Grant: Doctoral Award - Frederick Banting and Charles Best Canada Graduate Scholarships

Stroke is a leading cause of death, long-term adult disability and illness in Canada. Approximately 1/4 of strokes are preceded by a mini-stroke, or transient ischemic attack (TIA). TIA occurs when people experience stroke-like symptoms that rapidly disappear. The risk of stroke in these patients is very high, but it is difficult to identify which patients are at highest risk. Information about TIA symptoms, and data from brain imaging such as magnetic resonance imaging (MRI), can be variable and hard to interpret. New tools are needed to clearly identify those at highest risk of stroke and improve stroke prevention strategies. The objective of this project is to test if a brain stimulation technology, called Transcranial Magnetic Stimulation (TMS), is a useful tool for identifying patients at high risk of stroke after a TIA. TMS provides information about the activity of different types of neurons in the brain and has previously been used to track recovery in patients with chronic stroke. Recently TMS has been tested in small numbers of patients with TIA. These initial studies suggest that TMS may provide valuable information about the effect of TIA on the brain. In the proposed study, we will use TMS to measure the activity of different types of neurons in the brains of patients who have had a TIA. Patients will be enrolled into the study and followed for a period of 18 months, with follow-up sessions at 90 days and one year. Patients will undergo a TMS session within one week of their TIA. Follow-up sessions will allow us to determine if the information from the initial TMS session can predict the risk and severity of stroke within a year after a TIA. The results of this study will provide a new way to identify high-risk patients, which will have important implications for the clinical management of these individuals. Ultimately, this study has the potential to improve stroke prevention strategies and the overall quality of life of people at risk for stroke.