Effects of Antimuscarinics on Cognition in Spinal Cord Injury
Effects of Antimuscarinic Drugs on the Cognition of Patients With Acute Spinal Cord Injury
Prospective evaluation of the cognitive function of in-house patients suffering from an acute traumatic spinal cord injury before and three months after the initiation of antimuscarinic treatment.
The following hypothesis will be tested: Antimuscarinic treatment results in significantly worse cognitive test results three months after traumatic spinal cord injury compared to the pre-treatment results and the results of the control group.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
There will be two groups: 1) patients receiving antimuscarinic treatment 2) patients without antimuscarinic treatment (control).
The control group will be investigated in order to determine the effects of traumatic spinal cord injury on cognition and the natural history of potential cognitive impairment within the first three months after spinal cord injury.
Six to eight weeks after traumatic spinal cord injury, patients are examined in order to determine the type of neurogenic bladder dysfunction they are suffering from. Patients suffering from an overactive bladder will receive antimuscarinic treatment in order to prevent high urine storage and voiding pressures, that put the kidneys at risk.
Prior to the urologic examination, patients fulfilling inclusion criteria will be contacted. If informed consent is given, cognitive function will be evaluated in both patient groups using different standard neuropsychologic tests. The same neuropsychologic tests will be repeated three months later. Evaluation will take place under standardized conditions (e.g. time of day).
Furthermore,different factors influencing cognition, e.g. depression, pain, medication, will be assessed at the beginning and end of the study.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Contacts and Locations
Study Locations
-
-
LU
-
Nottwil, LU, Switzerland, 6207
- Swiss Paraplegic Centre
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- acute traumatic spinal cord injury
- primary rehabilitation / in-house patient
- 18-65 years of age
- treatment group: indication for antimuscarinic treatment (oxybutynin, tolterodine
- willingness and motivation to participate in study
Exclusion Criteria:
- lesion level above C4
- traumatic brain injury (initial Glasgow Coma Score < 13)
- pre-existing dementia
- pre-existing impaired cognitive function
- previous antimuscarinic treatment
- treatment group: antimuscarinic treatment other than oxybutynin, tolterodine
- acute psychologic disorders, diseases, schizophrenia
- alcohol abuse, consumption of illegal drugs (incl. marijuana)
- moderate to severe depression (Beck Depression Inventory Score > 18)
- moderate to severe pain (International Spinal Cord Injury Pain Basic Data Set)
- progressive disease
- tricyclic antidepressant
- color blindness, impaired sight, blindness
- insufficient German language skills
- no informed consent
Study Plan
How is the study designed?
Design Details
- Observational Models: Cohort
- Time Perspectives: Prospective
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
antimuscarinic treatment
|
|
|
no antimuscarinic treatment (control)
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
d2 Test
Time Frame: change from enrollement to 3 months
|
change from enrollement to 3 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
International Spinal Cord Injury Pain Basic Data Set
Time Frame: day 0 and at 3 months
|
day 0 and at 3 months
|
|
|
Beck Depression Inventory Score
Time Frame: day 0 and at 3 months
|
day 0 and at 3 months
|
|
|
patient characteristics
Time Frame: day 0
|
age
|
day 0
|
|
type of neurologic lower urinary tract dysfunction
Time Frame: day 0
|
day 0
|
|
|
Stroop Test
Time Frame: day 0 and at 3 months
|
day 0 and at 3 months
|
|
|
California Verbal Learning Test
Time Frame: day 0 and at 3 months
|
day 0 and at 3 months
|
|
|
Verbal Fluency Test according to Thurstone
Time Frame: day 0 and at 3 months
|
day 0 and at 3 months
|
|
|
visuospatial performance
Time Frame: day 0 and at 3 months
|
subtests from Wechsler Adult Intelligence Scale
|
day 0 and at 3 months
|
|
divided attention
Time Frame: day 0 and at 3 months
|
subtests from test battery according to Zimmermann and Fimm
|
day 0 and at 3 months
|
|
patient characteristics
Time Frame: day 0
|
sex
|
day 0
|
|
patient characteristics
Time Frame: day 0
|
date of injury
|
day 0
|
|
patient characteristics
Time Frame: day 0
|
tpe of accident
|
day 0
|
|
patient characteristics
Time Frame: day 0
|
Glasgow Coma Scale
|
day 0
|
|
patient characteristics
Time Frame: day 0
|
lesion level
|
day 0
|
|
patient characteristics
Time Frame: day 0
|
completeness of injury
|
day 0
|
|
patient characteristics
Time Frame: day 0
|
ASIA impairment score
|
day 0
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Jürgen Pannek, Prof, Swiss Paraplegic Centre
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Mental Disorders
- Central Nervous System Diseases
- Nervous System Diseases
- Neurocognitive Disorders
- Trauma, Nervous System
- Spinal Cord Diseases
- Cognition Disorders
- Wounds and Injuries
- Cognitive Dysfunction
- Spinal Cord Injuries
- Physiological Effects of Drugs
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Cholinergic Antagonists
- Cholinergic Agents
- Muscarinic Antagonists
Other Study ID Numbers
Other Study ID Numbers
- 2011-25 (Other Identifier: AP HM)
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