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.
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 research study is to see whether ticagrelor and aspirin or rivaroxaban and aspirin compared to clopidogrel and aspirin will have the most success in preventing another stroke, bleed in the brain, or death in participants who have already had a stroke from a narrowed brain artery.
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.
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.
Underserved, racial and ethnic minority communities are experiencing higher rates of COVID-19 cases and associated mortality compared to whites due to long standing social and structural inequities that also drive disparities in chronic diseases such as stroke, cardiovascular disease, diabetes, and hypertension. Patients with underlying chronic diseases who are recovering from COVID-19 depend on the support of family and friends (informal caregivers/care partners) who are being exposed to the same pandemic and racial stressors, exposure that can affect the health and quality of life of both partners. The primary goal of this study is to test the efficacy of an adapted, telehealth-enhanced intervention that targets barriers impacting family illness management behaviors of Black/African American (AA) adult COVID-19 survivors and carepartner dyads for improved quality of life and COVID/chronic illness health related outcomes.