The Recovery and Outcomes from StrokE – Longitudinal Assessment With Neuroimaging (ROSE-LAWN) study

What is a stroke?

A stroke occurs when a blood vessel that carries blood to the brain from the heart is either blocked or bursts. As a result, the part of the brain the blood vessel was supplying does not get the blood it needs and starts to die.

What is ICH?

An intracerebral hemorrhage (ICH) is a type of stroke where the blood vessel ruptures or bursts inside the brain (Figure 1). Even though these types of stroke are less than 20 percent of all strokes, ICH causes half of all stroke-related deaths. Patients who survive an ICH are often seriously disabled.

What is the purpose of the ROSE-LAWN Sub-study?

The Recovery and Outcomes from StrokE – Longitudinal Assessment With Neuroimaging (ROSE-LAWN) study is the first long-term follow-up of patients with ICH that repeats the special MRI used at baseline (in the ROSE study) as well as performing follow-up with a comprehensive examination in a time frame of years after the ICH. Our purpose is to identify what causes some patients to develop a progressive decline in their cognition or thinking.

We have found that a very high (40%) proportion of patients who survive a brain hemorrhage develop progressive problems with their thinking even after the hemorrhage has resolved. Figure 2 shows a patient who had a moderate sized hemorrhage at the age of 51 and 18 months later, their hemorrhage had resolved. But using a more modern technique of brain imaging, we can see that there is progressive degeneration occurring around the area where the hemorrhage was in this patient. Other patients show no signs of progressive degeneration. We theorize that inflammation from the hemorrhage may become chronic in some patients leading to progressive degeneration and if we can find the specific mechanisms, we may be able to screen patients at risk and potentially decrease the inflammation in future studies.

Frequently asked questions

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Because we need the baseline advanced imaging study for comparison, only patients who have been in the parent ROSE study are eligible to be in the ROSE-LAWN study. You do not have to be able to provide your own consent (permission) to be in the study. If you can’t give your own consent to be in the study, a person who is allowed to make healthcare decisions for you (known as a proxy) can give consent.
You (or your loved one) will be in the study for an additional 12 months. You (or your loved one) will undergo an hour long examination that will test items like your strength, balance, and cognition. We will then re-test this in the future (about 6 months and 12 months) to see how well you have recovered. In addition, ROSE-LAWN study patients will undergo an MRI that will look at the tracts of the brain to see if they are still intact, damaged, or destroyed.

After your first interview, you will have a small sample of your blood drawn for genetic testing. Your blood samples will be used for research purposes only. They will be specially processed and stored in a biorepository (a collection of biological samples and health-related information) that can be used for future research. Your name and other information about you will be removed from your sample and it will be given a code number when it is provided to researchers.
You are not required to participate in the study. If you choose to participate, you may withdraw at any time in the future. Patients may be enrolled after 9 months from the time of their brain hemorrhage. It also takes several days to arrange the MRI so it is best to have enrollment completed several days in advance of the deadline.
Although there is no direct medical benefit to you, the study doctors hope that what they learn from this research study will help them identify new tests and treatments for ICH in order to help future generations.
For the ROSE-LAWN study, the only medical risks are related to the MRI such as claustrophobia or minor discomfort from laying flat for 45 minutes to an hour which we will try to address when you are having the MRI, and the blood draw which has a risk of discomfort and bruising. The physical examinations have minimal risk but may be tiring.

There is a possible risk that information you share during the interview or the genetic testing done on your blood could be lost or stolen. Extra protections and safeguards are made to help keep data and biologic samples safe and the study is protected by a Certificate of Confidentiality from the Department of Health and Human Services.
There are no costs to participate in the ROSE-LAWN Project. The blood draw and MRI (if needed) are done at no cost to you. You are responsible for your ongoing medical care.
The ROSE-LAWN Project is a group effort involving researchers at the following sites:
  • University of Cincinnati
  • Baptist Health Louisville
  • Columbia University
  • Duke University
  • Houston Methodist
  • University of Chicago-Illinois
  • University of Maryland (Baltimore)
  • Wake Forest University
The ROSE-LAWN study is funded by grants from the National Institute of Neurological Disorders and Stroke of the National Institutes of Health.

Want to enroll?

Because we need the baseline MRI and blood draw and exam, only those patients who were initially enrolled in the ROSE study are eligible for the ROSE-LAWN study. If ou are near one of the sites (see ‘Where is the study being conducted?’), you may already have been approached by one of the investigators. If not, please feel free to contact us through the email below. Please leave as much information in the email as possible to be able to get back with you and in particular, what city you are in so that we can have the right center call you. Thank you for considering! With your help, we may be able to find new treatments for ICH!

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Our other studies

The Recovery and Outcomes from StrokE (ROSE)
Some patients after ICH recover nearly back to normal again while others are left devastated by the stroke. This may be true with the same size and location of hemorrhage. If we can identify the different proteins or biologic mechanisms that helps people to recover, we may be able to apply it to all ICH patients to improve recovery. This may relate to inflammation, new blood vessel growth or preserving the brain’s functions The Recovery and Outcomes from StrokE (ROSE) study uses a special kind of MRI that looks at the connections within the brain.

ROSE Study