title: STroke imAging pRevention and treatment (START): A longitudinal stroke cohort study: Clinical trials protocol.
abstract: BACKGROUND
  Stroke and poststroke depression are common and have a profound and ongoing impact on an individual's quality of life. However, reliable biological correlates of poststroke depression and functional outcome have not been well established in humans.
  
  
  OBJECTIVE
  Our aim is to identify biological factors, molecular and imaging, associated with poststroke depression and recovery that may be used to guide more targeted interventions.
  
  
  METHODS
  In a longitudinal cohort study of 200 stroke survivors, the START-STroke imAging pRevention and Treatment cohort, we will examine the relationship between gene expression, regulator proteins, depression, and functional outcome. Stroke survivors will be investigated at baseline, 24 h, three-days, three-months, and 12 months poststroke for blood-based biological associates and at days 3-7, three-months, and 12 months for depression and functional outcomes. A sub-group (n = 100), the PrePARE: Prediction and Prevention to Achieve optimal Recovery Endpoints after stroke cohort, will also be investigated for functional and structural changes in putative depression-related brain networks and for additional cognition and activity participation outcomes. Stroke severity, diet, and lifestyle factors that may influence depression will be monitored. The impact of depression on stroke outcomes and participation in previous life activities will be quantified.
  
  
  RESULTS
  Clinical significance lies in the identification of biological factors associated with functional outcome to guide prevention and inform personalized and targeted treatments. Evidence of associations between depression, gene expression and regulator proteins, functional and structural brain changes, lifestyle and functional outcome will provide new insights for mechanism-based models of poststroke depression.
authors.affiliation: National Stroke Research Institute, Florey Institute of Neuroscience and Mental Health, Heidelberg, Vic., Australia.|Department of Occupational Therapy, School of Allied Health, La Trobe University, Bundoora, Vic., Australia.
authors.forename: Leeanne M
authors.initials: LM
authors.lastname: Carey
authors.affiliation: National Stroke Research Institute, Florey Institute of Neuroscience and Mental Health, Heidelberg, Vic., Australia.|School of Psychological Sciences, La Trobe University, Bundoora, Vic., Australia.
authors.forename: Sheila
authors.initials: S
authors.lastname: Crewther
authors.affiliation: Preventative Health National Research Flagship, The Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Herston, Qld, Australia.
authors.forename: Olivier
authors.initials: O
authors.lastname: Salvado
authors.affiliation: National Stroke Research Institute, Florey Institute of Neuroscience and Mental Health, Heidelberg, Vic., Australia.|Institute of Neuroscience and Physiology, The Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
authors.forename: Thomas
authors.initials: T
authors.lastname: Lindén
authors.affiliation: Brain Research Institute, Florey Institute of Neuroscience and Mental Health, Heidelberg, Vic., Australia.
authors.forename: Alan
authors.initials: A
authors.lastname: Connelly
authors.affiliation: Preventative Health National Research Flagship, Neurodegenerative Diseases, Mental Disorders and Brain Health, CSIRO, North Ryde, NSW, Australia.
authors.forename: William
authors.initials: W
authors.lastname: Wilson
authors.affiliation: National Stroke Research Institute, Florey Institute of Neuroscience and Mental Health, Heidelberg, Vic., Australia.
authors.forename: David W
authors.initials: DW
authors.lastname: Howells
authors.affiliation: National Stroke Research Institute, Florey Institute of Neuroscience and Mental Health, Heidelberg, Vic., Australia.
authors.forename: Leonid
authors.initials: L
authors.lastname: Churilov
authors.affiliation: National Stroke Research Institute, Florey Institute of Neuroscience and Mental Health, Heidelberg, Vic., Australia.|Stroke Unit, Monash Medical Centre, Department of Medicine, Monash University, Clayton, Vic., Australia.
authors.forename: Henry
authors.initials: H
authors.lastname: Ma
authors.affiliation: National Stroke Research Institute, Florey Institute of Neuroscience and Mental Health, Heidelberg, Vic., Australia.|Department of Occupational Therapy, School of Allied Health, La Trobe University, Bundoora, Vic., Australia.
authors.forename: Tamara
authors.initials: T
authors.lastname: Tse
authors.affiliation: Preventative Health National Research Flagship, The Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Herston, Qld, Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Rose
authors.affiliation: National Stroke Research Institute, Florey Institute of Neuroscience and Mental Health, Heidelberg, Vic., Australia.
authors.forename: Susan
authors.initials: S
authors.lastname: Palmer
authors.affiliation: Preventative Health National Research Flagship, The Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Herston, Qld, Australia.
authors.forename: Pierrick
authors.initials: P
authors.lastname: Bougeat
authors.affiliation: Department of Medicine, Melbourne Brain Centre, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Bruce C V
authors.initials: BC
authors.lastname: Campbell
authors.affiliation: Department of Medicine, Melbourne Brain Centre, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Soren
authors.initials: S
authors.lastname: Christensen
authors.affiliation: Preventative Health National Research Flagship, Neurodegenerative Diseases, Mental Disorders and Brain Health, CSIRO, Parkville, Vic., Australia.
authors.forename: S Lance
authors.initials: SL
authors.lastname: Macaulay
authors.affiliation: National Stroke Research Institute, Florey Institute of Neuroscience and Mental Health, Heidelberg, Vic., Australia.
authors.forename: Jenny
authors.initials: J
authors.lastname: Favaloro
authors.affiliation: National Stroke Research Institute, Florey Institute of Neuroscience and Mental Health, Heidelberg, Vic., Australia.
authors.forename: Victoria
authors.initials: V
authors.lastname: O' Collins
authors.affiliation: Preventative Health National Research Flagship, The Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Herston, Qld, Australia.
authors.forename: Simon
authors.initials: S
authors.lastname: McBride
authors.affiliation: Neuroscience Trials Australia, Melbourne Brain Centre - Austin Campus, Heidelberg, Vic., Australia.
authors.forename: Susan
authors.initials: S
authors.lastname: Bates
authors.affiliation: Neuroscience Trials Australia, Melbourne Brain Centre - Austin Campus, Heidelberg, Vic., Australia.
authors.forename: Elise
authors.initials: E
authors.lastname: Cowley
authors.affiliation: Department of Neurology, Austin Health, Heidelberg, Vic., Australia.
authors.forename: Helen
authors.initials: H
authors.lastname: Dewey
authors.affiliation: Department of Neurology, Western Hospital, Western Health, Melbourne, Vic., Australia.
authors.forename: Tissa
authors.initials: T
authors.lastname: Wijeratne
authors.affiliation: Epworth Healthcare, Melbourne, Vic., Australia.
authors.forename: Richard
authors.initials: R
authors.lastname: Gerraty
authors.affiliation: Stroke Unit, Monash Medical Centre, Department of Medicine, Monash University, Clayton, Vic., Australia.
authors.forename: Thanh G
authors.initials: TG
authors.lastname: Phan
authors.affiliation: Department of Medicine, Melbourne Brain Centre, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Bernard
authors.initials: B
authors.lastname: Yan
authors.affiliation: Department of Neurology, John Hunter Hospital, University of Newcastle, Newcastle, NSW, Australia.
authors.forename: Mark W
authors.initials: MW
authors.lastname: Parsons
authors.affiliation: Department of Neurology, Box Hill Hospital, Eastern Health, Melbourne, Vic., Australia.
authors.forename: Chris
authors.initials: C
authors.lastname: Bladin
authors.affiliation: Department of Neurology, Auckland City Hospital, Auckland, New Zealand.
authors.forename: P Alan
authors.initials: PA
authors.lastname: Barber
authors.affiliation: Department of Neurology, Royal Brisbane and Women's Hospital, Brisbane, Qld, Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Read
authors.affiliation: Department of Neurology, Royal Brisbane and Women's Hospital, Brisbane, Qld, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Wong
authors.affiliation: Flinders Comprehensive Stroke Centre, Flinders Medical Centre and University, Adelaide, SA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Lee
authors.affiliation: Department of Neurology, Royal Adelaide Hospital, Adelaide, SA, Australia.
authors.forename: Tim
authors.initials: T
authors.lastname: Kleinig
authors.affiliation: School of Medicine and Pharmacology, The University of Western Australia, Perth, WA, Australia.|Department of Neurology, Sir Charles Gairdner Hospital, Perth, WA, Australia.
authors.forename: Graeme J
authors.initials: GJ
authors.lastname: Hankey
authors.affiliation: Department of Neurology, Sir Charles Gairdner Hospital, Perth, WA, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Blacker
authors.affiliation: Department of Neurology, St. Vincent's Hospital, Sydney, NSW, Australia.
authors.forename: Romesh
authors.initials: R
authors.lastname: Markus
authors.affiliation: Department of Neurology, Lyell McEwin Hospital, Adelaide, SA, Australia.
authors.forename: James
authors.initials: J
authors.lastname: Leyden
authors.affiliation: Department of Neurology, Royal North Shore Hospital, Sydney, NSW, Australia.
authors.forename: Martin
authors.initials: M
authors.lastname: Krause
authors.affiliation: Department of Neurology, Nambour General Hospital, Nambour, Qld, Australia.
authors.forename: Rohan
authors.initials: R
authors.lastname: Grimley
authors.affiliation: Department of Neurology, Westmead Hospital, Sydney, NSW, Australia.
authors.forename: Neil
authors.initials: N
authors.lastname: Mahant
authors.affiliation: Department of Neurology, The Queen Elizabeth Hospital, SA.
authors.forename: Jim
authors.initials: J
authors.lastname: Jannes
authors.affiliation: Department of Neurology, Gosford Hospital, Gosford, NSW, Australia.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Sturm
authors.affiliation: Department of Medicine, Melbourne Brain Centre, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Davis
authors.affiliation: National Stroke Research Institute, Florey Institute of Neuroscience and Mental Health, Heidelberg, Vic., Australia.
authors.forename: Geoffrey A
authors.initials: GA
authors.lastname: Donnan
mesh_terms: D006801:Humans; D001921:Brain / Q000473:pathology; D003866:Depressive Disorder / Q000209:etiology / Q000378:metabolism / Q000473:pathology / Q000628:therapy; D004032:Diet; D015870:Gene Expression; D008019:Life Style; D008137:Longitudinal Studies; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications / Q000378:metabolism / Q000473:pathology / Q000523:psychology / Q000628:therapy; D013997:Time Factors; D016896:Treatment Outcome; D064887:Observational Studies as Topic
keywords: cohort; cortical thickness; depression; functional neuroimaging; gene expression; stroke