Brain Abscess

Researchers are investigating the effects of two different doses of bevifibatide citrate injection for patients who have had an acute ischemic stroke without large or medium-sized vessel blockage. This phase 2, single-center, randomized, double-blind trial aims to find a dose that improves neurological outcomes 90 days after stroke while minimizing the risk of symptomatic brain bleeding and serious side effects. The trial will provide important information to guide future larger studies on dosing. Participants receive bevifibatide citrate injection through an intravenous bolus of 220 mcg/kg over 1 to 2 minutes, followed by a continuous intravenous infusion for 24 hours. Two groups receive different maintenance infusion rates: one at 2.5 mcg/kg/min and the other at 2.0 mcg/kg/min. After the infusion and if imaging within 48 hours shows no significant brain bleeding, patients will take aspirin and clopidogrel tablets daily until day 90. Patients are also managed according to current stroke care guidelines, including possible use of low molecular weight heparin for blood clot prevention. During the study, participants will have neurological assessments using the modified Rankin Scale and National Institute of Health Stroke Scale at various time points up to 90 days. Brain scans will monitor for bleeding within 48 hours. Researchers will track adverse events, mortality, platelet aggregation inhibition, and quality of life. Follow-up lasts 90 days after treatment to evaluate both safety and neurological recovery. The total participation duration covers initial treatment and multiple assessments over this period.

Researchers are studying the development of neural flexibility, measured by MRI, as an indicator of cognitive flexibility in Chinese toddlers aged 32 to 42 months. The study also evaluates executive functions such as inhibition, shifting attention, emotional control, working memory, and planning using the Global Executive Composite score from a standardized rating scale. This research aims to better understand brain development and cognitive abilities during early childhood. Participants are divided into two groups based on their daily milk consumption: one group receives S-26 GOLD or ULTIMA GUM formula, while the other consumes cow's milk. Parents continue feeding their children these milk products throughout the study, and information about milk consumption is collected starting up to two months before and during the study period. The brain is examined using MRI, a safe and non-invasive imaging technology. During the study, toddlers undergo MRI scans and assessments of brain structure and function at the start and again at 42 months of age. Researchers also evaluate cognitive flexibility, behavior, curiosity, sleep quality, home environment, feeding practices, and fecal microbiota composition over time. Parents provide information through interviews, and the child's development and school readiness are monitored. The study runs from baseline through 42 months of age, with additional home environment data collected at 8 months after baseline.

Researchers are evaluating the CIPHER System in patients undergoing brain tumor removal surgery for newly diagnosed supratentorial glioma. This First-in-Human clinical investigation aims to assess the safety and basic performance of a novel, highly flexible, electrode-dense cortical probe designed for neurophysiological mapping and stimulation during brain tumor resection. The study focuses on how well the device functions and its handling characteristics during short-term use in surgery. Participants will have the CIPHER Probe placed on the surface of the brain during standard tumor removal surgery. Two groups are studied: one where only neural activity is recorded and another where both recording and electrical stimulation are performed using the probe. No stimulation is delivered in the recording-only group. The device is tested on the main tumor area and the surrounding tissue margin just before tumor removal. During the study, participants will be monitored through hospital visits during their recovery period, including follow-ups at two and six weeks after surgery. Researchers will collect data on any device or procedure-related adverse events, spontaneous neural activity, signal quality, and device deficiencies. The total study period includes enrollment through the six-week postoperative follow-up to evaluate safety and device performance.

Gliomas are aggressive tumors that originate from glial or stem cells, with patients typically surviving between 12 to 15 months. This research investigates whether a classic ketogenic diet (CKD), which restricts carbohydrate intake and increases fat consumption to induce ketosis, can help extend survival in patients with high-grade gliomas and brain metastases. The study compares outcomes to historical controls to evaluate the diet's potential therapeutic effect. Participants will follow the CKD for an initial period of 3 months, which is a high-fat, low-carbohydrate diet adjusted to each patient's energy needs by dietitians. This diet aims to reduce blood glucose levels and increase ketone bodies to stimulate biochemical changes. Patients and their families will receive training on meal planning and ketone/glucose monitoring, and dietitians will provide ongoing support and follow-up visits. Throughout the study, participants will regularly monitor their urine and blood ketone levels daily and maintain records. Researchers will assess overall survival up to 36 months, tumor size changes, time to progression, quality of life, and functional impairment using established scales and surveys. Follow-up evaluations will occur at baseline and various intervals up to 24 months. The study includes safety assessments and continues monitoring until death or the study endpoint.

Researchers are investigating the effects of a multidomain lifestyle intervention to slow cognitive decline and dementia risk in elderly residents aged 60 to 80 in Zhejiang Province, China. The study builds on findings from Finland, where a similar approach combining physical activity, nutrition, cognitive training, social activities, and vascular risk management showed promise in healthy older adults at risk of cognitive decline. This trial aims to explore how such an intervention may change brain structure and function as well as cognitive abilities in an Asian population. Participants are randomly assigned to either a structured multidomain intervention group or a self-guided control group. The intervention group receives tailored nutritional guidance, cognitive training, physical exercises, and vascular risk monitoring, all adapted to Chinese cultural norms. The control group receives regular health education campaigns and basic health monitoring every 6 to 12 months. This trial runs for two years with ongoing assessments to evaluate the impact of these lifestyle changes. During the study, participants undergo various evaluations including cognitive tests measuring global and domain-specific cognition, neuroimaging scans like MRI and fMRI, laboratory blood tests, and physical performance measures such as grip strength and gait speed. Questionnaires assess quality of life, depression, sleep quality, and daily activities. Researchers also monitor cardiovascular health, dementia onset, and falls. This comprehensive monitoring will help determine the intervention's effects on brain health and daily functioning over the 24-month period.

Researchers are evaluating the use of a bioresorbable bone adhesive called Tetranite for improving cranial flap fixation in patients undergoing craniotomy. This pilot clinical study aims to demonstrate the safety and effectiveness of Tetranite compared to current metal fixation methods, with assessments at the time of fixation and after six months. The study focuses on safety outcomes and patient-reported results to support further clinical studies involving more patients. Participants will receive cranial flap fixation using either the standard metal plates and screws with Tetranite applied to fill kerf lines and burr holes, or Tetranite alone for flap fixation. The study includes two groups: the first five patients will have metal fixation plus Tetranite augmentation, followed by patients receiving only Tetranite. Treatments are delivered during surgery, with follow-up evaluations extending to twelve months. Participants will be monitored through clinical assessments including CT imaging to evaluate bone healing and flap position, clinical palpation to check flap immobility, and patient surveys measuring pain and quality of life. The primary safety outcome is the rate of serious device or procedure-related adverse effects within six months. Secondary measures include radiolucency changes, device-related events, flap translation, and patient-reported outcomes over a one-year period. The total participation time includes surgery and follow-up visits for up to twelve months.

Researchers are evaluating the effects of different durations of dual-antiplatelet therapy (DAPT) followed by ticagrelor monotherapy in patients with symptomatic vertebral artery stenosis who have undergone Bridge implantation. The study compares the incidence of a combined outcome including non-fatal ischemic stroke, transient ischemic attack (TIA), and all-cause mortality over a 12-month follow-up period. This trial aims to determine the optimal length of DAPT to improve patient outcomes after the procedure. Participants are randomly assigned to one of two treatment groups: one group receives 3 months of dual-antiplatelet therapy followed by 9 months of ticagrelor alone, while the other group receives 6 months of dual-antiplatelet therapy followed by 6 months of ticagrelor monotherapy. The Bridge device (MicroPort NeuroTech, Shanghai, China) is implanted in all participants as part of the treatment for vertebral artery stenosis. Throughout the study, participants will be monitored regularly to assess the occurrence of stroke, TIA, mortality, bleeding events, and neurological outcomes at various time points, including 1 month and 12 months after treatment. Imaging follow-up will evaluate in-stent stenosis in a subgroup of patients. The primary outcome is measured at 12 months, and safety and efficacy are closely observed during this period. The total study duration for each participant is approximately one year.

Researchers are developing a new, comprehensive AI vision-language foundation model to improve diagnosis and interpretation of various brain diseases. This observational study aims to use multiple types of data including patient demographics, medical imaging like MRI, CT, and PET scans, histopathological and genomic data when available, plus other lab tests to create a detailed screening and diagnostic tool for brain diseases. The study also seeks to establish a diagnostic model that includes uncertainty quantification and automated report generation for a wide range of brain conditions. Additionally, the model will be validated using MRI scans from large populations. This study does not involve any interventions or treatments. Instead, it collects and analyzes a variety of clinical and imaging data from patients diagnosed with brain diseases such as brain tumors and neurodegenerative disorders, as well as from individuals without brain disease who have complete brain MRI scans and clinical data. Data quality is important, so cases with incomplete or poor-quality MRI scans are excluded from analysis. Participants will contribute their existing clinical case data and brain imaging results to support model development and validation. The main outcome measure is the performance of the AI model in diagnosing brain diseases during the perioperative period. Since this is an observational study, there are no active treatments or procedures for participants. The study is sponsored by Xiangya Hospital of Central South University and aims to advance brain disease diagnosis through large-scale data analysis and AI technology.

Researchers are evaluating the safety and effectiveness of a new device called the IRRAflow Active Fluid Exchange System compared to the standard External Ventricular Drain (EVD) in patients with brain bleeding and infections. This study focuses on conditions such as intraventricular hemorrhage, subarachnoid hemorrhage, subdural hematoma, and ventriculitis. The goal is to see if the IRRAflow device can better remove cerebrospinal fluid, blood, and harmful bacteria from specific brain spaces. Participants will be randomly assigned to receive either the IRRAflow device or the EVD device. Both devices are used to monitor and reduce intracranial pressure by draining excess fluid from the brain. The IRRAflow system includes an irrigation feature to help keep the drainage catheter clear by using programmed pulses of fluid, while the EVD device represents the current standard care method. After the procedure, participants will be followed for one month to compare outcomes between the two groups. During the study, participants will undergo various assessments including head CT scans to measure clearance of blood or bacterial mass, monitoring for catheter-related infections, tracking the length of stay in intensive care, and evaluating functional status at the start and 30 days after discharge. Researchers will also monitor rates of revision procedures, shunt dependency, and mortality during and after treatment. The study aims to provide detailed information about how these devices perform in managing intracranial bleeding and infections over a one-month period.

Researchers are evaluating whether the widely available artificial intelligence platform ChatGPT can accurately identify abnormalities on cytology specimens taken during endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) of solid mass lesions in the gastrointestinal tract. The study compares AI interpretations with those made by experienced cytopathologists, who are considered the gold standard. The research aims to address the limited availability of onsite cytopathology services that currently affect diagnostic accuracy and efficiency. The study involves the use of EUS-guided fine needle biopsy to collect cytology specimens from solid mass lesions in the gastrointestinal tract. There are two interpretation groups: one where cytopathologists review specimens onsite, and another where the AI program analyzes the samples. The study observes and compares diagnostic accuracy between these two methods without intervening in patient care. Participants will undergo the biopsy procedure, and their cytology specimens will be evaluated either by onsite cytopathologists or by the AI program. Researchers will measure the diagnostic accuracy at rapid onsite evaluation within one day and compare it to final pathology results obtained within seven days. The study is observational and will monitor these outcomes without additional treatment, lasting until October 2027.