The study team is recruiting 20 adults with spasticity due to chronic stroke and 20 adults with no neurological injuries for a 2 day study. In people with chronic stroke, one of the most common and disabling problems is spasticity (increased muscle tone or muscle stiffness). The purpose of this research study is to examine effects of dry needling on the nervous system (pathways between the muscle, spinal cord, and brain) in people with spasticity due to chronic stroke. Dry needling is a procedure in which a thin, stainless steel needle is inserted into your skin to produce a muscle twitch response. It is intended to release a knot in your muscle and relieve pain.
The total study duration is 2 days. The first visit will take about 3 hours, during which dry needling will take place, and the second visit will take about 1 hour. During both visits you will be asked to participate in examinations of reflexes (muscle responses to non-invasive nerve stimulation) and arm/leg function.
After a stroke, many people experience a language impairment called aphasia. One of the most debilitating types of aphasia is non-fluent aphasia. Non-fluent aphasia is defined by significantly reduced speech production, with the speaker producing only a few words or even less. Speech entrainment therapy (SET) is a treatment that has been shown to increase fluency in people with non-fluent aphasia. Our study looks to define the best dose of SET that leads to sustained improvements in spontaneous speech production.
Participants who are eligible will undergo baseline language testing, an MRI, and will be randomized into one of 4 treatment groups: SET for 3 weeks, SET for 4.5 weeks, SET for 6 weeks, and no treatment (control group).
Protocol Title: Angiogenic Factors in Intracranial Arterial Stenosis
The purpose of this study is to look at factors in the blood that effect the process of new blood vessel formation (those that help or "pro-angiogenic" and those that inhibit "anti-angiogenic") in patients with Intracranial Arterial Stenosis (ICAS) or narrowing of the brain arteries. Male and female adult subjects between 30-80 years will participate. Approximately 273 eligible subjects will be enrolled study wide at multiple sites. Subjects will participate in the study for 12 months including 3 visits with collection of medical information and blood draws. De-identified blood samples will be stored and although direct participation is completed after 12 months, a patient's blood may be studied years later.
The purpose of the study is to compare the effects of apixaban (also known as Eliquis®) with aspirin in patients with atrial fibrillation and a recent brain hemorrhage to see which is better in preventing strokes and death.
Subjects will be in the research study for up to 3 years (minimum of 1 year). About 700 people will take part in this study at approximately 125 sites throughout the United States.
Transcranial direct current stimulation (tDCS) has shown the potential to improve symptoms in patients with movement deficits, such as Parkinson's disease and chronic stroke. However, the effects of tDCS have so far not been proven on a wider scale due to lack of knowledge regarding exactly how tDCS works. This has limited the adoption of this potentially useful therapy for patients with Parkinson's disease, chronic stroke and other conditions affecting movement. We think that by studying the effect of tDCS on brain signals while subjects perform a virtual reality task that requires integration of visual and motor information we can separate out exactly what occurs in the brain when tDCS is turned on. We expect this approach to broaden our understanding of tDCS application in conditions affecting movement and possibly lead to therapeutic advances in this population.
Hand disability after stroke has a profound negative impact on functional ability and independence. Hand therapy may be augmented with sensory stimulation for better outcomes. We have developed a novel sensory stimulation - unfelt vibration applied via a wristwatch. In this study, we will determine if combining this stimulation with hand task practice is superior to hand task practice alone.
This is a research study looking to compare the effects (good and bad) of the ARCADIA study drugs (apixaban and aspirin) on the occurrence of silent strokes and memory loss after stroke.
This add-on study to the ARCADIA trial involves cognitive testing (tests designed to measure subjects memory, thinking, reasoning and understanding) and an MRI scan of their brain.
There will be about 5 study visits over the length of the study (approximately 3 years), or for a long as subjects are in the parent ARCADIA study.
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.
Investigator-initiated, phase 3 multicenter, prospective randomized open-, blinded-endpoint (PROBE) controlled trial to test whether treatment of obstructive sleep apnea (OSA) with continuous positive airway pressure is effective for secondary prevention and recovery after stroke.
Patients with recent (?14 days) acute ischemic stroke or high-risk TIA (ABCD2 ?4) are enrolled during their acute or rehabilitation hospitalization and treated for 6 months. After consent, a portable cardiopulmonary sleep apnea test (the Nox T3) is used to screen for OSA (AHIT3?10) and to exclude central sleep apnea (where CAI ?50% of the total AHIT3). aCPAP is then used on one night to determine tolerability (the "run-in" night). Subjects who use the device for ?4 hours on that night, and do not have excessive treatment-emergent central sleep apnea (CAI remains <10 on aCPAP machine-generated data), are randomized to receive either 6 months of aCPAP plus usual medical therapy, or usual medical therapy alone. Adherence information is provided to subjects in the intervention group, to offer education about treatment and to increase treatment adherence. Subjects and their caregivers also are taught about aCPAP use. Through a centralized service, managed by FusionHealth, adherence to aCPAP is monitored in nearly real time in most cases by wireless means, and supported remotely throughout the treatment period.