Effects of Intranasal Nerve Growth Factor for Acute Ischemic Stroke
Acute Ischemic StrokeStroke remains one of the leading causes of death and adult disability worldwide. Yet, currently, the only accepted treatment for acute ischemic stroke(AIS) is recanalization of occluded arteries. Thrombolysis with tissue plasminogen activator, limited by its narrow therapeutic time window and the concern of hemorrhagic complication, is still uncommon in use. The other approach is to try to impede the ischemic cascade by targeting various components of the cascade that are deemed to be of importance, namely, a neuroprotection strategy. Nerve growth factor (NGF) plays extensive roles in preventing ischemic injury. Besides that, it is also involved in neurogenesis of the central nervous system (CNS). In addition, the levels of NGF protein and messenger RNA significantly decreased in the CNS at the first few hours and returned to normal levels several days later after middle cerebral artery occlusion (MCAO) in animal models. These observed results suggested that NGF was demanded in ischemic brain injury, but endogenous NGF is insufficient for the requirement and delivering exogenous ones will be blocked in entering into the CNS by the blood-brain barrier (BBB). Intracerebroventricular or intracerebral injection of NGF or grafting of NGF-producing cells may be less practicable due to invasiveness and safety concerns. Intranasal (IN) administration is a noninvasive and acceptable delivery strategy for drugs bypassing BBB and can deliver NGF to the CNS, which has been proved to show neuroprotective effects on brain injury. The effects of intranasal NGF in human ischemic stroke is still controversial that need further evaluation.
The Effect of Trazodone on the Severity of Obstructive Sleep Apnea in Insomnic Stroke Patients With...
Sleep Apnea SyndromesCerebral InfarctionThe investigators hypothesize that trazodone does not worse nocturnal oxygen saturation in insomnic ischemic stroke patients with obstructive sleep apnea (OSA) and depression and has beneficial effect in selected stroke patients with low arousal threshold phenotype OSA.
Telerehabilitation With Aims to Improve Lower Extremity Recovery Post-Stroke
StrokeStroke10 moreThe purpose of this study is to examine the feasibility and effectiveness of a lower extremity telerehabilitation protocol with aims to improve lower extremity recovery among community-living stroke survivors across Canada.
THE IMPACT- 24M TRIAL (IMPlant Augmenting Cerebral Blood Flow in Mild Strokes Trial 24 Hours From...
Ischemic StrokeStudy Population: Subjects with Mild Acute Ischemic Stroke in the anterior circulation within 24 hours from onset. Study objectives: Identify the personal stimulation level for each patient based on physiological biomarkers Identify improvement in stroke symptoms during ISS treatment at the personal stimulation level
INdobufen Versus aSpirin in acUte Ischemic stRokE,INSURE
Ischemic StrokeIndobufen1 moreChina has the largest burden of cerebrovascular disease in the world. About 60% to 80% of which are ischemic stroke. In recent years, stroke has replaced heart disease and tumor diseases as the first cause of death and disability in adult population. The primary purpose of this study is to evaluate the efficacy of indobufen treatment in reducing the risk of a 3-month new stroke (any type of stroke, including ischemic stroke and hemorrhagic stroke) for patients with moderate/severe ischemic stroke is not inferior to aspirin therapy.
Efficacy Argatroban in Ischemic Stroke With Early Deterioration (EASE)
Acute Progressive Ischemic StrokeAcute ischemic stroke (AIS) has the characteristics of high morbidity, high mortality, high disability rate and high recurrence rate. Progressive cerebral infarction (PIS) is a subtype of AIS, accounting for 10% - 40%. Because of the gradual aggravation of neurological deficit symptoms, it has a higher rate of disability and death, which brings heavy mental and economic burden to families, society and the country. The progress of acute cerebral infarction is generally within 6 hours to 1 week after the onset of the disease. At present, it is considered that thrombus prolongation is one of the important pathogenesis of PIS. Heparin can reduce the incidence of post-stroke embolism, but its benefits are offset by the risk of hemorrhage due to the high risk of hemorrhage. The 2013AHA guidelines in the United States do not recommend it as a routine anticoagulant therapy. Therefore, reducing the risk of bleeding is the key to the anticoagulation therapy of PIS. Argatroban is a new thrombin inhibitor. Its mechanism of action is to bind and inactivate thrombin (factor Ⅱ a) directly.Compared with traditional anticoagulants, argatroban not only has the advantages of good anticoagulant effect and rapid onset, but also has high safety. Therefore, this study aims to verify the clinical efficacy of Argatroban in the treatment of PIS in a large population. In this study, 628 patients are expected to be enrolled into the study group. The experimental group and the control group are selected by dynamic random method. Both groups are given standard medical treatment, including routine antiplatelet, blood pressure control, statins to stabilize plaque, etc. The control group is only given standard medical treatment. In the experimental group, Argatroban is used on the basis of standard medical treatment. Both groups are treated for 7 days, and the second-class prevention standard medical treatment is given from the 8th to the 90th day. The main outcome measure is the good prognosis rate at the third month after PIS. The good prognosis was defined as the modified Rankin Scale (mRS) ≤ 3.
Blood Pressure Variability and Ischemic Stroke Outcome
Acute Ischemic StrokeBlood Pressure VariabilityThe goal of this observational study is to evaluate the role of blood pressure (BPV) variability in patients suffering from acute ischemic stroke. The main questions it aims to answer are: To determine the association of BPV with functional/cognitive outcome after ischemic stroke. To determine a pathophysiologic mechanism of BPV's deleterious effect on functional outcome. To evaluate potential treatment targets to pharmacologically reduce BPV after ischemic stroke.
Phase Ib/IIa Clinical Study of ApTOLL for the Treatment of Acute Ischemic Stroke
StrokeAcute Stroke1 moreThis is a prospective, multicenter, double-blind, randomized, placebo-controlled, Phase Ib/IIa clinical study to assess the administration of ApTOLL together with endovascular therapy in acute ischemic stroke patients who are candidates to receive reperfusion therapies.
Construction and Validation of an In-hospital Mortality Risk Prediction Model for Acute Ischemic...
Acute Ischemic StrokeFirstly, the application effect of the existing predictive models, SOAR and GWTG-Stroke, was verified in Guangdong acute ischemic Stroke population, and the clinical application effect of the existing predictive models was verified. Secondly, the predictive value of clinical indicators was analyzed, SOAR and GWTG-Stroke scores were optimized, and an improved prediction Model (New Model) was constructed. The third is to apply the New Model to clinical practice, collect clinical data and evaluate the prediction effect of the Model, and evaluate the prediction efficiency of the improved prediction Model.
Comparison of the Effects of Ordinary and Differential Learning Based Physiotherapy on Subjects...
Ischemic StrokeThe purpose of this study was to assess the effect or ordinary and differential learning based physiotherapy for torso control, balance and gait on subjects with ischemic stroke in the second phase of rehabilitation