Chronic cerebral artery occlusion (CCAO), which is characterized by the pathophysiological change of long-term cerebral hemodynamic disorder, is one of the major risk factors affect the occurrence and recurrence of ischemic stroke. However, the mechanism of CCAO injury is not clear and effective treatment is warranted. The purpose of this study is to investigate the protective effect and underlying mechanism of remote ischemic conditioning (RIC) on CCAO.
CCAO is a cerebrovascular disease due to cerebral hypo-perfusion. It is often associated with repeated ischemic stroke or transient neurological symptoms, progressive cognitive decline and reduction of daily ability. Specific and effective treatment is warranted for symptomatic management of CCAO. RIC is a non-invasive strategy to protect the brain. The clinical trials have demonstrated that daily limb RIC seems to be potentially effective in patients with symptomatic intracranial arterial stenosis in cerebral blood flow and metabolism. RIC can also ameliorate cerebral small vessel disease in slowing cognition decline and reducing white matter. Therefore, it is worth to investigate the neuroprotective mechanism of RIC for CCAO.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
30
The LRIC treatment consisted of 5 cycles of bilateral upper limb ischemia for 5 minutes followed by reperfusion for another 5 minutes performed twice a day for a total of 180 consecutive days.The procedure was performed by using an electric autocontrol device with cuffs that inflated to a pressure of 200 mmHg during the ischemic period and deflated during the reperfusion.(Patent No.CN200820123637.X, China).
Xuanwu Hospital Capital Medical University
Beijing, China
RECRUITINGChange of cerebral blood flow perfusion
The investigators evaluate the change of perfusion capacity of cerebral blood vessels on PWI-MRI.
Time frame: 180 days
Recurrence times of stroke or transient ischemic attack (TIA)
The investigators evaluate the times of stroke or transient ischemic attack (TIA) recurrence.
Time frame: 180 days
Changes of volume of WMHs
The investigators evaluate the the change of volume of WMHs on Flairs-MRI.
Time frame: 180 days
Change of the direction of white matter cellulose
The investigators evaluate the change of direction of white matter cellulose on DTI-MRI.
Time frame: 180 days
Change of cerebral hemoglobin oxygenation status
The investigators evaluate the change of cerebral hemoglobin oxygenation status on BOLD-rsfMRI.
Time frame: 180 days
Change of collateral circulation
The investigators evaluate the change of collateral circulation on ASL-MRI.
Time frame: 180 days
Change of the Montreal Cognitive Assessment (MoCA) score
The investigators evaluate the change of neurobehavioral function by the Montreal Cognitive Assessment (MoCA) score. The minimum value is 0 and maximum value is 30. The higher scores represent the better outcome.
Time frame: 180 days
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Change of the Verbal Fluency Test (VFT) score
The investigators evaluate the change of neurobehavioral function by the Verbal Fluency Test (VFT) score. The minimum value is 0 and without the maximum value. The higher scores represent the better outcome.
Time frame: 180 days
Change of the Digit Span Forward and Backward score
The investigators evaluate the change of neurobehavioral function by the Digit Span Forward and Backward score. The minimum value is 3 and maximum value is 12. The higher scores represent the better outcome.
Time frame: 180 days
Change of the Hamilton Depression-17 (HAMD-17) scale
The investigators evaluate the change of neuropsychological function by the Hamilton Depression-17 (HAMD-17) scale. The minimum value is 0 and maximum value is 54. The higher scores represent the worse outcome.
Time frame: 180 days
Change of the Hamilton Anxiety (HAMA) scale
The investigators evaluate the change of neuropsychological function by the Hamilton Anxiety (HAMA) scale. The minimum value is 0 and maximum value is 56. The higher scores represent the worse outcome.
Time frame: 180 days
Adverse events related to RIC treatment
Adverse events related to RIC treatment, such as mucocutaneous hemorrhage, changes in coagulation function and so on.
Time frame: From baseline to 180-day treatment