brain plasticity functional magnetic resonance imaging cerebrovascular reactivity stroke recovery Stroke
Conditions
Interventions
MRI scan en Respiract systeem (medical device used to precisely control and monitor the levels of carbon dioxide (CO2) and oxygen (O2) that a person inhales).
Sponsors
Universitair Medisch Centrum Utrecht
Eligibility
Age
18 Years to 99 Years
Inclusion criteria
Inclusion criteria: Sufficient knowledge of the Dutch language to allow reliable use of standardized test Age, 18 years or older First-ever unilateral stroke within the cerebrum or brainstem.Cognitive impairment based on assessment by the treating rehabilitation physician (at least <26 on the MoCA).Signed informed consent.
Exclusion criteria
Exclusion criteria: Unwilling or unable to cooperate with the breathing manoeuvres or keeping still Unable to provide consent by themselves due to severe cognitive impairment or (global/receptive) aphasiaStandard contraindications for 7T MRI scanning; Contraindications for using the RespirAct (see D2 IMDD 2.5 contraindications) including:Subjects refusing to undergo testingSubjects with obstructive or resistive lung disease whose PaCO2 at rest is greater than 50mmHg or whose venous serum bicarbonate is greater than 26 mEq/LSubjects with pre-existing respiratory acidosis. This will be determined during the test outside of the scanner. Respiratory acidosis will be inferred if they have a resting PaCO2 greater than 50 mmHg as measured by the RespirAct.Subjects who require portable oxygen at rest or with exerciseSubjects with chronic heart failure or severe pulmonary diseaseIncreased intracranial pressure or obstruction of outflow of CSFSymptoms of possible elevated intracranial pressure such as headache and nauseaFindings of significant edema (>10% brain volume, see section 11.4) or hydrocephalus in the last week.Metabolic acidosisPulmonary disease as diagnosed by a pulmonologist: oxygen dependency at rest or with exercise, restrictive lung disease with resting respiratory rate over 15 breaths/min; Concurrent severe or uncontrolled medical disease (e.g., active systemic infection); Body weight <30 kg, >120 kg; Pregnant during the studyUpper limb paresis prior to stroke onset Severe impairments that can impede study participation as determined by the treating rehabilitation physician (i.e. extreme fatigue, severe communication deficits).
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| To identify what amount of changes in FC over time are explained by CVR. For this we use the marginal and partial R² from mixed-effects modelling. | — |
Secondary
| Measure | Time frame |
|---|---|
| A) To determine whether baseline CVR predict later FC normalization. For this we will compute changes to the laterality index (LI) for our parameters. B) To apply primary analysis methods to include possible changes in OEF. | — |
Countries
Netherlands
Contacts
Public ContactA.A. Bhogal
Universitair Medisch Centrum Utrecht
Outcome results
None listed