Fatigue is a common and disabling symptom post-stroke.
Causes of post-stroke fatigue are not well known.
This study will investigate how changes in the way the brain communicates may be associated with post-stroke fatigue.
To do this the investigators will use transcranial magnetic stimulation, TMS, to measure how the brain communicates.
TMS uses a magnet that turns on parts of the brain, and researchers can measure the response by placing sensors on specific muscles in the legs.
The researchers will also measure how you walk by placing sensors on your body and having you walk on a treadmill.
Post-stroke hand impairment diminishes stroke survivors' ability to perform activities of daily living. Motor recovery has been shown to improve through peripheral sensory stimulation. This study aims to determine if vibration from a smartwatch improves post-stroke hand function.
This research is being done to figure out whether treatment for sleep apnea, in people who have had a stroke or TIA, improves recovery from stroke, and helps prevent future stroke, heart problems, and death.
The intervention being tested is called continuous positive airway pressure (CPAP). The U.S. Food and Drug Administration (FDA) has approved CPAP for the treatment of obstructive sleep apnea.
A total of 15,010 patients are expected to enroll in this study and be screened for sleep apnea across about 110 sites in the United States. About 3,000 are expected to participate in the second part of the study, in which sleep apnea treatment is tested. Participation in this study is approximately 6 months.
The purpose of this research study is to understand how the brain communicates with the muscles in the leg in people who have sustained a stroke by using a type of brain stimulation called transcranial magnetic stimulation, or TMS. TMS has been used successfully in numerous investigations but we are not confident of which measures are best to use in those with stroke. The purpose of this study is to establish how best to collect these measures when walking ability is of primary concern. In this study participants will undergo testing while sitting comfortably, which is standard practice, and then again while standing, our experimental condition.
This study explores the use of a new form of neuromodulation known as transcutaneous auricular vagus nerve stimulation (taVNS) which stimulates the ear. This stimulation will be delivered concurrently with upper limb motor rehabilitation training (3 days/week for 4 weeks) in chronic stroke patients. Patients will undergo a series of baseline assessments (including a brain scan), a 4-week course of motor rehabilitation, and post-assessments (including a second brain scan).
The purpose of this research study is to evaluate the desired outcome and safety of the study drug, tenecteplase, compared to a placebo in patients with an acute ischemic stroke. Tenecteplase is approved by the health authorities for the treatment of heart attack, but it is not approved for stroke.
Participants will be screened within 4.5 to 24 hours after the onset of the stroke and will undergo 2 followup MRIs within 96 hours.
Follow-up clinic visits will occur at 30 and 90 days after study treatment. Total study duration is about 3 months.
The objective is to determine if continuous use of TheraBracelet in the home has a clinically meaningful effect in chronic stroke survivors. The study design is a double-blinded randomized controlled trial. We will enroll 40 chronic stroke survivors with moderate hand impairment. Subjects will be randomly assigned to the treatment or control group (n=20 per group). All subjects will wear the TheraBracelet device on the paretic wrist for 8 hours/day every day during their normal daily activity for 1 month. The device will deliver vibration (treatment) or no vibration (control). Double-blinding is possible because the treatment vibration is imperceptible (i.e., subthreshold). Measures of neural plasticity, the amount of the paretic arm use in daily living, clinical hand function, biomechanical grip control, and self-reported abilities for activities of daily living will be assessed at baseline, once a week during the month of wearing the device, and for 3-month follow-up, allowing determination of the efficacy and persistence.
This research is being done to find out if brain stimulation combined with a rehabilitation therapy improves arm weakness as a result of having a stroke. The stimulation technique is called transcranial direct current stimulation (tDCS). The treatment uses direct electrical currents to stimulate specific parts of the brain. The rehabilitation therapy is called "modified Constraint Induced Movement Therapy" (mCIMT). During this rehabilitation therapy study participants will wear a mitt on the hand of the arm that was not affected by their stroke. It is designed to restrain the use of the unaffected arm, while performing therapy with impaired one.
It is not known if brain stimulation combined with rehabilitation therapy will improve arm weakness. Study participants will receive rehabilitation therapy while on this study. Study participants may or may not receive the brain stimulation therapy.
Multi-arm Optimization of Stroke Thrombolysis (MOST): The goal of this study is to determine the effectiveness of combining a drug known as tissue plasminogen activator, or tPA, with blood thinners argatroban or eptifibatide. The research will look at whether combining tPA with either argatroban or eptifibatide will produce better results in stroke patients in the first 90 days after suffering a stroke versus tPA with a placebo. The safety of argatroban and eptifibatide in combination with IV rt-PA and endovascular thrombectomy will also be assessed.
The plan is for 110 hospitals to take part in the study through NIH StrokeNet, the University of Cincinnati based National Coordinating Center for all stroke trials funded by the National Institute of Neurological Disorders and Stroke. A maximum of 1200 subjects will be enrolled.
The first 150 subjects will be randomized in a 1:1:1 ratio to either argatroban, eptifibatide, or placebo. From the 150th to the 500th subject enrollment, response adaptive randomization (RAR) will favor the active arm showing the greatest benefit based on accrued data. After 500 subjects, one or both intervention arms may be carried forward for fixed randomization versus placebo.