FIND Stroke Recovery Study (FIND): rationale and protocol for a longitudinal observational cohort study of trajectories of recovery and biomarkers poststroke

BMJ Open · 12 authors, 14 centres

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This paper describes the protocol for the FIND Stroke Recovery Study, a prospective longitudinal cohort study designed to track trajectories of cognitive, neurological, and functional recovery in first-ever stroke patients.

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The FIND Stroke Recovery Study is a prospective observational cohort study enrolling first-ever stroke patients at a Swedish hospital. The protocol outlines a design for repeated assessments of neurological, cognitive, functional, and patient-reported outcomes at multiple time points over five years. It includes broad cognitive testing, validated clinical scales (NIHSS, mRS), advanced neuroimaging (MRI), and repetitive blood sampling for multi-omic biomarker profiling (protein, RNA, DNA). The study aims to capture detailed trajectories of recovery and associate them with biomarkers. Key strengths are the comprehensive, longitudinal phenotyping and biomarker collection. Limitations noted include potential heterogeneity in acute-phase sample timing, under-representation of severe stroke cases, and the impact of aphasia on cognitive test performance and the COVID-19 pandemic on recruitment and follow-up procedures.

STUDY TYPE

cohort

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neurology

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ORIGINAL PAPER

PMC10173956

FIND Stroke Recovery Study (FIND): rationale and protocol for a longitudinal observational cohort study of trajectories of recovery and biomarkers poststroke

BMJ Open

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ABSTRACT

Introduction Comprehensive studies mapping domain-specific trajectories of recovery after stroke and biomarkers reflecting these processes are scarce. We, therefore, initiated an exploratory prospective observational study of stroke cases with repeated evaluation, the FIND Stroke Recovery Study . We aim to capture trajectories of recovery from different impairments, including cognition, in combination with broad profiling of blood and imaging biomarkers of the recovery. Methods and analysis We recruit individuals with first-ever stroke at the stroke unit at the Sahlgrenska University Hospital, Sweden, to FIND. The inclusion started early 2018 and we aim to enrol minimum 500 patients. Neurological and cognitive impairments across multiple domains are assessed using validated clinical assessment methods, advanced neuroimaging is performed and blood samples for biomarker measuring (protein, RNA and DNA) at inclusion and follow-up visits at 3 months, 6 months, 1 year, 2 years and 5 years poststroke. At baseline and at each follow-up visit, we also register clinical variables known to influence outcomes such as prestroke functioning, stroke severity, acute interventions, rehabilitation, other treatments, socioeconomic status, infections (including COVID-19) and other comorbidities. Recurrent stroke and other major vascular events are identified continuously in national registers. Ethics and dissemination FIND composes a unique stroke cohort with detailed phenotyping, repetitive assessments of outcomes across multiple neurological and cognitive domains and patient-reported outcomes as well as blood and imaging biomarker profiling. Ethical approval for the FIND study has been obtained from the Regional Ethics Review Board in Gothenburg and the Swedish Ethics Review Board. The results of this exploratory study will provide novel data on the time course of recovery and biomarkers after stroke. The description of this protocol will inform the stroke research community of our ongoing study and facilitate comparisons with other data sets. Trial registration number The protocol is registered at http://www.clinicaltrials.gov , Study ID: NCT05708807 .

CITATION EXPORT

Cecilia Brännmark, Sofia Klasson, Tara M Stanne et al.. FIND Stroke Recovery Study (FIND): rationale and protocol for a longitudinal observational cohort study of trajectories of recovery and biomarkers poststroke. BMJ Open. (2023). https://doi.org/10.1136/bmjopen-2023-072493

AUTHORS

12 · 14 CENTRES

Cecilia Brännmark, Sofia Klasson, Tara M Stanne, Hans Samuelsson, Margit Alt Murphy, Katharina S Sunnerhagen, N. David Åberg, Oscar Jalnefjord, Isabella Björkman-Burtscher, Katarina Jood, Turgut Tatlisumak, Christina Jern

1Department of Laboratory Medicine, Institute of Biomedicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
2Region Västra Götaland, Sahlgrenska University Hospital, Department of Research, Development, Education and Innovation, Gothenburg, Sweden
3Region Västra Götaland, Sahlgrenska University Hospital, Department of Clinical Genetics and Genomics, Gothenburg, Sweden
4Institute of Psychology, Faculty of Social Sciences, University of Gothenburg, Gothenburg, Sweden
5Region Västra Göraland, Sahlgrenska University Hospital, Department of Rehabilitation Medicin, Gothenburg, Sweden
6Region Västra Götaland, Sahlgrenska University Hospital, Department of Occupational Therapy and Physiotherapy, Gothenburg, Sweden
7Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
8Region Västra Götaland, Sahlgrenska University Hospital, Department of Acute Medicine and Geriatrics, Gothenburg, Sweden
9Institute of Medicine, Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
10Department of Medical Radiation Sciences, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg, Sweden
11Region Västra Götaland, Sahlgrenska University Hospital, Department of Medical Physics and Biomedical Engineering, Gothenburg, Sweden
12Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg, Sweden
13Region Västra Götaland, Sahlgrenska University Hospital, Department of Radiology, Gothenburg, Sweden
14Region Västra Götaland, Sahlgrenska University Hospital, Department of Neurology, Gothenburg, Sweden