TDCS to Improve Post-Stroke Cognitive Impairment
Johns Hopkins University
Summary
The investigators will conduct a randomized, double-blinded, sham-controlled trial of approximately 60 patients with minor stroke and post-stroke mild cognitive impairment (psMCI). Participants will be individually randomized on enrollment using a random number generator to treatment with anodal tDCS + computerized cognitive treatment (CCT) versus sham + CCT (approximately 30 patients in each arm). Clinical evaluation including assessment of cognition will be performed pre- and post-intervention by individuals on the study team blinded to the participant's intervention. Participants will also undergo functional neuroimaging with magnetoencephalography (MEG) pre- and post-intervention (1, 3, and 6 months post-stroke to evaluate for initial and longer-term effects of treatment on cerebral activation patterns and functional connectivity). Neuroimaging and clinical outcomes will be assessed to determine the effect of tDCS versus sham + CCT on psMCI.
Description
Vascular cognitive impairment, ranging from vascular mild cognitive impairment to vascular dementia, is a leading cause of progressive cognitive dysfunction second only to Alzheimer Disease. While the accumulation of ischemic infarcts or a large cortical stroke can result in permanent cognitive dysfunction, a single small stroke can also result in disabling impairment. The investigators have shown that small lesions, regardless of the location, result in acute cognitive decline. Similar to those with progressive vascular cognitive impairment, post-stroke MCI (psMCI) patients display slowed rea…
Eligibility
- Age range
- 18–100 years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: 1. Adults (≥18 years) presenting with neurological symptoms due to acute ischemic stroke (symptom onset within the week prior to admission). 2. Evidence on brain MRI of acute ischemic stroke (imaging negative strokes and TIAs will be excluded). 3. Native English speaker (by self-report) prior to stroke. 4. NIHSS \<8 at initial follow-up visit (approximately 30 days post-stroke). 5. mRS 0-2 at initial follow-up visit. Exclusion Criteria: 1. Primary intracerebral hemorrhage- as evidenced by blood on head CT or MRI. 2. Presence of proximal large vessel occlusion. 3. Cortica…
Interventions
- DeviceAnodal transcranial Direct Current Stimulation (A-tDCS)
Participants randomized to tDCS will undergo 5 weeks of A-tDCS + CCT.
- DeviceSham Intervention
Participants randomized to sham-intervention will undergo 5 weeks of sham + CCT.
Location
- Johns Hopkins Bayview Medical CenterBaltimore, Maryland