MST in adults with acquired aphasia? Researchers will compare outcomes between these two treatments to see if SFA+MST yields larger effects in picture naming and spontaneous speech outcomes than traditional SFA. Participants will complete: * 5-7 pre-treatment assessment sessions where they will be asked to name pictures, tell stories/describe pictures, answer questions, and complete questionnaires, * 3 treatment sessions of SFA \*OR\* SFA+MST per week for 8 weeks, for a total of 24 sessions, * 7 weekly probes (i.e., short, intermittent assessments throughout the treatment phase), * 3 post-treatment assessment sessions immediately after treatment ends, where they will complete the same assessment tasks as they did pre-treatment (e.g., naming pictures, telling stories, etc.), * 2 retention assessment sessions, one 30 days and the other 60 days following the final treatment session, where they will be asked to name pictures, tell stories/describe pictures, and describe what they learned during the study.
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.
NCT07496645
The use of transcranial direct current stimulation (tDCS) for the management of deficits developed in stroke is a relatively new type of management option. Many of the studies performed using tDCS have focused on improvements noted in hemiplegia as compared to aphasia, which is an equally disabling outcome of strokes. The results of these studies have not been conclusive and concordant with each other. In aphasia management, the majority of the studies have focused on chronic strokes. Since the use of tDCS is relatively new, the studies have not focused on a particular type of deficit or stroke. Very few studies have focused on the impact of solely using tDCS. Very few studies have focused on acute to subacute strokes. The results of the studies have, nevertheless, been encouraging. Improvements in aspects of language tested after a single session of tDCS are short-lived. There is an unmet need to probe the utility of repetitive tDCS on aspects of language function in patients who are aphasic due to acute stroke. There is also a paucity of data in the Indian scenario regarding the same.
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).
NCT06942845
Lung cancer remains the world's leading cancer in terms of morbidity and mortality, with more than 20 million new cases and 9.7 million deaths annually. Despite improvements in surgical techniques and medical care, the number of elderly people undergoing surgery is gradually increasing, so there are an increasing number of complications following lung resection. Postoperative cerebral infarction is a relatively rare but devastating complication that places a heavy burden on patients and families. The incidence of postoperative cerebral infarction in patients after thoracic surgery has been reported to be 0.6-1.1%. There is a risk of postoperative cerebral infarction after lung cancer surgery, and the results of a few studies have shown that postoperative cerebral infarction is related to old age, male, hypertension, hyperlipidemia, and lobectomy factors, but the pathogenesis of the occurrence of cerebral infarction has not been clearly proved for the time being, and so these risk factors cannot be taken as the direct cause of cerebral infarction. Therefore, we need to further explore the factors leading to cerebral infarction after lung cancer surgery. If we can further prove that some of the risk factors are related to the causes of cerebral infarction after lung cancer surgery, we can make corresponding strategies in the perioperative period to improve the safety of surgery and reduce the incidence of cerebral infarction in the postoperative period.
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.
NCT03305614
This study evaluates the neuromodulatory effect of combined tDCS and aphasia therapy in patients in the chronic phase after stroke. Half of the participants will receive aphasia therapy and tDCS, the other half will receive aphasia therapy and sham-tDCS.
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).