Cognitive Control Functions for Stroke

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Kai Hwang

Disqualifiers: Psychiatric conditions, Implanted devices, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 27

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how brain lesions affect cognitive control, the brain's management of goal-directed behaviors. Researchers aim to understand how damage in specific brain areas, particularly the thalamus, impacts actions and decision-making. Participants will undergo cognitive tests, brain scans (such as MRIs), and EEGs to track brain activity. Suitable candidates include healthy adults without metal implants or claustrophobia, as well as patients with brain lesions but no psychiatric disorders. As an unphased trial, this study offers participants the chance to contribute to foundational research that could lead to new insights into brain function and cognitive health.

What prior data suggests that these testing procedures are safe?

Research has shown that studying brain damage, particularly in the thalamus (a part of the brain that helps control movement and senses), can reveal its impact on thinking and decision-making. This is crucial for individuals recovering from a stroke.

In previous studies, researchers used MRI scans to examine how thalamus damage affects recovery. Some results suggested that this damage can lead to poor recovery outcomes, such as difficulties in regaining movement and thinking skills.

Regarding safety, the procedures in this study—cognitive tests, MRI, and EEG (a test that measures brain activity)—are non-invasive and widely used. These methods are common in many research and medical settings, and no major safety concerns have been reported. Participants usually handle them well. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores how subcortical thalamic lesions affect cognitive control in stroke patients using various testing procedures like cognitive behavioral testing, EEG, and MRI. Unlike traditional treatments for stroke that mainly focus on physical rehabilitation and medication to improve blood flow or prevent further strokes, this approach aims to understand and potentially improve cognitive functions. By examining different brain activities and responses, this trial could lead to new strategies to enhance cognitive recovery, offering hope for improved quality of life for stroke survivors.

What evidence suggests that this study's methods are effective for understanding cognitive control in stroke patients?

Research has shown that damage to the thalamus, a part of the brain, can affect thinking skills like memory and language. For example, studies find that people who have had strokes in the thalamus often struggle more with remembering things they see and hear compared to those without such strokes. Other evidence suggests these individuals may also face difficulties with language and skills needed for planning and decision-making. Additionally, problems in the brain connections linked to the thalamus can cause both movement and thinking challenges. This trial will determine the effects of subcortical thalamic lesions using cognitive behavioral testing, EEG, and MRI. These findings help scientists understand how damage to the thalamus affects thinking and guide future research on recovery methods. ^{5 6 7 8 9}

Are You a Good Fit for This Trial?

This trial is for adults who have had a stroke and are interested in how it may affect their cognitive control, such as the ability to adapt thoughts and actions based on goals. Participants will undergo tests like working memory and set-switching tasks, along with MRI scans and EEG studies.

Inclusion Criteria

I am 18-35, mentally healthy, have no metal implants, and am not claustrophobic.

I am over 18, have a specific brain lesion, no mental health diagnoses, no metal in my body, and am not claustrophobic.

I am over 18, have specific brain lesions, no mental health diagnoses, no metal implants, and am not claustrophobic.

Exclusion Criteria

Claustrophobic psychiatric conditions such as depression and ADHD, implanted devices such as cardiac pacemakers and defibrillators, aneurysm, cochlear implants

I am not fluent in English.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Cognitive Behavioral Testing

Participants perform cognitive tasks to assess their ability to monitor internal goals, maintain and manipulate information, and inhibit distractions.

1-3 hours per session

Multiple sessions, up to 9 hours total

EEG Procedures

EEG recordings are taken while participants perform tasks involving cognitive control, with eye movements passively recorded.

1-3 hours per session

Multiple sessions, up to 9 hours total

MRI Procedures

MRI scans are conducted to determine the location of brain structures, with participants screened for contraindications.

40-60 minutes per session

Multiple sessions, up to 9 hours total

Follow-up

Participants are monitored for cognitive flexibility performance and reaction time to cognitive switching manipulation.

2 weeks

What Are the Treatments Tested in This Trial?

Trial Overview The study aims to understand the impact of brain lesions on cognitive control by having participants perform specific cognitive tasks while tracking their brain activity using advanced imaging (MRI) and monitoring techniques (EEG).

How Is the Trial Designed?

Group I: Determine the effects of subcortical thalamic lesions Experimental Treatment 1 Intervention

There are 3 types of testing procedures, (cognitive behavioral testing, EEG, and MRI). The types of procedures involved vary from participant to participant, depending on what kind of data investigators need and which procedure subjects agree to participate. The subject may participate in all testing procedures.

Who Is Running the Clinical Trial?

Kai Hwang

Lead Sponsor

National Institute of Mental Health (NIMH)

Collaborator

Trials

3,007

Recruited

2,852,000+

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC4401357/

Social cognitive and neurocognitive deficits in inpatients ... Thalamic stroke patients came off much worse than healthy controls in memorizing both visual and verbal material measured by CVLT and GML-DR. The significantly ...

2. ahajournals.org ahajournals.org/doi/10.1161/STROKEAHA.121.037750

A Case-Control Study | Stroke Patients with paramedian thalamic stroke showed moderate language (44.7 [42.8–55.9]) and executive (49.5 [44.3–55.1]) deficits and no verbal ...

3. link.springer.com link.springer.com/article/10.1007/s00415-024-12777-4

Factors behind poor cognitive outcome following a ... This study aims to identify the factors that influence the severity of cognitive impairment following thalamic stroke.

4. frontiersin.org frontiersin.org/journals/neurology/articles/10.3389/fneur.2025.1584290/full

Alterations in the functional connectivity of thalamic ... Conclusion: BG stroke disrupts thalamocortical circuitry at subregional levels, with distinct FC patterns linking to motor/cognitive deficits.

5. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0010945214004080

Dissociable spatial and non-spatial attentional deficits after ... Patients with lateral thalamic lesions showed a deficit in processing speed while all other TVA parameters were within the normal range. Medial thalamic lesions ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11813981/

A Resting‐State fMRI Study - PMC - PubMed Central This study provides new insights into the role of the thalamus in motor function recovery after stroke, offering preliminary evidence for its ...

7. jamanetwork.com jamanetwork.com/journals/jamanetworkopen/fullarticle/2822025

Outcomes and Mechanisms Associated With Selective ... Previous studies using MRI have found subacute thalamic impairment to be associated with poor long-term outcome across all severities of TBI, ...

8. ahajournals.org ahajournals.org/doi/10.1161/01.str.27.9.1530

Thalamic Vascular Lesions | Stroke Most of the cases of thalamic stroke were associated with infarcts in other territories (60.7%), whereas isolated lesions were only present in 39.3% of cases.

9. nature.com nature.com/articles/s41598-025-01703-x

Spatial neglect after subcortical stroke may reflect cortico- ... We investigated if disruption of functional or structural connectivity can explain spatial neglect in subcortical stroke.