Imaging and Serological Biomarkers of Autonomic Dysfunction After Ischemic Stroke

Summary

The goal of this observational study is to * to investigate the prevalence and time course of autonomic dysfunction in acute ischemic stroke patients; * to evaluate the influence of lesion location on autonomic dysfunction; * to identify patterns of structural and functional brain connectivity within the central autonomic control circuits associated with autonomic dysfunction; and * to explore causal models of the link between brain lesions; cardiac, immunological and endocrine biomarkers; and dysautonomia. Researchers will compare patients with acute ischemic stroke to patients with transient ischemic attacks to study the effect of acute ischemic brain lesions. Participants will * undergo cardiovascular autonomic function testing; * receive structural and functional MR imaging; * provide blood samples for determinaton of serological biomarkers auf dysautonomia.

Eligibility

Inclusion Criteria:

* Diagnosis of either

  * acute ischemic stroke with either an ischemic lesion visible on CT/MRI or persistent focal deficits 24 hours after symptom onset, or
  * Transient ischemic attack with transient clinical deficits including motor or speech disturbance and not restricted to isolated vertigo/dizziness, visual disturbance, or sensory disturbance.
* symptom onset within 72h prior to hospital admission,
* a pre-stroke/TIA ability to walk without help from another person (modified Rankin scale score \< 4),
* age \> 18 years, and
* informed consent by either the patient or a legal representative (including a spouse)

Exclusion Criteria:

* In-hospital stroke,
* contraindications to MR imaging (e.g., claustrophobia, pregnancy, pacemakers, implants),
* known moderate to severe dementia,
* previous structural brain damage (except leukoariosis due to cerebral small vessel disease),
* hemodynamically relevant stenosis of the common or internal carotid artery, or
* left heart failure with estimated left ventricular ejection fraction \< 50%,
* concomitant systemic illness that can lead to dysautonomia, such as an active infection, thyroid disease, or neurodegenerative disorder (e.g. PD, MSA).

Conditions3

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