Journal of neuroimaging : official journal of the American Society of Neuroimaging
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
CLOTBUST: design of a randomized trial of ultrasound-enhanced thrombolysis for acute ischemic stroke.
Intravenous tissue plasminogen activator (TPA) therapy can be monitored with 2 MHz transcranial Doppler (TCD). This article describes the design of CLOTBUST (combined lysis of thrombus in brain ischemia using transcranial ultrasound and systemic TPA), the first prospective international multicenter randomized clinical trial of noninvasive externally applied ultrasound to enhance systemic thrombolysis in human stroke. ⋯ The aim of phase II CLOTBUST trial is to determine the rates of early complete recanalization and dramatic/early clinical recovery in TPA + TCD and TPA groups. The sample size is set at 126 patients since a medium effect size (.50) is anticipated for TPA + TCD group vs TPA alone to achieve combined primary end-point.
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Case Reports Comparative Study
Is magnetic resonance spectroscopy superior to conventional diagnostic tools in hypoxic-ischemic encephalopathy?
Anoxic brain injury carries a poor prognosis. Therefore, a diagnostic tool sensitive enough to predict its outcome is needed. ⋯ Electroencephalography, somatosensory evoked potentials, and magnetic resonance imaging did not prove to be useful in establishing a definitive prognosis. Magnetic resonance spectroscopy demonstrated the presence of significant neuronal loss in the cortex and cerebellum and was the only diagnostic procedure closely associated with this patient's prognosis.
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Verbal working memory (VWM) deficits have been a well-replicated finding among patients with multiple sclerosis (MS). Functional magnetic resonance imaging (FMRI) studies have described a VWM system in healthy samples; however, functional neuroimaging of this system among MS patients is just beginning to appear. ⋯ Normal performance of a challenging VWM task among high-functioning MS patients is associated with a shift toward greater activity in regions related to sensorimotor functions and anterior attentional/executive components of the VWM system. Posterior memory storage systems appeared unaffected, while portions of the visual processing and subvocal rehearsal systems were less active. Although a shift in neural activity was noted relative to HC participants, deviation from regions normally involved in VWM function was not observed in this patient sample.