VA Principal Investigators plan to gather information about veterans at the VAHCS who are interested in participating in rehabilitation research. Subject information collected will be housed in a centralized Rehabilitation Research Repository. VAHCS investigators may access this repository to quickly identify and recruit individuals who wish to be contacted for current and future VA IRB R&D approved rehabilitation research.
The purpose of this study is to investigate the efficacy of the oral FXIa inhibitor asundexian in prevention of ischemic stroke and its safety (bleeding) compared with placebo on top of background antiplatelet therapy in adult participants after an acute non-cardioembolic ischemic stroke or high-risk TIA.
Apathy is a common set of symptoms seen in many people following a stroke. Apathy occurs when a person has lost motivation, becomes withdrawn, and stops doing things that used to be important to them. Apathy has a large negative impact on a person's quality of life, and can also have a large impact the people who take care of individuals with apathy. There are currently no FDA-approved treatments to help with apathy, and other services like therapy may be difficult to access for people who have had a stroke. To address this problem, we are conducting a study to find out if a form of treatment called repetitive transcranial magnetic stimulation (rTMS) can be safe and helpful for people struggling with apathy after a stroke. Our study will apply a new form of rTMS which can be delivered quickly to a part of the brain called the medial prefrontal cortex (mPFC). Our study will help establish whether this treatment is safe, comfortable, and effective for people with apathy after a stroke, and will help researchers develop new forms of treatment.
This small stroke rehabilitation study will test the feasibility of a new method to personalize a home exercise program for arm/hand recovery. The research study will last ~8 weeks. Participants will be included if they are adults who have experienced a stroke that has caused one arm/hand to become weak, are able to come to the MUSC main campus 3 times for ~2hr arm movement evaluations, and are willing and able to engage in 60 minute telerehabilitation video visits with an occupational therapist 1-2 times per week for 6 weeks. We anticipate that the results of this study will enable occupational therapists and stroke survivors to, together, design home exercise programs that are meaningful, motivating and effective.
Research shows that exercising at home can improve arm and hand movement after a stroke. Unfortunately, it can be hard to exercise enough to make a difference in arm and hand movement after stroke. In this study, we will try to determine things that make it easy or hard for Veterans to exercise their arm and hand after a stroke. In this study, we will recruit Veteran stroke survivors who have difficulty using their arm and hand after a stroke. First, we will administer surveys and questionnaires to get Veteran stroke survivors' perspectives on their self-confidence, mood, sleep, and more. Then, we will ask them to track their home exercise using a wearable movement tracker (like a smart watch). Then, Veteran stroke survivors will meet with a researcher to talk about their experience doing home exercise and why they think it was easy or hard to do.
Over 2400 people who have sickle cell disease and are between the ages of 15 and 45 have been enrolled into the National Registry (SCDIC-I) of patients with Sickle Cell Disease (SCD). A rich resource of natural history data, the SCDIC-I Registry has longitudinal data collected yearly since 2016 from patient surveys (e.g. self reported pain incidences, sleep, barriers to care, experiences during and after pregnancy), medical record abstraction (e.g. medications, transfusion history, co-morbidities) and laboratory results. The 150 patients (or 1200 among the 8 sites) will be selected from both MUSC adult and pediatric SCD clinics starting at 12 years of age; those not previously enrolled in the SCDIC National Registry will be offered the possibility to enroll in SCDIC-II.
We will look at the following:
1- Compare the effect of new SCD medications – crizanlizumab, voxelotor, and L-glutamine – on clinical outcomes in individuals with SCD.
2 - Identify genetic and genomic predictors of response to crizanlizumab, voxelotor, and L-glutamine
3 - Integrate study data into the CureSCi metadata catalog (MDC) to enhance future cross-study analyses.
Following stroke, communication between brain areas and to the lower limbs can be compromised, leading to impairments in walking ability. Paired associative stimulation (PAS), a method of non-invasive brain stimulation, is thought to be a useful tool in understanding the relationship between different parts of the brain, and functional ability. However, PAS protocols have not been optimized for use post-stroke. The purpose of this research study is to determine the reliability and effectiveness PAS. This study involve individuals >6 months after having a stroke.
ELEVATE is a device study that will look at the effectiveness of the Pipeline™ Shield Device in treating adults with acutely ruptured brain aneurysms that are shallow and are deemed unsuitable for treating with both clipping (placing a metal clip over the neck of the aneurysm) and coiling (stopping the blood flow into the aneurysm by packing it tightly with small pieces of metal). The primary goals for this study are a complete blocking of the blood vessel without narrowing of the blood vessel and no rebleeding or retreatment of the aneurysm through the 180-day follow-up.
After signing the consent subjects will be treated with the device which is a flow diverter (is a braided metal mesh cylinder that would be implanted across the opening (or ‘neck') of the aneurysm slow down or stop the blood flow into the aneurysm, causing the blood within the aneurysm to clot). The study will follow subjects from consent until the 365-day follow up post procedure. There are some risks associated with study participation such as death, stroke, and device failure. All other risks will be discussed with subjects at time of consent.
We are studying whether visual field testing can be completed using a virtual reality headset with software designed and installed to cause a "blink to threat" response. A positive "blink to threat" response implies an intact visual field. Subject volunteers will have both in person "blink to threat" visual field testing and headset "blink to threat" visual field testing. We are testing the accuracy, timing, tolerability and satisfaction (of both examiner and patient) with the use of virtual reality visual field testing.
Approximately 50% of people who have had a stroke report feelings of tiredness and/or a lack of energy that is not reduced with rest and sleep. This phenomenon is known as post-stroke fatigue. Post-stroke fatigue negatively affects an individual's quality of life and participation in rehabilitation, social, and physical activities. There are currently no known effective treatment options for people with post-stroke fatigue. This study will investigate the use of a non-invasive brain stimulation technique called transcranial magnetic stimulation (TMS) to treat post-stroke fatigue. This method has proven useful in other conditions such as depression and we will measure the effects of TMS on reducing fatigue in individuals more than six months post-stroke.