Stroke is a leading cause of disability in the U.S. and many Veteran stroke survivors live with severe disability. Despite recent advances in rehabilitation treatments many stroke survivors have persistent physical and mental difficulties such as reduced arm and leg function, difficulty thinking, and depression.
Developing treatments that address these problems is necessary to improve long-term recovery for stroke survivors. Aerobic exercise (AEx) can improve physical and mental function, and reduce depression. Additionally, AEx may enhance physical rehabilitation by making the brain more receptive to, and consequently improving the response to a rehabilitation treatment. Therefore, combining AEx with physical rehabilitation has the potential to improve multiple parts of stroke recovery. This study will examine the effect of combining AEx with physical rehabilitation on physical and mental function in stroke survivors. By gaining a better understanding of the effects of this combined intervention we aim to advance the rehabilitative care of Veteran stroke survivors.

TESLA is a multicenter trial in which patients with moderate-large acute ischemic stroke infarcts will be assigned to either best medical management alone (including intravenous recombinant tissue-type plasminogen activator (IV rtPA)) or intra-arterial treatment (IAT) with mechanical thrombectomy added to best medical management.

Mechanical thrombectomy will be performed with FDA-approved thrombectomy devices in accordance with the instructions for use (IFU) and under FDA Investigational Device Exemption G190006. Patients will be enrolled at up to 35 U.S. centers and 5 European centers over an anticipated three-year period, with an additional year for trial closeout.

Following a stroke, many individuals have a high risk of falls, which can negatively influence quality of life. Unfortunately, current treatments have not effectively addressed this problem. This study investigates whether two methods of delivering mechanical perturbations during walking have the potential to improve post-stroke walking balance and reduce real-world fall incidence.

The purpose of this research project is to evaluate the effectiveness of a mobile health (mHealth) application in improving adherence to hydroxyurea therapy in patients with Sickle Cell Disease (SCD). Participants will be asked to install an application on their phone that will remind them to take their medication regularly. It notifies the participants when it is time to request a refill, it tracks their hydroxyurea use, and it gives them information on their medication. It also has resources that could be helpful for the ongoing care of their sickle cell disease. This is a 24-week project with 3 study visits. The first study visit will be at the beginning of the study period (enrollment or baseline visit), the second will be at approximately 12 weeks, and the third is at the end of the 24 weeks. At each visit, participants will complete a survey, share with us their experience with the application, and share with us where they refilled their medications. Some participants will also be asked to complete an interview at the end of their final study visit. Patient participants will receive a $25 Walmart Gift card at each of visits (including an additional $25 gift card for the optional interview) for their participation.

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.

C3FIT is a randomized trial to determine the most effective way for hospitals to take care of stroke patients after they are discharged by comparing two plans. Plan 1 is the usual standard of care way performed at Comprehensive/Primary Stroke Centers and developed by the Amercian Heart Association and the Joint Comissiona. Plan 2 is the same as Plan 1 PLUS in-home rehabilitation. MUSC has been selected as a study site for Plan 1 only.

Patients over the age of 18 with a clinical diagnosis of acute stroke with brain imaging with intracerebral hemorrhage or ischemic stroke are eligible who meet addtional study qualification requirements. Total duration of participation is 2 years. Study enrollment will be performed at approximately 18 sites for a total enrollment goal of 1800 patients, 100 per site.

Data from C3FIT may be used to help identify the best methods for health systems to use in managing stroke patients.

MultiStem is regenerative medicine derived from donated human cells to treat acute ischemic stroke within 36 hours after symptom onset. Stroke leads to brain cell injury and many stroke patients suffer functional deficits as results. The purpose of this study is to evaluate safety and effectiveness of MultiStem on functional outcome in subjects with ischemic stroke.