ICH Recovery Grant

项目总结/摘要 中风是美国第三大死亡原因和成人残疾的主要原因。更 成年人每年受中风的影响超过阿尔茨海默病、多发性硬化症、肌萎缩侧索硬化症 或帕金森氏症。出血性卒中是卒中中最严重的亚型。估计有40- 50%的出血性中风患者会死亡，超过80%的幸存者在出血性中风后仍然残疾。 中风然而，绝大多数关于卒中后结局的分析主要集中在大体指标上 功能性成果。 此外，出血性中风不同于缺血性中风，缺血性中风是失血导致受影响的区域 在扫描时容易看到。但是对于出血性中风，不仅是我们可以直接看到的区域， 被出血块挤压或拉伸的邻近管道可能受伤。 我们建议对500例深部和脑叶性脑出血进行随访，以进行运动和 认知功能和先进的神经影像学，以确定预测恢复，进行性认知或 功能障碍我们的建议具有增加前瞻性ICH研究的优势， 识别和招募病例，评估生存和严重性偏倚的程度和影响的能力，基线 神经影像学检查，包括基线MRI，生物样本，包括载脂蛋白E等位基因的基因分型 统一的表型定义以及恢复/结局分析、高级神经影像学 过程和流行病学研究。

Project Summary/Abstract Stroke is the third leading cause of death and the leading cause of adult disability in the United States. More adults are affected by stroke each year than Alzheimer’s disease, multiple sclerosis, amyotrophic lateral sclerosis or Parkinson’s disease. Hemorrhagic strokes represent the most severe subtypes of stroke. An estimated 40- 50% of hemorrhagic stroke victims will die and more than 80% of survivors remain disabled after hemorrhagic stroke. Yet the vast majority of analyses on outcome after stroke have focused principally on gross measures of functional outcome. Furthermore, hemorrhagic stroke differs from ischemic stroke where a loss of blood causes the area affected to be readily visible on scanning. But with hemorrhagic stroke, not only the area that we can directly see, but nearby tracts that have been compressed or stretched by the mass of the hemorrhage can be injured. We propose to follow-up on 500 cases of deep and lobar ICH to perform serial evaluations of motor and cognitive function and advanced neuroimaging to determine predictors of recovery, progressive cognitive or functional impairment. Our proposal has the advantages of adding onto a prospective ICH study which will identify and recruit cases, ability to evaluate for the degree and impact of survival and severity biases, baseline neuroimaging which includes baseline MRI, biologic samples including genotyping for apolipoprotein E alleles and uniform phenotype definitions as well as expertise in recovery/outcome analyses, advanced neuroimaging processes and epidemiologic study.