Predictors for Poststroke Outcomes: Tel Aviv Brain Acute Stroke Cohort Acute Stroke Cohort (TABASCO)
Background: Recent studies have demonstrated that even mild stroke survivors experience residual damage, which persists and in fact increases in subsequent years. About 45% of stroke victims remain with different levels of disability. While studies on cognitive impairment and dementia after stroke are receiving increasing clinical attention, the underlying pathophysiology is poorly understood. Identifying the mechanisms involved and recognizing early biomarkers for individual vulnerability, require a multi-modal approach, as the mechanisms involved in cerebrovascular disease and individual trajectories of post-stroke recovery may impact upon each other on various levels.
Aims and Hypothesis: To date there is no single measure that can be used to identify patients who are prone to develop cognitive impairment and other disabilities from those with better recovery prospects.
We hypothesize that data based on biochemical, neuroimaging, genetic and psychological measures can, in aggregate, serve as better predictors for subsequent disability, cognitive and neurological deterioration, and suggest possible interventions.
Design: The TABASCO (Tel-Aviv Brain Acute Stroke Cohort) study is an ongoing, prospective cohort study aim to recruit about approximately 1125 consecutive first-ever mild-moderate stroke patients. It is designed to evaluate the association between predefined demographic, psychological, inflammatory, biochemical, neuro-imaging and genetic markers, measured during the acute phase, and long-term outcome: subsequent cognitive deterioration, vascular events (including recurrent strokes), falls, affective changes, functional everyday difficulties and mortality.
Discussion: This study is an attempt to comprehensively investigate the long term outcome of mild-moderate strokes. Its prospective design will provide quantitative data on stroke recurrence, the incidence of other vascular events and the evaluation of cognitive, affective and functional decline. Identifying the factors associated with post stroke cognitive and functional decline could potentially yield more effective therapeutic approaches.
We believe that an extensive approach of analyzing the interaction between different risk factors would more accurately predict neurological deterioration.
|Study Type:||Observational [Patient Registry]|
|Study Design:||Observational Model: Cohort
Time Perspective: Prospective
|Target Follow-Up Duration:||10 Years|
|Official Title:||Predictors for Poststroke Outcomes: the Tel Aviv Brain Acute Stroke Cohort (TABASCO) Study|
- dementia/cognitive decline occurrence [ Time Frame: 10 years ] [ Designated as safety issue: No ]This evaluation will be based on a neurological and general clinical examination, as well as an interview with the patient's family, by a cognitive neurologist, and a senior clinician to determine whether the participant meets the DSM IV criteria for dementia or is defined as minimal cognitive impairment (MCI).
- dementia or cognitive decline occurrence [ Time Frame: 6 months - 10 years ] [ Designated as safety issue: No ]Dementia/ cognitive decline occurrence [ Time Frame: 6, 12, 18 months and annually up to 10 years] this evaluation will be based on a neurological and general clinical examination, same as for primary outcome.
- Death or recurrent vascular events occurence [ Time Frame: Study entry - 10 years ] [ Designated as safety issue: No ]Death or recurrent vascular events that occured after the first acute stroke.
Biospecimen Retention: Samples With DNA
whole blood, serum, white cells, saliva
|Study Start Date:||April 2008|
|Estimated Primary Completion Date:||April 2018 (Final data collection date for primary outcome measure)|
Acute First-ever Stroke
Patients over 50 years and without pre-stroke dementia, displaying an ischemic first-ever stroke or transient ischemic attack (TIA), onset within the last 72 hours, Israeli residents.
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|Tel Aviv Sourasky Medical Center||Recruiting|
|Tel Aviv, Israel, 64239|
|Contact: Einor Ben Assayag, PhD +972-3-6973414 firstname.lastname@example.org|
|Contact: Natan Bornstein, Prof. +972-3-6973159 email@example.com|
|Principal Investigator: Natan Bornstein, Prof.|
|Principal Investigator: Einor Ben Assayag, PhD|