IPSS Sub-Studies

 

Vascular Effects of Infection in Pediatric Stroke (VIPS) I and II

The purpose of the VIPS study is to learn more about childhood ischemic stroke. It is hypothesized that infections and the body’s reaction to it can play a role in the occurrence of a stroke.

The first VIPS study took place between 2010-2012 with 355 paediatric stroke cases and 354 controls enrolled from 39 centres. It helped us better understand the relationship between infections and childhood stroke. We found that:

  • Minor childhood infections can act as a trigger for a stroke, especially in children who have some other reason for stroke, like a heart abnormality.
  • The infections that occur right before a childhood stroke are mostly just the common cold.
  • Blood tests for a family of viruses called herpesviruses showed that many children with stroke had the herpes simplex virus type 1. The herpes simplex virus type 1 is the cause of cold sores. Most of the herpesvirus infections were “subclinical”, meaning the child did not have cold sores or any other outward signs of infection.
  • Routine childhood vaccinations seem to help protect children against stroke.

However, infections are so common in children, but stroke is so rare. How does this add up? This question is why the VIPS study was extended to Part 2. In VIPS II, blood samples and throat swabs are collected from our study participants to detect the bugs that are infecting children with stroke and to study their inflammatory response.

VIPS II began enrolling participants in December 2016 and will continue until 2021. The goal is to enroll 200 acute stroke patients, 100 well controls, and 100 ill controls. Hospitals in Canada, the USA and Australia are participating in this study.
This study is funded by a grant from the National Institutes of Health (NIH) and Neurological Disorders and Stroke (NINDS).

Seizures in Pediatric Stroke (SIPS) I and II

The purpose of the SIPS study is learn more about acute seizures after paediatric stroke. SIPS patients are being studied longitudinally to observe neurological recovery and to determine the neuroimaging and electrographic biomarkers associated with seizure after stroke.

The first part of the SIPS study enrolled 142 acute stroke patients from 2011-2013. An extension to this study (SIPS II) was awarded in December 2015, with an additional 160 acute stroke patients recruited to participate in SIPS II. All SIPS patients had follow-up data collected one-year after their stroke to assess the role of seizures in neurological outcomes.

The SIPS Study completed enrollment and data collection in August 2018. The SIPS Investigators are currently analyzing the clinical data in preparation for manuscript writing. The manuscripts will focus on the association between seizures after stroke with stroke-related death, neurological recovery and epilepsy risk. Furthermore, we will analyze neuroimaging and electrophysiology data to identify biomarkers that are associated with neurological outcomes and epilepsy.

This study is funded by a grant from Pediatric Epilepsy Research Foundation (PERF).

PTSD, Anxiety and Depression in Parents and Children with PAIS (PIPS)

This is a prospective cross-sectional study examining children and their parents 9 to 31 months from diagnosis of the child’s arterial ischemic stroke for chronic symptoms of Post-Traumatic Stress Disorder (PTSD), anxiety, and depression. The purpose of this study is to investigate the association between both child’s and parental emotional adjustment with each other and with child’s functional outcome. The study will also analyze the relationship between stroke size and location with child and parental emotional outcomes.

The study will involve a series of questionnaires that collect information emotional symptoms and outcomes after stroke, specifically PTSD, anxiety, and depression in the parent(s) and child. This includes the UCLA PTSD Reaction Index, Behavioural Assessment System for Children (BASC-3), PTSD Checklist (PCL-5) and the Becks Depression Inventory-II (BDI-II) and Becks Anxiety Inventory (BAI).  These findings will then be compared to the location of the stroke as well as the size of the stroke to see if there is an association between the lesion location and the emotional outcomes of the child. Additionally, the Recovery and Recurrence Questionnaire (RRQ) and Pediatric Stroke Outcome measure (PSOM) will also be used. The study plans to finish enrollment by end of 2021.

Parental Outcome following Perinatal Stroke Study (POPS)

This is a longitudinal cohort study of parents of children with neonatal stroke with an educational video intervention. The parents will be given access to an online video discussing etiology of perinatal stroke after filling out the baseline surveys on their emotional symptoms.

The purpose of this study to determine the prevalence of Post-Traumatic Stress Disorder (PTSD), anxiety and depression in a large international cohort of parents of children diagnosed with perinatal stroke. The study also aims to determine whether an educational video on etiology of perinatal stroke will decrease parental guilt and blame along with symptoms of PTSD, anxiety, and depression in parents of children recently diagnosed with perinatal stroke.

The study involves having both a pre and post video assessment for guilt and blame as well as symptoms of anxiety, depression, and PTSD. Parents will have unlimited use of the video and there will be a plan to retest at three months post video release to see if there is a lasting benefit from the video. The study will also involve a demographic survey, the Recovery and Recurrence Questionnaire (RRQ), Parental Outcome Measure (POM), Beck’s Anxiety Inventory (BAI), Beck’s Depression Inventory-Second edition (BDI-II) and post Traumatic Stress Checklist for DSM-5 (PCL-5). The study plans to finish enrollment by end of 2021 with a recruitment goal of 60 parents.

If you are interested in joining IPSS to get involved with our current and upcoming studies please contact us !