Aben Hugo P, Reijmer Yael D, Visser-Meily Johanna Ma, Spikman Jacoba M, de Bresser Jeroen, Biessels Geert Jan, de Kort Paul Lm
Elisabeth Tweesteden Hospital, Department of Neurology, Tilburg, Netherlands.
Brain Center Rudolf Magnus, Department of Neurology, University Medical Center Utrecht, Utrecht, Netherlands.
JMIR Res Protoc. 2018 May 28;7(5):e127. doi: 10.2196/resprot.9431.
Cognitive impairment is common after acute ischemic stroke, affecting up to 75% of the patients. About half of the patients will show recovery, whereas the others will remain cognitively impaired or deteriorate. It is difficult to predict these different cognitive outcomes.
The objective of this study is to investigate whether diffusion tensor imaging-based measures of brain connectivity predict cognitive recovery after 1 year, in addition to patient characteristics and stroke severity. A specific premise of the Prediction of Cognitive Recovery After Stroke (PROCRAS) study is that it is conducted in a daily practice setting.
The PROCRAS study is a prospective, mono-center cohort study conducted in a large teaching hospital in the Netherlands. A total of 350 patients suffering from an ischemic stroke who screen positive for cognitive impairment on the Montreal Cognitive Assessment (MoCA<26) in the acute stage will undergo a 3Tesla-Magnetic Resonance Imaging (3T-MRI) with a diffusion-weighted sequence and a neuropsychological assessment. Patients will be classified as being unimpaired, as having a mild vascular cognitive disorder, or as having a major vascular cognitive disorder. One year after stroke, patients will undergo follow-up neuropsychological assessment. The primary endpoint is recovery of cognitive function 1 year after stroke in patients with a confirmed poststroke cognitive disorder. The secondary endpoint is deterioration of cognitive function in the first year after stroke.
The study is already ongoing for 1.5 years, and thus far, 252 patients have provided written informed consent. Final results are expected in June 2019.
The PROCRAS study will show the additional predictive value of diffusion tensor imaging-based measures of brain connectivity for cognitive outcome at 1 year in patients with a poststroke cognitive disorder in a daily clinical practice setting.
RR1-10.2196/9431.
急性缺血性卒中后认知障碍很常见，影响多达75%的患者。约一半的患者会显示恢复，而其他患者将持续存在认知障碍或病情恶化。很难预测这些不同的认知结果。
本研究的目的是调查除患者特征和卒中严重程度外，基于扩散张量成像的脑连接测量是否能预测1年后的认知恢复。卒中后认知恢复预测（PROCRAS）研究的一个特定前提是在日常实践环境中进行。
PROCRAS研究是一项在荷兰一家大型教学医院进行的前瞻性单中心队列研究。共有350例在急性期蒙特利尔认知评估（MoCA<26）筛查认知障碍呈阳性的缺血性卒中患者将接受3特斯拉磁共振成像（3T-MRI）检查，包括扩散加权序列和神经心理学评估。患者将被分类为无认知障碍、患有轻度血管性认知障碍或患有重度血管性认知障碍。卒中1年后，患者将接受随访神经心理学评估。主要终点是确诊为卒中后认知障碍的患者卒中1年后认知功能的恢复。次要终点是卒中后第一年认知功能的恶化。
该研究已进行1.5年，迄今为止，已有252例患者提供了书面知情同意书。预计最终结果将于2019年6月得出。
PROCRAS研究将显示在日常临床实践环境中，基于扩散张量成像的脑连接测量对卒中后认知障碍患者1年后认知结局的额外预测价值。
RR1-10.2196/9431。
