Lacunar Strokes
Conditions
Keywords
Small subcortical infarct, Cerebrovascular disorders, Neurocognitive and cardiovascular disorders, Disability, Dementia, Stroke
Brief summary
The aim of this study is to determine in patients with a recent lacunar strokes (\<15 days), the natural history of cognitive disturbances and disability.
Detailed description
This bi-centric cohort study aims at determining in patients with recent lacunar strokes (\<15 days), the main clinical, radiological, or genetic predictive markers of recurrent stroke, cognitive impairment, dementia, depression gait disturbances and disability.
Interventions
None listed
Sponsors
Assistance Publique - Hôpitaux de Paris
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age 18 years and above * History of recent (less than 15 days) neurological deficit related to a small subcortical infarct (evidenced by medical history or physical examination) * Diagnosis of recent small subcortical infarct on MRI (hyperintensity on diffusion-weighted imaging showing an infarction in the territory of one perforating artery) presumably responsible for the corresponding neurological deficit * Lesion diameter mess than 20 mm * Ability to comply with scheduled follow-up and annual neurological evaluation * Affiliation to the national French health insurance (sécurité sociale) * Signature of informed consent
Exclusion criteria
* Prior diagnosis of dementia according to DSM IV criteria * Prior severe disability with Rankin scale ≥ 4 * Serious concomitant systemic disorder that can compromise the follow-up study; * Leukoencephalopathy of non-vascular origin; * Severe psychiatric disorder; * Inability to obtain an informed signed consent from the patient or his/her family; * Medical contraindication or refusal to undergo cerebral magnetic resonance scanning (MRI).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Time to the occurrence of cognitive decline | 5 years | diagnosis of mild or major neurocognitive disorder according to DSM5 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Recurrent stroke | 5 years | Time to the occurrence of one of the following event |
| Transient ischaemic attacks | 5 years | Transient ischemic attack is a well recognized outcome in clinical trials in neurovascular disorders. We chose the most commonly definition of TIA according to international guidelinesorigin, without recent ischemic lesion on diffusion weighted imaging |
| Cardiovascular events | 5 years | myocardial infarction or cardiac failure |
| Attacks of migraine with aura | 5 years | according to international classification of headache disorders 2nd edition (ICHD-2) |
| Memory complaints | 5 years | any spontaneous complain of memory deficit, irrespective of the neuropsychological battery results |
| Dementia | 5 years | diagnosis of major neurocognitive disorder (dementia) according to DSMV criteria |
| Behavioural disorders | 5 years | according to DSMV classification |
| Balance disturbances | 5 years | according to the SPPB battery |
| Falls | 5 years | according to patient's relatives recording |
| Urinary complaints | 5 years | any spontaneous complain from the patients and/or his relative |
| Depression or other mood alterations | 5 years | HADS refers to Hamilton Anxiety and Depression Scale, as stated initially in the title. The scale comprises 14 questions with structured answers ranging from 0 to 3, leading to 2 scores (1 for anxiety, 1 for depression, ranging each from 0 to 21). In each case, larger values are considered to represent worse outcomes. Scores larger or equal to 11 correspond to thresholds to define anxiety and depression |
Countries
France
Contacts
Primary ContactEric JOUVENT, MD, PhD
Outcome results
None listed