MicroRNA Diagnostics in Subarachnoid Hemorrhage 2
Keywords
Abstract
Description
In this study of patients suffering an aneurysmal subarachnoid hemorrhage (SAH) we would like to validate former results from CSF studies through microRNA profiling investigate the pathophysiological mechanisms that lead to systemic complications such as cardiac dysfunction, acute lung injury (ALI) and systemic inflammatory response syndrome(SIRS).
We will accomplish this through analyzing the profile of microRNA expression in blood and cerebrospinal fluid from SAH patients.
Validation:
As in our earlier study we wish to compare the expression of 20 specific microRNA between 12 patients developing DCI (group 1) and 12 patients without DCI (group 2) in cerebrospinal fluid drawn on day 5 after ictus. In addition, some of the patients will have established invasive neuromonitoring including microdialysis in which we will study changes of certain microRNAs.
DCI as defined by Vergouwen et al in Stroke 2010;41(10):2391-2395:
"The occurrence of focal neurological impairment (such as hemiparesis, aphasia, apraxia, hemianopia, or neglect), or a decrease of at least 2 points on the Glasgow Coma Scale (either on the total score or on one of its individual components [eye, motor on either side, verbal]). This should last for at least 1 hour, is not apparent immediately after aneurysm occlusion, and cannot be attributed to other causes by means of clinical assessment, CT or MRI scanning of the brain, and appropriate laboratory studies."
Systemic complications:
Furthermore, we wish to compare the expression of 754 specific microRNA in blood drawn on day 3 after ictus between patients with ALI (as described Kahn et al, Crit Care Med. 2006; 34: 196-202) and patients without ALI. Of at least 36 patients expected to be included 12 should statistically develop ALI according to the referred definition.
Additionally, we wish to compare the expression of 754 specific microRNA between 12 patients developing DCI (group 1) and 12 patients without DCI (group 2) in blood drawn on day 3 after ictus.
Moreover, we wish to compare the expression of 754 specific microRNA in blood between 36 patients (group 1-3) to that of healthy controls. The specific microRNAs of interest in which the expression in blood between patients with systemic complication are analyzed daily to investigate the dynamic changes in expression and compared to the clinical course.
Dates
| Last Verified: | 04/30/2015 |
| First Submitted: | 10/27/2014 |
| Estimated Enrollment Submitted: | 12/14/2014 |
| First Posted: | 12/18/2014 |
| Last Update Submitted: | 05/24/2015 |
| Last Update Posted: | 05/26/2015 |
| Actual Study Start Date: | 10/31/2014 |
| Estimated Primary Completion Date: | 04/30/2015 |
| Estimated Study Completion Date: | 04/30/2015 |
Condition or disease
Phase
Arm Groups
| Arm | Intervention/treatment |
|---|---|
| SAH with DCI After 21 days from ictus the patients with subarachnoid hemorrhage are stratified to group 1 or 2 depending on their development of delayed cerebral ischemia. | |
| SAH without DCI After 21 days from ictus the patients with subarachnoid hemorrhage are stratified to group 1 or 2 depending on their development of delayed cerebral ischemia. | |
| SAH good grade SAH without external ventricular drainage | |
| Healthy controls Blood sample in healthy donors registered in the National Donor Registry. |
Eligibility Criteria
| Ages Eligible for Study | 18 Years To 18 Years |
| Sexes Eligible for Study | All |
| Sampling method | Probability Sample |
| Accepts Healthy Volunteers | Yes |
| Criteria | Inclusion Criteria Group 1-3: - Uncertainty < 24 times on time of ictus Inclusion Criteria Group 1-2: - Patients admitted to Neurointensive Department in Rigshospitalet with aneurysmal SAH treated with external ventricular drain. Inclusion Criteria Group 3: - Patients admitted to Neurointensive Department in Rigshospitalet with aneurysmal SAH treated without external ventricular drain. Exclusion Criteria Group 1-3: - Transfer to other hospital within 5 days of admission |
Outcome
Primary Outcome Measures
1. Delayed Cerebral Ischemia [21 days]
2. Delayed Cerebral Ischemia and Cerebral infarction [21 days]
3. Delayed Cerebral infarction [21 days]
Secondary Outcome Measures
1. Acute Lung Injury [21 days]
2. Cardiac Dysfunction [21 days]
3. Systemic Inflammatory Response Syndrome [21 days]
4. Early Brain Injury [Clinical evaluation 24-72 hours after ictus. (Wake-up call if sedated)]
