Magnetoencephalography for Stroke Recovery

Overseen By Elisabeth B Marsh, MD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Johns Hopkins University

Disqualifiers: Intracerebral hemorrhage, Neurological disease, others

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

Compensation: Varies

Number of Visits: 4

55 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial examines brain recovery after a minor stroke using magnetoencephalography (MEG), a technology that captures brain activity. Researchers aim to understand why individuals with small strokes often face difficulties with attention, concentration, and energy, even when the stroke appears minor. Participants will undergo MEG scans at 1, 6, and 12 months post-stroke to observe changes in brain activity over time. The trial seeks individuals who have experienced a minor stroke, face cognitive challenges, and are willing to visit the University of Maryland for two MEG sessions. As an unphased trial, it offers participants the chance to contribute to groundbreaking research that could enhance understanding and treatment of cognitive challenges following minor strokes.

Do I need to stop my current medications for the trial?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What prior data suggests that magnetoencephalography (MEG) is safe for studying recovery in minor stroke patients?

Research has shown that magnetoencephalography (MEG) is a safe and comfortable method for studying brain activity. In a study with patients who recently had strokes, researchers used MEG to examine brain function without causing harm or discomfort. No major reports of negative effects have emerged from using MEG in stroke research. This makes MEG a safe choice for those considering participation in a clinical study. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about using magnetoencephalography (MEG) to evaluate post-stroke recovery because it offers a non-invasive way to capture real-time brain activity with high precision. Unlike traditional imaging methods, such as MRI or CT scans, which provide static images, MEG captures dynamic brain processes, helping scientists understand how cognitive functions are affected after a stroke. This could lead to more personalized rehabilitation strategies, potentially improving recovery outcomes for stroke patients by tailoring treatment to their specific brain activity patterns.

What evidence suggests that magnetoencephalography (MEG) is effective for studying recovery in minor stroke?

This trial will use magnetoencephalography (MEG) to study brain recovery after minor strokes. Research has shown that MEG can enhance understanding of brain healing by measuring brain activity and detecting changes in brain cell connections and communication. Studies have found that even small strokes can affect thinking and communication, and MEG identifies these issues by revealing changes in brain activity. Early evidence suggests that MEG might reveal how the brain adapts and recovers over time. ^{1 2 5 6 7}

Who Is on the Research Team?

Elisabeth B Marsh, MD

Principal Investigator

Johns Hopkins School of Medicine

Are You a Good Fit for This Trial?

Inclusion Criteria

Evidence of acute ischemic stroke (CT or MRI)- lacunar stroke or branch occlusion (M3/A3/P3 or smaller) OR NIHSS ≤ 8 on admission.

Competent speaker of English (by self or family report) prior to stroke.

Return for follow-up 4-6 weeks post event (+/- 4 wks).

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Initial Assessment

Patients are admitted to the hospital for acute stroke and undergo work-up including MRI; they are entered into a clinical outcomes database

4-6 weeks post-stroke

1 visit (in-person)

MEG Testing

Participants undergo MEG testing at 1 month post-stroke to measure brain activity at rest and during cognitive tasks

1 month post-stroke

1 visit (in-person)

Follow-up MEG Testing

Repeat MEG testing at approximately 6 months post-stroke to evaluate changes in cerebral activity

6 months post-stroke

1 visit (in-person)

Extended Follow-up

Participants return for 12-month post-stroke follow-up appointments and testing

12 months post-stroke

1 visit (in-person)

What Are the Treatments Tested in This Trial?

Interventions

• Magnetoencephalography (MEG)

How Is the Trial Designed?

Group I: Minor Stroke Experimental Treatment 1 Intervention

We will enroll a cohort of 15 adult patients previously admitted to Johns Hopkins Bayview Medical Center with small/minor acute ischemic stroke visible on neuroimaging. Patients will follow-up in clinic 4-6 weeks following hospital discharge. To be eligible for the study, patients must have a "minor stroke", defined as NIH Stroke Scale score at follow-up of less than or equal to 8, modified Rankin score of 0-2, be competent speakers of English, and have no prior history of stroke, dementia, or untreated psychiatric disease. Those with proximal large vessel (M1) or branch (M2) occlusions will be excluded. \*Based on preliminary results we have expanded our trial and will continue to recruit up to 40 patients with minor stroke.

Group II: Controls Experimental Treatment 1 Intervention

For comparison, we will recruit a group of age-similar controls (n=15) without neurologic disease or prior clinical history of stroke.

Who Is Running the Clinical Trial?

Johns Hopkins University

Lead Sponsor

Trials

2,366

Recruited

15,160,000+

University of Maryland, College Park

Collaborator

Trials

163

Recruited

46,800+

American Heart Association

Collaborator

Trials

352

Recruited

6,196,000+

Citations

1.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC4815903/

Magnetoencephalography in Stroke Recovery and ...

This review focuses on experimental use of MEG in neurorehabilitation. MEG has been employed to detect early modifications in neuroplasticity and connectivity.

2.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC10275835/

Outcomes in Patients with Minor Stroke: Diagnosis and ...

In one study, over 50% of those with minor stroke and transient ischemic attack reported issues with communication and cognition on returning ...

3.

sciencedirect.com

sciencedirect.com/science/article/pii/S0165027018302450

A systematic review investigating the relationship of ...

The aim of this systematic review was to summarize the current evidence for EEG/MEG-based measures to index neural activity after stroke and ...

4.

centerwatch.com

centerwatch.com/clinical-trials/listings/NCT04188522/imaging-post-stroke-recovery-using-meg-to-evaluate-cognition

Imaging Post-Stroke Recovery: Using MEG to Evaluate ...

This is a study using magnetoencephalography (MEG) to look at recovery in those with minor stroke. The investigators know that these

5.

hopkinsmedicine.org

hopkinsmedicine.org/news/newsroom/news-releases/2021/01/research-story-tip-minor-strokes-lead-to-global-disruptions-in-brain-signaling-and-cognitive-dysfunction

Research Story Tip: Minor Strokes Lead to Global ...

“In this study, we show how minor damage anywhere in the brain can disrupt the entire cognitive network and result in a global dysfunction.” As ...

6.

nature.com

nature.com/articles/s41598-020-75379-w

Predicting stroke severity with a 3-min recording from the ...

In this study, we demonstrated the use of low-cost portable electroencephalography (EEG) as a method for prehospital stroke diagnosis.

7.

pubmed.ncbi.nlm.nih.gov

pubmed.ncbi.nlm.nih.gov/12823488/

Magnetoencephalography in stroke: a 1-year follow-up study

In the present work, a cohort of patients has been studied with MEG. Twelve patients with a recent ischemic or hemorragic stroke were included as soon as ...