None listed
Conditions
Brief summary
Stroke and dementia are two of the most common and disabling conditions worldwide, responsible for an enormous and growing burden of disease. There is increasing awareness that the two conditions are linked, with cognitive impairment and dementia common after stroke, vascular dementia accounting for about one-fifth of all dementia cases and recent evidence on the contribution of vascular risk factors to Alzheimer’s disease. Yet we still know very little about whether brain volume loss – a hallmark of dementia – occurs after stroke, and whether such atrophy is related to cognitive decline. The aim of this research is to establish whether stroke patients have reductions in brain volume in the first three years post-stroke compared to control subjects, and whether regional and global brain volume change is associated with post-stroke dementia in order to elucidate potential causal mechanisms (including genetic markers, amyloid deposition and vascular risk factors). We hypothesise that stroke patients will exhibit greater brain volume loss than comparable cohorts of stroke-free controls, and further, that stroke patients who develop dementia will exhibit greater global and regional brain volume loss than those who do not dement. An understanding of whether stroke is neurodegenerative, and in which patients, may be used to help guide the early delivery of disease-modifying therapies.
Interventions
135 ishaemic stroke patients will have an 3 Tesla Magnetic Resonance Imaging (MRI) scan, and undergo cognitive testing, at five time points - baseline; 3 months post-stroke; 1 year post-stroke; 3 years post-stroke; and 5 years post-stroke.. Cognitive tests include the MOCA, HVLT-R, REY Copy, Trails A and B, Cogstate battery, BNT, Token Test, NART, Digit Span, and Digit Symbol tasks.
For each MRI scan, participants will lie down flat, and still, in the scanner, for between 30 minutes (first sca
135 ishaemic stroke patients will have an 3 Tesla Magnetic Resonance Imaging (MRI) scan, and undergo cognitive testing, at five time points - baseline; 3 months post-stroke; 1 year post-stroke; 3 years post-stroke; and 5 years post-stroke.. Cognitive tests include the MOCA, HVLT-R, REY Copy, Trails A and B, Cogstate battery, BNT, Token Test, NART, Digit Span, and Digit Symbol tasks. For each MRI scan, participants will lie down flat, and still, in the scanner, for between 30 minutes (first scan) and 55 minutes (each review scan).
Sponsors
Austin Health
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Inclusion criteria for the stroke group include: 1. Clinical ischaemic stroke; 2. Aged greater than 18 years; 3. Able to have cognitive testing and MRI scan; and 4. Able to give informed consent. Inclusion criteria for healthy controls are the same, excluding, of course, the stroke diagnosis.
Exclusion criteria
Exclusion criteria for stroke patients and control participants are the same. These include: 1. Significant medical comorbidities precluding participation in cognitive testing, or making survival for 3 years unlikely; 2. Normal exclusion criteria for MRI; e.g., implanted metal, severe claustrophobia; 3. Pre-existing dementia; 4. Pregnancy, as a precaution to prevent exposing them to multiple MRI scans in a 12-month period; 5. People in existing dependent or unequal relationships with any member of research team, to protect against coercion.
Outcome results
None listed