CNS Changes Following Stroke

Study Overview
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Brief Summary
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The objective of this study is to better understand the structural and functional changes that the CNS undergoes following stroke and how these changes relate to clinical measures. Both macroscopic and microscopic changes of the brain and the spinal cord will be examined in stroke patients and compared to healthy controls. In terms of structural plasticity, we aim to identify MR biomarkers that allow predicting the course of the patient's neurological status and accurately describe the course of the disease and the recovery. Importantly, we aim to investigate which factors scale the patients' symptoms. In terms of functional plasticity, we will combine fMRI with behavioural motor and sensory testing to understand i) the structural and functional interplay between spinal and supraspinal neural circuits after stroke possibly driven by beneficial plasticity/regeneration vs. maladaptive plasticity/degeneration and ii) which clinical and behavioural determinants drive functional hand representations in the primary somatosensory and motor cortices to be maintained and which determinants drive reorganisation of functional representations following sensory input loss. We will further investigate the contribution of brainstem reorganisation to plasticity observed at the cortical level and, by doing so, aim to better understand the mechanistic underpinnings of functional reorganisation.

Official Title
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Functional, Structural, and Metabolic Central Nervous System Changes Following Damage of the Central Nervous System

Conditions
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Stroke

Intervention / Treatment
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* Diagnostic Test: MRI
* Diagnostic Test: MRI


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria - Patients: Age 18-80 Stroke (> 3months) Signed informed consent Exclusion Criteria - Patients: Contraindications to magnetic resonance imaging Neurological impairment of body function impairments not induced by stroke BMI > 40 Pregnancy Claustrophobia Inclusion Criteria - Healthy subjects: Age 18-80 Signed informed consent Exclusion Criteria - Healthy subjects: Contraindications to magnetic resonance imaging Pregnancy Neurological illness Impairment of body function induced by stroke Claustrophobia BMI >40

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Patients with stroke<br> | Diagnostic Test: MRI<br>* We will examine chronic (>3 months post stroke) patients using functional, structural, and metabolic MRI in both the brain and the spinal cord.<br>|
| Healthy subjects<br> | Diagnostic Test: MRI<br>* We will examine healthy control participants using functional, structural, and metabolic MRI in both the brain and the spinal cord.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Conventional magnetic resonance imaging (MRI) parameter | Structural characteristics in the brain and spinal cord are assessed in chronic stroke patients using conventional MRI and compared to healthy controls | Up to 50 weeks] | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Magnetic resonance spectroscopy (MRS) parameter | Metabolic parameter are assessed in chronic stroke patients using MRS in the brain and spinal cord and compared to healthy controls | Up to 50 weeks | 
| Functional MRI (fMRI) parameter | Brain activity or change of brain activities between 2 to 5 time points is assessed using fMRI during resting-state or a specific task in chronic stroke patients and compared to healthy controls | Up to 50 weeks |