Frontiers in Neurology (Sep 2022)

Toward individualized medicine in stroke—The TiMeS project: Protocol of longitudinal, multi-modal, multi-domain study in stroke

  • Lisa Fleury,
  • Lisa Fleury,
  • Philipp J. Koch,
  • Philipp J. Koch,
  • Philipp J. Koch,
  • Maximilian J. Wessel,
  • Maximilian J. Wessel,
  • Maximilian J. Wessel,
  • Christophe Bonvin,
  • Diego San Millan,
  • Christophe Constantin,
  • Philippe Vuadens,
  • Jan Adolphsen,
  • Andéol Cadic Melchior,
  • Andéol Cadic Melchior,
  • Julia Brügger,
  • Julia Brügger,
  • Elena Beanato,
  • Elena Beanato,
  • Martino Ceroni,
  • Martino Ceroni,
  • Pauline Menoud,
  • Pauline Menoud,
  • Diego De Leon Rodriguez,
  • Valérie Zufferey,
  • Nathalie H. Meyer,
  • Philip Egger,
  • Philip Egger,
  • Sylvain Harquel,
  • Sylvain Harquel,
  • Traian Popa,
  • Traian Popa,
  • Estelle Raffin,
  • Estelle Raffin,
  • Gabriel Girard,
  • Gabriel Girard,
  • Gabriel Girard,
  • Jean-Philippe Thiran,
  • Jean-Philippe Thiran,
  • Jean-Philippe Thiran,
  • Claude Vaney,
  • Vincent Alvarez,
  • Jean-Luc Turlan,
  • Andreas Mühl,
  • Bertrand Léger,
  • Takuya Morishita,
  • Takuya Morishita,
  • Silvestro Micera,
  • Silvestro Micera,
  • Olaf Blanke,
  • Olaf Blanke,
  • Dimitri Van De Ville,
  • Dimitri Van De Ville,
  • Dimitri Van De Ville,
  • Friedhelm C. Hummel,
  • Friedhelm C. Hummel,
  • Friedhelm C. Hummel

DOI
https://doi.org/10.3389/fneur.2022.939640
Journal volume & issue
Vol. 13

Abstract

Read online

Despite recent improvements, complete motor recovery occurs in <15% of stroke patients. To improve the therapeutic outcomes, there is a strong need to tailor treatments to each individual patient. However, there is a lack of knowledge concerning the precise neuronal mechanisms underlying the degree and course of motor recovery and its individual differences, especially in the view of brain network properties despite the fact that it became more and more clear that stroke is a network disorder. The TiMeS project is a longitudinal exploratory study aiming at characterizing stroke phenotypes of a large, representative stroke cohort through an extensive, multi-modal and multi-domain evaluation. The ultimate goal of the study is to identify prognostic biomarkers allowing to predict the individual degree and course of motor recovery and its underlying neuronal mechanisms paving the way for novel interventions and treatment stratification for the individual patients. A total of up to 100 patients will be assessed at 4 timepoints over the first year after the stroke: during the first (T1) and third (T2) week, then three (T3) and twelve (T4) months after stroke onset. To assess underlying mechanisms of recovery with a focus on network analyses and brain connectivity, we will apply synergistic state-of-the-art systems neuroscience methods including functional, diffusion, and structural magnetic resonance imaging (MRI), and electrophysiological evaluation based on transcranial magnetic stimulation (TMS) coupled with electroencephalography (EEG) and electromyography (EMG). In addition, an extensive, multi-domain neuropsychological evaluation will be performed at each timepoint, covering all sensorimotor and cognitive domains. This project will significantly add to the understanding of underlying mechanisms of motor recovery with a strong focus on the interactions between the motor and other cognitive domains and multimodal network analyses. The population-based, multi-dimensional dataset will serve as a basis to develop biomarkers to predict outcome and promote personalized stratification toward individually tailored treatment concepts using neuro-technologies, thus paving the way toward personalized precision medicine approaches in stroke rehabilitation.

Keywords