Determinants of Incident Stroke Cognitive Outcomes and Vascular Effects on RecoverY

Recruiting now

Conditions studied: Ischemic Stroke, Intracerebral Hemorrhage, Subarachnoid Hemorrhage, Dementia, Vascular, Mild Cognitive Impairment, Vascular Cognitive Impairment

In brief

The overall goal of the DISCOVERY study is to better understand what factors contribute to changes in cognitive (i.e., thinking and memory) abilities in patients who experienced a stroke. The purpose of the study is to help doctors identify patients at risk for dementia (decline in memory, thinking and other mental abilities that significantly affects daily functioning) after their stroke so that future treatments may be developed to improve outcomes in stroke patients. For this study, a "stroke" is defined as either (1) an acute ischemic stroke (AIS, or blood clot in the brain), (2) an intracerebral hemorrhage (ICH, or bleeding in the brain), (3) or an aneurysmal subarachnoid hemorrhage (aSAH, or bleeding around the brain caused by an abnormal bulge in a blood vessel that bursts). The investigators hypothesize that: 1. The size, type and location of the stroke play an important role in recovery of thinking and memory abilities after stroke, and pre-existing indicators of brain health further determine the extent of this recovery. 2. Specific stroke events occurring in individuals with underlying genetic or biological risk factors can cause further declines in brain heath, leading to changes in thinking and memory abilities after stroke. 3. Studying thinking and memory alongside brain imaging and blood samples in patients who have had a stroke allows for earlier identification of declining brain health and development of individualized treatment plans to improve patient outcomes in the future.

Key facts

Study ID: NCT04916210
Run by: Massachusetts General Hospital
People needed: 8000
Starts: 2021-03-05
Expected to finish: 2026-08-31
Last updated by the study team: 2025-11-03

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

Age ≥18 years
Admitted to the enrolling clinical performance site (CPS) hospital with a diagnosis of acute ischemic stroke (AIS), intracerebral hemorrhage (ICH), or aneurysmal subarachnoid hemorrhage (aSAH)
Radiographic confirmatory evidence of: (1) AIS (based on a focal area of restricted diffusion on MRI), (2) non-traumatic primary ICH (based on evidence of acute parenchymal hemorrhage on CT or brain MRI) or (3) non-traumatic acute aSAH (based on evidence of subarachnoid hemorrhage on CT or MRI and evidence of aneurysm on CT angiography, MR angiography, or conventional catheter-based angiography)
Able to complete baseline visit in person or by phone within 6 weeks of stroke onset
Able to provide informed consent by self or proxy
Fluent in English or Spanish prior to stroke onset

You may not qualify if…

Documented history of pre-stroke dementia or fails dementia pre-screen
Concurrently enrolled into a study that is not approved under the DISCOVERY Co-Enrollment Policy
Unable to complete study protocol (advanced directives such as comfort measures only, or inability to complete the study due to severe medical/behavioral co-morbidities), as determined by physician investigator during screening process
Additional exclusion criteria for Tier 2 participants:
Contraindication to MRI: presence of electrically, magnetically, or mechanically activated implants (such as cardiac pacemakers, cochlear implants, implanted pumps); or metallic clips in the brain
Additional exclusion criteria for Tier 3 participants:
Age <50 years
Biologically female individuals who are pregnant or seeking to become pregnant
Known to have one of the following genetic conditions which can increase the risk of developing cancer: Cowden disease, Lynch syndrome, hypogammaglobulinemia, Wiskott-Aldrich syndrome, Down's syndrome.

Where it is running

University of Washington, Harborview Medical Center — Seattle, Washington, United States (enrolling)
Kaiser Permanente Los Angeles Medical Center — Los Angeles, California, United States (enrolling)
Cedars Sinai Medical Center — Los Angeles, California, United States (enrolling)
University of California Los Angeles — Los Angeles, California, United States (enrolling)
University of California San Diego — San Diego, California, United States (enrolling)
University of Colorado — Denver, Colorado, United States (enrolling)
Mayo Clinic — Jacksonville, Florida, United States (enrolling)
University of Miami Health System — Miami, Florida, United States (enrolling)
The University of Chicago Medical Center — Chicago, Illinois, United States (enrolling)
Indiana University — Indianapolis, Indiana, United States (enrolling)
University of Utah — Salt Lake City, Utah, United States (enrolling)
University of Virginia — Charlottesville, Virginia, United States (enrolling)
Barrow Neurological Institute — Phoenix, Arizona, United States (enrolling)
University of Maryland Medical Center — Baltimore, Maryland, United States (enrolling)
Massachusetts General Hospital — Boston, Massachusetts, United States (enrolling)
Boston Medical Center — Boston, Massachusetts, United States (enrolling)
University of Minnesota Health — Minneapolis, Minnesota, United States (enrolling)
Mayo Clinic — Rochester, Minnesota, United States (enrolling)
University of Mississippi Medical Center — Jackson, Mississippi, United States (enrolling)
Icahn School of Medicine at Mount Sinai — New York, New York, United States (enrolling)
Montefiore Medical Center — The Bronx, New York, United States (enrolling)
Duke University Medical Center — Durham, North Carolina, United States (enrolling)
University of Cincinnati — Cincinnati, Ohio, United States (enrolling)
The Hospital of the University of Pennsylvania — Philadelphia, Pennsylvania, United States (enrolling)
Methodist University Hospital — Memphis, Tennessee, United States (enrolling)

Full record on ClinicalTrials.gov

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