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.
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.
Transcranial direct current stimulation (tDCS) can be an effective therapy for stroke recovery patients. However, the extent to which patients show improvements with tDCS is highly variable. This variability may arise due to the differences of stroke location in the brain and because of differences in brain damage, all of which may differ between patients. If the relationship between these factors and tDCS efficacy were known, recovery from stroke using tDCS might become more predictable. Our overall objective is to understand potential measures of tDCS efficacy that may someday allow for optimization of clinical outcomes and patient care.
The purpose of this study is to identify domains in which stroke suvivors may have struggled since experiencing a stroke. These include things like emotional, family and work function. This study entails an interview and questionnaires that ask about functioning in these areas.
The longer-term goal of this work is to identify areas these areas so that we can develop a psychotherapy that could be helpful for individuals recovering from and living with the aftermath of stroke.
Sensory stimulation has been shown to enhance rehabilitation outcomes. However, most sensory stimulation devices interfere with natural hand tasks. Thus, a new wearable stimulation device has been developed to deliver imperceptible vibration to wrist skin. This study is to evaluate the community use of the device for patients with neurologic movement disorders. Participation will include wearing the provided device and charging the device every night. The knowledge regarding community use of the device may contribute to improving the device functionality and usability for future users of the device.
People who experience a stroke often have problems performing many different tasks during daily life. Most studies investigating stroke recovery and rehabilitation focus only on one type of task. The purpose of this research study is to measure individuals' function in many areas that can be affected by a stroke, such as their balance, mood, memory, reaching, and speech. This study will also track changes that can occur with task performance over time.
VERIFY will validate biomarkers of upper extremity (UE) motor outcome in the acute ischemic stroke window for immediate use in clinical trials, and explore these biomarkers in acute intracerebral hemorrhage. The central hypothesis is that patients have different UE outcomes depending on corticomotor system (CMS) function, measured as motor evoked potential (MEP) status with TMS, and on CMS structure, measured as acute lesion load with MRI. VERIFY will create the first multicenter, large-scale, prospective dataset of clinical, TMS, and MRI measures in the acute stroke time window.
Portable Neuromodulation Stimulator (PoNS) is non-invasive stimulation device placed on the tongue to stimulate those brain regions understood to be important for maintaining balance. This research study aims to collect evidence that PoNS therapy along with balance training and breathing exercises improves walking stability post-stroke.
Constraint-induced movement therapy (CIMT) is the most efficacious treatment for children with hemiparesis from a perinatal arterial stroke but instead, weekly low-dose OT and/or PT is typical. The aims of this study are to compare 2 high doses of treatment to usual care in helping infants improve skills on the hemiplegic hand/arm and to improve bimanual activities. In addition, the association with gross motor, language and cognition will be explored.