Imaging the Network: Using MEG to Determine the Pathophysiology Underlying Post-Stroke Cognitive Impairment
Johns Hopkins University
Summary
This is a study using magnetoencephalography (MEG) to look at recovery in those with minor stroke. The investigators know that these individuals report difficulties in attention, concentration, multi-tasking, energy level, and processing speed that appear to be independent of lesion size or location. The underlying pathophysiology is unclear; however, anecdotally, many individuals are significantly improved by 6 months post-stroke. One hypothesis is that a single lesion, regardless of size, may disrupt the classic neural networks required for cognitive function. The investigators are currently collecting data to better characterize these difficulties and stroke patients' recovery as part of a previously approved recovery study. In this sub-study, the investigators propose to add MEG at 1 and 6 months in a subset of individuals with small: 1) subcortical, and 2) cortical lesions. The investigators will partner with colleagues at the University of Maryland (College Park), who are well experienced with MEG to conduct this research. In addition a control population of age-similar individuals will be recruited for comparison. Cerebral activation patterns of individuals with stroke versus controls will be compared, both across patients with stroke at a given time point, and within subjects from 1 to 6 months to determine the association of abnormal activation with cognitive dysfunction and recovery. \*\*The investigators have recently extended follow-up by adding an additional assessment at 12 months and will enroll additional participants (up to 40 patients with minor stroke, 15 age-similar controls).
Description
This is a prospective longitudinal study of patients with minor stroke versus age-similar controls that will make use of the following protocol: * Patients are admitted to the hospital for acute stroke and undergo work-up including MRI; they are entered into a clinical outcomes database (routine clinical care) * All patients are scheduled for an appointment in the Bayview Stroke Intervention Clinic approximately 4-6 weeks +/- 4 weeks post-stroke * Seen at 4-6 weeks (routine care)- consented and tested if enrolled (per research protocol, as part of a prior approved study on stroke recovery) *…
Eligibility
- Age range
- 18–100 years
- Sex
- All
- Healthy volunteers
- Not specified
Inclusion Criteria: 1. Adults (≥18 years) admitted to Bayview Medical Center Neurology. 2. Evidence of acute ischemic stroke (CT or MRI)- lacunar stroke or branch occlusion (M3/A3/P3 or smaller) OR NIHSS ≤ 8 on admission. 3. Competent speaker of English (by self or family report) prior to stroke. 4. Return for follow-up 4-6 weeks post event (+/- 4 wks). 5. Cognitive deficits present on initial testing.\*\* unique to MEG study 6. Willing to travel to the University of Maryland twice for MEG.\*\* unique to MEG study 7. Fully independent functionally and able to travel to the University of Maryl…
Interventions
- Diagnostic TestMagnetoencephalography (MEG)
Participants will undergo MEG at the University of Maryland (College Park) to measure cerebral activity while performing a visual naming task. The Montreal Cognitive Assessment (MOCA) will also be administered.
Location
- Johns Hopkins Bayview Medical CenterBaltimore, Maryland