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.
Stroke affects millions of Americans and is a leading cause of disability. In addition to chronic disability, many survivors experience depressive symptoms such as reductions in mood and motivation. Post-stroke depression (PSD) is associated with poorer recovery from stroke, increased health care costs and higher mortality. Additionally, PSD may interfere with the recovery of the nervous system after stroke. Effective treatment options for PSD are limited and often come with side effects, highlighting the need for alternative treatment approaches. Aerobic exercise (AEx) has positive effects on the nervous system, is a powerful anti-depressant, and has limited side effects, yet remains underutilized in stroke survivors with PSD. This study will examine the short-term effects of AEx on the nervous system in stroke survivors with and without PSD. The results will serve as a foundation for the study of AEx as a treatment for PSD.
This study is to determine which stroke patients will develop moderate-to-severe limb tightness (spasticity) or limb weakness 90 days after a stroke.
Inpatients at Medical University of South Carolina, 21 years old or older, with first-ever stroke with limb tightness or weakness on one side can participate.
This study has 3 visits in 90 days.
The data from this study will then be combined with existing data to develop a simple bedside assessment for post-stroke limb spasticity 90 days post-stroke.
The goal of this pilot study is to determine whether a repetitive high-dose form of non-invasive brain stimulation is a promising and safe treatment for stroke-related cognitive difficulties. Repetitive transcranial magnetic stimulation (rTMS) is an FDA approved treatment for depression, and is used commonly to treat people for their depression. In studies of rTMS for depression and other disorders, individuals have experienced improved cognitive function. Thus, we are testing here whether cognitive function in individuals with chronic stroke could be improved by rTMS.