The primary aim of the TABASCO study is to identify predictors of post stroke cognitive decline. A particular focus will be on inflammatory and stress markers, as well as neuroimaging measures.
Eligibility
Participants are recruited from patients admitted to the Department of Emergency Medicine at the Tel-Aviv Sourasky Medical Center (TASMC) within 72 hours of their first-ever acute ischemic stroke or transient ischemic attack (TIA) symptoms onset.
Criteria
Inclusion Criteria:
1. Age ≥ 50 years
2. Israeli residents
3. Acute stroke/TIA that occurred within the last 3 days as defined by:
acute focal neurological deficit with a total score on the NIH Stroke Scale (NIHSS) \<17
4. Written informed consent by patient prior to study participation
5. Willingness to participate in follow-up
Exclusion Criteria:
patients presenting with a primary hemorrhagic stroke (intracerebral or subarachnoid)
1. history of any preceding cerebral vascular event (excluding previous TIA)
2. imminent death or unconscious state
3. patients unlikely to be released from hospital following the qualifying stroke, or have a severe disability after the qualifying stroke which makes follow-up unlikely
4. known malignant disease or other chronic disease with poor prognosis (predicted survival less than two-years)
5. stroke resulting from trauma or invasive procedure
6. patients with a prestroke history consistent with dementia or cognitive impairment before the stroke
7. severe aphasia.
Stroke diagnosis is verified by senior vascular neurologists and baseline demographic and clinical data are collected. Interviews are conducted by trained interviewers at baseline, 3, 6, 12 and 24 months, and yearly thereafter up to 10 years.
Assessments and data collection A senior vascular neurologist conducts a thorough physical examination and reviews the imaging data and medical records of potential participants to determine eligibility. Participants are asked to consent for all study examinations and a signed informed consent is obtained from patients who agree.
Information is collected for the evaluation of co-morbidities at the time of recruitment and throughout the study.
All subjects are prospectively followed at three-, six-, 12 and 24 months from stroke onset and annually thereafter. Approximately three-months after stroke, consenting participants are visited at home by trained occupational therapists.
For subjects who died, the date of death is recorded along with its cause, based on information obtained from the family, medical records, death certificates and data from the government's official civil registry.
Sample size In an attempt to identify a 40% difference in post stroke cognitive decline, we have calculated the required sample size (Ben Assayag E et al,International Journal of Stroke,Vol 7, June 2012, 341-347).
The investigators aim to recruit at least 1125 participants to allow for loss to follow-up, potential clustering effects, missing data and to provide sufficient numbers for multivariate modeling.
Investigators
Principal Investigators:
Natan Bornstein, Prof. Tel Aviv Sourasky Medical Center Amos Korczyn, Prof. Tel Aviv University Einor Ben Assayag, Phd Tel Aviv Sourasky Medical Center
