Transcranial Electrical Stimulation in Stroke EaRly After Onset Clinical Trial_ Bridging and Adjunctive Neuroprotection
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Acute Ischemic Stroke
- Sponsor
- University of California, Los Angeles
- Enrollment
- 1
- Locations
- 1
- Primary Endpoint
- Primary Safety Outcome- Number of Participants With Symptomatic Intracranial Hemorrhage (SICH)
- Status
- Terminated
- Last Updated
- 2 years ago
Overview
Brief Summary
This proposal is a prospective, single-center, dose-escalation safety, tolerability, feasibility and potential efficacy study of transcranial direct current stimulation (tDCS) in acute stroke patients with substantial salvageable penumbra due to a large vessel occlusion before and after endovascular therapy.
Detailed Description
This is a single-center, sham-controlled, dose-escalation study where cathodal tDCS is delivered to threatened but not yet irreversibly damaged (penumbral) tissue in patients with large vessel occlusion who are undergoing recanalization procedure. Patients will be randomized in a 3:1 design, to cathodal versus sham (control) stimulation, at each six designed dose tiers. The dose tiers will be increasing in both intensity and duration of the stimulation. All patients will be receiving the first dose (stimulation cycle) after the recanalization procedure and patients at dose tiers 5-6 will also be receiving stimulation cycles before the recanalization procedure begins. The occurrence of symptomatic intracranial hemorrhage will determine the pace of the escalation through the dose tiers.
Investigators
Mersedeh Bahr Hosseini, MD
Principal Investigator
University of California, Los Angeles
Eligibility Criteria
Inclusion Criteria
- Not provided
Exclusion Criteria
- Not provided
Outcomes
Primary Outcomes
Primary Safety Outcome- Number of Participants With Symptomatic Intracranial Hemorrhage (SICH)
Time Frame: At 24-hour post-stimulation
Symptomatic intracranial hemorrhage (SICH) is defined as an increase of 4 or more points on the National Institute of Health Stroke Scale (NIHSS) total score within 24 hours of stimulation associated with parenchymal hematoma type 1 (PH1), parenchymal hematoma type 2 (PH2), remote intraparenchymal hemorrhage (RIH), subarachnoid hemorrhage (SAH), or intraventricular hemorrhage (IVH). The NIHSS is a 15-item neurologic examination stroke scale used to evaluate the effect of acute stroke on the levels of consciousness, language, neglect, visual-field loss, extraocular movement, motor strength, ataxia, dysarthria, and sensory loss. A trained observer rates the patent's ability to answer questions and perform activities. Ratings for each item are scored with 3 to 5 grades with 0 as normal, and there is an allowance for untestable items. Accordingly, 0 is the lowest and 42 is the highest total score possible. In the NIHSS, the higher the score, the more impaired a stroke patient is.
Primary Tolerability Outcome-Number of Participants Completing the Protocol-assigned Stimulation
Time Frame: After 5 minutes of stimulation period
The percentage of the patients completing the protocol-assigned stimulation treatment with no intolerability.
Primary Feasibility Outcome- Assessing the Speed of Stimulation Implementation From Randomization.
Time Frame: Median time from randomization to tDCS initiation
The median times from randomization to bridging C-tDCS initiation and the time form end of endovascular thrombectomy procedure to adjunctive C-tDCS initiation in the last 10 enrolled patients.
Secondary Outcomes
- Secondary Safety Outcome-Number of Participants With All Serious Adverse Events (Anticipated and Unanticipated)(At 90 days post-stimulation)
- Secondary Safety Outcome-Number of Participants With Asymptomatic Intracranial Hemorrhage (AICH)(At 24-hour post-stimulation)
- Secondary Safety Outcome-Number of Participants With Early Neurologic Deterioration(At 24-hour post-stimulation)
- Secondary Safety Outcome-Number of Participants With Mortality(At 90 days post-stimulation)