Recovery of StrokE - Longitudinal Assessment With Neuroimaging (ROSE LAWN)

项目主任/首席调查员(最后、第一、中间)：吴宇森，丹尼尔；安德森，克里斯托弗 3.项目摘要/摘要 我们最近完成了分析，确定了一组患有明显 患痴呆症/进行性认知障碍的风险增加。脑出血患者有 据报道，中风后大约三年半，他们有42%的进行性认知障碍风险 我们发现在独立的患者群体中有39%的风险。这一极高的比率在 无痴呆史的脑出血幸存者提出了多种不同的假说。首先，可能是因为 脑出血本身的原因也是痴呆症的危险因素。如果是这样，那么那些患痴呆症的人应该证明 这些病因的恶化标志，如脑小血管疾病和脑淀粉样血管病。 然而，该领域的另一个突出假设是，出血本身具有明显的炎症性。如果这个 如果炎症反应触发了进行性认知功能下降，那么这些病例应该证明 炎性基因表达的差异性改变。 卒中恢复研究(NS100417)招募了计划中的500例脑出血患者中的163例 包括3T MRI，DNA、RNA测序和详细基线的基线和3个月样本，3和6 每月进行运动、认知、行为和功能检查。目前的提案寻求重新招收250人 计划对500例患者进行12~24个月的神经影像、RNA采样及复查 解决以下目标的措施：1)确定进行性认知障碍是否与 脑小血管疾病和脑淀粉样血管病标志物的增加；2)确定 用炎症的RNA测序标记物测量的炎症与进行性认知相关 3)找出与进行性认知功能衰退相关的新的神经影像标志物。 如果成功，我们将提供对非物质文化遗产最大的纵向多重评估评估，并回答 脑出血幸存者患痴呆症的主要假设。 PHS 398/2590(06/09版)页面续格式页面

Program Director/Principal Investigator (Last, First, Middle): Woo, Daniel; Anderson, Christopher 3. Project Summary/Abstract We have recently completed analyses which identifies a population of patients that have a markedly increased risk of developing dementia/progressive cognitive impairment. Intracerebral hemorrhage patients had been reported to have a 42% risk of progressive cognitive impairment roughly 3 and a half years after their stroke and we have found a 39% risk in an independent population of patients. This extraordinarily high rate among survivors of ICH without a prior history of dementia yields multiple different hypotheses. First, it may be that the causes of ICH itself are also risk factors for dementia. If so, then those that develop dementia should demonstrate worsening markers of these causes such as cerebral small vessel disease and cerebral amyloid angiopathy. However, another prominent hypothesis in the field is that the hemorrhage itself is markedly inflammatory. If this inflammatory response were to trigger a progressive cognitive decline, then these cases should demonstrate differential inflammatory gene expression changes. The Recovery of StrokE (NS100417) study has recruited 163 cases out of a planned 500 total cases of ICH including 3T MRI, baseline and 3 month samples for DNA, RNA-sequencing and detailed baseline, 3 and 6 month motor, cognitive, behavioral and functional examinations. The current proposal seeks to re-enroll 250 cases of the planned 500 for 12 to 24 month follow-up neuroimaging, RNA sampling and repeated examination measures to address the following aims: 1) Determine if progressive cognitive impairment correlates with an increase in markers of cerebral small vessel disease and cerebral amyloid angiopathy; 2) Determine if inflammation as measured by RNA-sequencing markers of inflammation correlates with progressive cognitive impairment and 3) identify novel neuroimaging markers associated with progressive cognitive decline. If successful, we will provide the largest longitudinal multiple assessment evaluation of ICH and answer the major hypotheses on the development of dementia among survivors of ICH. PHS 398/2590 (Rev. 06/09) Page Continuation Format Page