Acute Ischemic Stroke, Transient Ischemic Attack
Conditions
Keywords
Autonomic dysfunction, cardiovascular dysregulation, brain-heart axis, stroke-heart syndrome, acute ischemic stroke, transient ischemic attack, autonomic function test, central autonomic network, network lesion mapping, lesion symptom mapping, resting-state fMRI, functional brain network, structural brain network, diffusion tensor imaging
Brief summary
The goal of this observational study is to * to investigate the prevalence and time course of autonomic dysfunction in acute ischemic stroke patients; * to evaluate the influence of lesion location on autonomic dysfunction; * to identify patterns of structural and functional brain connectivity within the central autonomic control circuits associated with autonomic dysfunction; and * to explore causal models of the link between brain lesions; cardiac, immunological and endocrine biomarkers; and dysautonomia. Researchers will compare patients with acute ischemic stroke to patients with transient ischemic attacks to study the effect of acute ischemic brain lesions. Participants will * undergo cardiovascular autonomic function testing; * receive structural and functional MR imaging; * provide blood samples for determinaton of serological biomarkers auf dysautonomia.
Interventions
None listed
Sponsors
Universitätsklinikum Hamburg-Eppendorf
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Diagnosis of either * acute ischemic stroke with either an ischemic lesion visible on CT/MRI or persistent focal deficits 24 hours after symptom onset, or * Transient ischemic attack with transient clinical deficits including motor or speech disturbance and not restricted to isolated vertigo/dizziness, visual disturbance, or sensory disturbance. * symptom onset within 72h prior to hospital admission, * a pre-stroke/TIA ability to walk without help from another person (modified Rankin scale score \< 4), * age \> 18 years, and * informed consent by either the patient or a legal representative (including a spouse)
Exclusion criteria
* In-hospital stroke, * contraindications to MR imaging (e.g., claustrophobia, pregnancy, pacemakers, implants), * known moderate to severe dementia, * previous structural brain damage (except leukoariosis due to cerebral small vessel disease), * hemodynamically relevant stenosis of the common or internal carotid artery, or * left heart failure with estimated left ventricular ejection fraction \< 50%, * concomitant systemic illness that can lead to dysautonomia, such as an active infection, thyroid disease, or neurodegenerative disorder (e.g. PD, MSA).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Autonomic dysfunction | 3-5 days after stroke onset | Cardiovagal and Adrenergic Scores on the Composite Autonomic Scoring Scale (0-7, higher values indicate greater dysfunction) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Autonomic dysfunction | 90 days after stroke onset | Cardiovagal and Adrenergic Scores on the Composite Autonomic Scoring Scale (0-7, higher values indicate greater dysfunction) |
Countries
Germany
Contacts
CONTACTEckhard Schlemm
CONTACTThies Ingwersen
Outcome results
None listed