Natural History of Stroke: Cause and Development

NCT ID: NCT00009243

Last Updated: 2025-12-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

RECRUITING

Total Enrollment

4000 participants

Study Classification

OBSERVATIONAL

Study Start Date

2001-01-26

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

The purpose of this study is to learn more about stroke and obtain information that may serve as the basis for future investigations. It will 1) establish a registry of patients with cerebrovascular disease (stroke); 2) characterize the natural history of acute stroke and transient ischemic attacks (TIA)-an interruption of blood flow to the brain that causes stroke symptoms for a short period of time); and 3) evaluate the data to generate ideas for future studies.

Patients 18 years of age or older with suspected acute stroke or TIA may be eligible for this study. Subjects will be recruited from patients who present with stroke at the emergency department of Suburban Hospital in Bethesda, Maryland.

The study will gather data collected from diagnostic and laboratory tests the patient undergoes as part of standard medical care, including findings of medical and neurological examinations and other tests. In addition, studies will be done for research purposes only to gather data about stroke and TIA. These may include the following:

* Blood and urine tests not more than 2 tablespoons of blood will be drawn for various tests.
* Electrocardiogram (EKG) (heart tracing)-electrodes placed on the chest wall detect the heartbeat and heart rhythm.
* Computed tomography (CT) scan of the head-specialized X-rays are used to obtain images of the brain.
* Magnetic resonance imaging (MRI) of the brain-a strong magnetic field and radio waves are used to produce images that provide information about the brain tissue and blood vessels.
* Transcranial Doppler (TCD)-sound waves are used to image the arteries of the brain and neck.
* Echocardiogram-sound waves are used to image the heart and evaluate heart function.

Patients may be asked to return to Suburban Hospital for follow-up testing in 1, 3, and/or 12 months, when some of these tests may be repeated to assess changes over time

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Study Description:

This is a natural history/disease pathogenesis protocol for evaluation of patients with or at risk of acute stroke, transient ischemic attack (TIA), or other disturbances of cerebrovascular circulation. The purpose of this protocol is to generate natural history data to serve as the basis for future hypothesis-driven protocols as well as to contribute to the clinical and physiological understanding of cerebrovascular disease through the description of disease manifestation and the relationship among clinical, hematologic, and radiologic variables, as well as identifying potential subjects for future studies on stroke and other cerebrovascular diseases.

Objectives:

* To establish a registry of subjects with cerebrovascular disease including clinical, laboratory, and radiological variables associated with hemorrhagic and ischemic stroke, TIA, and other disturbances of cerebrovascular circulation.
* To characterize the natural history of acute stroke, TIA, and other disturbances of cerebrovascular circulation on these variables.
* To evaluate the relationship among these variables by exploratory analyses and to generate hypotheses for future testing.
* To identify potential subjects for research studies on stroke and other cerebrovascular diseases.

Endpoints:

A primary purpose of this observational protocol is to discover and study new imaging biomarkers that are i) relevant to the acute presentation and severity, ii) predictive of clinical outcome, and iii) are useful for stratifying the biological response as reflected in blood-biomarker and gene expression studies. As such, the primary outcome is the results from the imaging studies.

Primary Outcome Measures

Prevalence and type of abnormalities seen on neuroimaging as a function of time from acute insult such as:

* Imaging positive for acute ischemic cerebral vascular syndrome ( AICS positive )\[1\]
* Presence of a lesion on diffusion, perfusion, and mismatch between the two
* Evidence of a vascular occlusion on MR angiography
* Evidence of a thrombus or hemorrhage on T2\* GRE imaging
* Blood-brain barrier disruption as evidence by HARM \[2\]
* The evolution of these markers with time and treatment

Secondary Outcome Measures

* Stroke severity as measured by NIHSS as a function of time since index event.
* Clinical outcome measured using modified Rankin Scale and Barthel Index
* Gene expression profiles and biomarker levels obtained from blood samples.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Brain Disease Ischemic Attack, Transient Cerebrovascular Accident Cerebrovascular Disorder Vascular Diseases

Keywords

Explore important study keywords that can help with search, categorization, and topic discovery.

Stroke Natural History MRI (Magnetic Resonance Imaging) Magnetic Resonance Imaging Acute Stroke TIA

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Patients

Patients with acute stroke symptoms

No interventions assigned to this group

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

In order to be eligible to participate in this study, an individual must meet all of the following criteria:

1. Aged \>=18
2. Presented to participating study site (ED, ICU, or inpatient unit) with or at risk of acute stroke, TIA, or other disturbances of cerebrovascular circulation

Exclusion Criteria

An individual who meets any of the following criteria will be excluded from participation in this study:

1. Subjects with contraindication to MRI scanning will be excluded from any testing which involves the use of MRI. The contraindications include subjects with the following devices or conditions:

* Central nervous system aneurysm clips
* Implanted neural stimulator
* Implanted cardiac pacemaker or defibrillator
* Cochlear implant
* Ocular foreign body (e.g. metal shavings)
* Insulin pump
* Metal shrapnel or bullet
* Any implanted device that is incompatible with MRI

Subjects with a condition precluding entry in the scanner (e.g. morbid obesity, Claustrophobia, etc.) will not be included in the MRI portion of this study.
2. Pregnancy
Minimum Eligible Age

18 Years

Maximum Eligible Age

120 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

National Institute of Neurological Disorders and Stroke (NINDS)

NIH

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Lawrence L Latour, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

National Institute of Neurological Disorders and Stroke (NINDS)

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Medstar Washington Hospital Center

Washington D.C., District of Columbia, United States

Site Status RECRUITING

Suburban Hospital - Johns Hopkins Medicine

Bethesda, Maryland, United States

Site Status RECRUITING

National Institutes of Health Clinical Center

Bethesda, Maryland, United States

Site Status RECRUITING

Countries

Review the countries where the study has at least one active or historical site.

United States

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Nicole L Peterkin

Role: CONTACT

Phone: (301) 435-2395

Email: [email protected]

Lawrence L Latour, Ph.D.

Role: CONTACT

Phone: (301) 435-2395

Email: [email protected]

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

Lawrence Latour, Ph.D.

Role: primary

Lawrence Latour, Ph.D.

Role: primary

For more information at the NIH Clinical Center contact Office of Patient Recruitment (OPR)

Role: primary

References

Explore related publications, articles, or registry entries linked to this study.

Lomahan CA, Luby M, Kalarakis G, Hsia AW, Lynch JK, Nathani KP, Somani S, Thomas LC, Arnberg-Sandor F, Latour LL. Hyperemia detection on arterial spin labeling is associated with final infarct volume in stroke post-endovascular therapy. J Stroke Cerebrovasc Dis. 2025 Aug;34(8):108358. doi: 10.1016/j.jstrokecerebrovasdis.2025.108358. Epub 2025 May 26.

Reference Type DERIVED
PMID: 40436255 (View on PubMed)

Cho YE, Lee H, Bae HR, Kim H, Yun S, Vorn R, Cashion A, Rucker MJ, Afzal M, Latour L, Gill J. Circulating immune cell landscape in patients who had mild ischaemic stroke. Stroke Vasc Neurol. 2022 Aug;7(4):319-327. doi: 10.1136/svn-2021-001224. Epub 2022 Mar 9.

Reference Type DERIVED
PMID: 35264400 (View on PubMed)

Luby M, Hsia AW, Nadareishvili Z, Cullison K, Pednekar N, Adil MM, Latour LL. Frequency of Blood-Brain Barrier Disruption Post-Endovascular Therapy and Multiple Thrombectomy Passes in Acute Ischemic Stroke Patients. Stroke. 2019 Aug;50(8):2241-2244. doi: 10.1161/STROKEAHA.119.025914. Epub 2019 Jun 26.

Reference Type DERIVED
PMID: 31238832 (View on PubMed)

Hsia AW, Luby M, Cullison K, Burton S, Armonda R, Liu AH, Leigh R, Nadareishvili Z, Benson RT, Lynch JK, Latour LL. Rapid Apparent Diffusion Coefficient Evolution After Early Revascularization. Stroke. 2019 Aug;50(8):2086-2092. doi: 10.1161/STROKEAHA.119.025784. Epub 2019 Jun 26.

Reference Type DERIVED
PMID: 31238830 (View on PubMed)

Related Links

Access external resources that provide additional context or updates about the study.

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

01-N-0007

Identifier Type: -

Identifier Source: secondary_id

010007

Identifier Type: -

Identifier Source: org_study_id