Rehabilitation of Stroke Patients for Maximal Neurological Restoration

Study Overview
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Brief Summary
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Multimodal imaging of stroke patients. Patients included in the study will be investigated with multiparametric imaging tools including MRI and EEG imaging. Improvements in motor skills will be monitored clinically.

Detailed Description
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We aim to (i) quantify the size of the brain lesion and assess the surviving functional neural network connections; (ii) Analyze the type and degree of inflammation initiated by the stroke-induced brain lesion. We will stratify inflammation according to lesion volume, surviving functional neural network connections, age, NIHSS and Modified Rankin Scale (mRS) and analyze how inflammation markers change during rehabilitation; (iii) Train the surviving neural network to create new synaptic connections that can maximize restoration of motor functions; (iv) Apply and develop advanced mathematical and computational methods to model and predict how stroke rehabilitation can rewire the neural network connections to best facilitate restoration of lost motor function.

Official Title
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Training the Surviving Neural Network to Create New Synaptic Connections That Can Maximize Restoration of Motor Functions After Stroke

Conditions
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Stroke

Intervention / Treatment
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* Behavioral: Kinematic movement analysis


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: subcortical strokes resulting in arm motor deficits. admitted to the stroke unit, St Olav´s Hospital during 2021-2023 Exclusion Criteria: Previous stroke neurodegenerative disease brain tumors previous neurotrauma or brain operation aphasia cognitive dysfunction and claustrophobia preventing MRI examinations.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Stroke patients<br>Stroke patients admitted to the stroke unit, St Olav´s hospital, Trondheim, Norway, without previous stroke, neurological disease or central nervous system (CNS) trauma, will be eligible for inclusion into the study. The planned cohort size is 135 patients. | Behavioral: Kinematic movement analysis<br>* moving arm/leg while registration with electromyography, electroencephalogram, accelerometers, functional near infrared spectroscopy and 3 dimensional video registration of hand, arm, foot and leg movements.<br>|
| healthy volunteers<br>Age and gender matched controls without previous CNS disease or trauma are eligible for inclusion into the study. Estimated cohort size is 45 individuals. Volunteers will be recruited through announcement in local newspaper. | Behavioral: Kinematic movement analysis<br>* moving arm/leg while registration with electromyography, electroencephalogram, accelerometers, functional near infrared spectroscopy and 3 dimensional video registration of hand, arm, foot and leg movements.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in brain volume | Stroke induced brain volume changes (mm3) will be measured using magnetic resonance imaging (MRI) at 1 day and 6 months post-stroke. | 6 months | 
| Stroke induced changes in brain activity. | Document longitudinal changes in brain activity using EEG. Changes will be measured in cycles/second (Hertz, Hz). | 6 months | 
| Changes in inflammatory activity in brain | Markers of post-stroke inflammation will be measured in pg/ml and ng/ml. | 6 months | 
| muscle function | Longitudinal kinematic profiling. Electromyography measurements of muscle function post-stroke will be measured in cycles/second (Hz) and amplitude (mm). Extension and flexion of arm will be measured in cm. Joint angles will be measured in degrees. Speed of flexion and extension will be measured in cm/second | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Rehabilitation