Ischemic Stroke
Conditions
Keywords
Cortical focal atrophy, Stroke, Internal capsule, Corticospinal tract, Wallerian degeneration, Primary motor area.
Brief summary
Primary purpose of the trial is to demonstrate the arisen of focal cortical atrophy, localized in the ipsilateral primary motor area, measured in mm, three months after infarction of internal capsule. The patient is compared to himself between day zero to ten and three months. The study hypotheses are: * A focal cortical atrophy of the ipsilesional primary motor area occurs after cerebral infarction of the internal capsule. It is measurable accurately and reproducibly by MRI at three months. Other brain areas within the voluntary motor system will also be explored (supplementary motor area, pre motor area). * This atrophy is correlated with achievement of pyramidal tract, assessed by the fractional anisotropy of its fibers. * This atrophy is correlated with disability at three months, assessed by Rankin score.
Detailed description
Twenty-two patients with ischemic stroke, subcortical, involving the internal capsule, will be included. Each patient will be compared to himself, on day zero to ten and three months. An MRI will be performed between day zero and ten, then three months of infarction sequences with traditional threeD enabling acquisition and tractography and The measurement of cortical thickness is in mm The measurement of fractional anisotropy of the pyramidal tract A clinical evaluation will be done between Day zero and Day ten then three months, using a neurological score (NIHSS), a score of functional disability (Rankin) and more analytical and sensitive tests such as dynamometer, the Finger Tapping test and test new plugs.
Interventions
OTHERAdditional MRI
Sponsors
University Hospital, Toulouse
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
BASIC_SCIENCE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
* Patients of 18 to 90 years old. * Subcortical stroke * Achievement of the internal capsule, according to MRI * Ability to perform MRI within 10 days after the onset of symptoms * NIHSS over or equal 2 and \< 20 * Rankin Score over or equal 1 and ≤ 5 * Written informed consent after information about the protocol, from patients or reliable person if patient is in incapacity to sign * Affiliation to a social security scheme
Exclusion criteria
* Pregnant or nursing women * Other cerebral lesion, concomitant or preexisting * Concomitant disease causing unfavorable prognosis within 3 months after inclusion * pre-existing psychiatric illness * Alcoholism or other chronic intoxication * Cortical localization of the infarction * Patient in a coma, who cannot be examined and evaluated * Patient intubated, ventilated, sedated * Cerebral hemorrhage, intra-parenchymal and / or subarachnoid * Persons protected by law (guardianship, curators and judicial protection) * Contraindications to magnetic resonance examination: pacemaker, metal implants, neurostimulators, Clips neurosurgical wire sutures, staples, metal heart valves, ventricular bypass valve, metal workers, foreign eye, shrapnel, bullet , cochlear implants
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Decrease of cortical thickness | 3 months after infarction of corticospinal tract, in the ipsilateral primary motor area. | Decrease of cortical thickness in the ipsilateral primary motor area, after infarction of corticospinal tract at 3 months. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Calculation of fractional anisotropy | 3 months after infarction of corticospinal tract | Calculation of fractional anisotropy will be done through the sequence MRI tractography to D0-D10 and 3 months |
| Disability | at 3 months | The disability at 3 months will be evaluated with the Rankin score |
Countries
France
Outcome results
None listed