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

项目负责人/主要研究者（最后、第一、中间）：Woo，丹尼尔;安德森，克里斯托弗 3.项目总结/摘要 我们最近完成了一项分析，确定了一组患者， 患痴呆症/进行性认知障碍的风险增加。脑出血患者 据报道，在中风后大约3年半， 我们在一个独立的患者群体中发现了39%的风险。这一异常高的比率， 没有痴呆病史的脑出血幸存者产生了多种不同的假设。首先，可能是 脑出血本身的原因也是痴呆的危险因素。如果是这样，那么那些患痴呆症的人应该证明 这些原因的恶化标志物，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 炎症反应会引发进行性认知能力下降，那么这些病例应该证明 差异性炎症基因表达变化。 卒中恢复（NS 100417）研究在计划的500例ICH病例中招募了163例病例 包括3 T MRI、基线和3个月样本，用于DNA、RNA测序和详细基线，3和6 月运动、认知、行为和功能检查。目前的建议旨在重新招收250名 计划对500例患者进行12 ~ 24个月的神经影像学随访、RNA采样和重复检查 1）确定进行性认知障碍是否与以下目标相关： 脑小血管病和脑淀粉样血管病的标志物增加; 2）确定是否 通过炎症的RNA测序标记物测量的炎症与进行性认知功能相关 损伤和3）鉴定与进行性认知衰退相关的新的神经影像学标记物。 如果成功，我们将提供最大的ICH纵向多重评估评价，并回答 关于脑出血幸存者痴呆发展的主要假设。 PHS 398/2590（Rev.06/09）

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