MSC Secretome Therapy for Cognitive Recovery After Subacute Ischemic Stroke
Efficacy of Mesenchymal Stem Cell Secretome Therapy on Cognitive Recovery in Patients With Subacute Ischemic Stroke: A Pilot Randomized Controlled Trial Using qEEG, BDNF, and Interleukin-1β Evaluation
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
This study is a pilot, parallel-group, randomized controlled trial with blinded outcome assessment. The study population consists of patients aged 40 to 75 years with clinically and radiologically confirmed subacute ischemic stroke, defined as 7 days to 3 months after stroke onset. Eligible participants must be hemodynamically stable, able to undergo a basic neuropsychological assessment, and have mild-to-moderate cognitive impairment based on the Indonesian version of the Montreal Cognitive Assessment.
Participants will be randomized in a 1:1 ratio using block randomization with allocation concealment. The intervention group will receive standard stroke care and rehabilitation plus umbilical cord mesenchymal stem cell-derived secretome. The control group will receive standard medical treatment and standardized stroke rehabilitation without MSC secretome. Outcome assessors will remain unaware of treatment allocation.
Baseline assessments include demographic and vascular risk factor data, NIHSS, modified Rankin Scale, MoCA-Ina, quantitative electroencephalography, serum brain-derived neurotrophic factor, and serum interleukin-1β. Follow-up assessments will include cognitive, neurological, functional, electrophysiological, biomarker, and safety evaluations at the prespecified study visits.
The primary outcome is the change in MoCA-Ina total score from baseline to week 8. Secondary outcomes include changes in delta-to-alpha ratio, delta-theta-to-alpha-beta ratio, relative alpha power, relative theta power, serum BDNF, serum IL-1β, NIHSS, modified Rankin Scale, and the incidence of adverse events. The primary analysis will follow the intention-to-treat principle, with per-protocol analysis as an additional analysis.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Jumraini Tammasse, Sp.N, Subsp.NRE(K)
- Phone Number: +6282188833368
- Email: tejayanovi@gmail.com
Study Locations
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South Sulawesi
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Makassar, South Sulawesi, Indonesia, 90245
- Recruiting
- Hasanuddin University Hospital
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Contact:
- Jumraini Tammasse, Sp.N, Subsp.NRE(K)
- Phone Number: +6282188833368
- Email: tejayanovi@gmail.com
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Contact:
- Novi Tejaya, MD
- Phone Number: +6282126314018
- Email: tejayanovi@gmail.com
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Principal Investigator:
- Jumraini Tammasse, Sp.N, Subsp.NRE(K)
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age 40 to 75 years.
- Diagnosis of ischemic stroke confirmed by clinical examination and computed tomography or magnetic resonance imaging.
- Stroke onset between 7 days and 3 months before enrollment.
- Hemodynamically stable.
- Able to undergo a basic neuropsychological assessment.
- Mild-to-moderate cognitive impairment based on the Indonesian version of the Montreal Cognitive Assessment.
- Willing to participate in the study and provide written informed consent.
Exclusion Criteria:
- Hemorrhagic stroke or mixed ischemic and hemorrhagic stroke.
- Severe aphasia, impaired consciousness, or severe sensory deficits that make cognitive assessment invalid.
- History of dementia before stroke or a major neurodegenerative disorder.
- Active infection, active autoimmune disease, active malignancy, severe renal failure, or severe liver failure.
- Uncontrolled epilepsy.
- Concurrent participation in another clinical trial.
- Contraindication to any study intervention or study procedure.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: MSC Secretome Plus Standard of Care
Participants receive standard medical treatment and standardized stroke rehabilitation plus umbilical cord mesenchymal stem cell-derived secretome.
The secretome intervention is administered according to the study protocol, with safety monitoring during and after administration.
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Umbilical cord mesenchymal stem cell-derived secretome is administered in addition to standard medical treatment and standardized stroke rehabilitation.
The intervention is administered twice, on day 1 and day 8, according to the investigational product protocol.
Participants are monitored during and after administration for hypersensitivity reactions, fever, and other adverse events.
Other Names:
Participants receive standard medical management for subacute ischemic stroke and standardized stroke rehabilitation according to the treating physician and institutional clinical practice.
The same standard care and rehabilitation are provided to both study groups.
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Active Comparator: Standard of Care Alone
Participants receive standard medical treatment and standardized stroke rehabilitation without MSC secretome.
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Participants receive standard medical management for subacute ischemic stroke and standardized stroke rehabilitation according to the treating physician and institutional clinical practice.
The same standard care and rehabilitation are provided to both study groups.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in Montreal Cognitive Assessment-Indonesian Version Total Score
Time Frame: Baseline to week 8
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The MoCA-Ina assesses visuospatial-executive function, naming, attention, language, abstraction, delayed recall, and orientation.
The total score ranges from 0 to 30, with higher scores indicating better cognitive performance.
The outcome is the change in total MoCA-Ina score from baseline to the final follow-up assessment.
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Baseline to week 8
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in Delta-to-Alpha Ratio on Quantitative Electroencephalography
Time Frame: Baseline, week 4, and week 8
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The delta-to-alpha ratio is calculated from quantitative electroencephalography spectral power measurements.
The outcome is the change in DAR from baseline to week 4 and week 8.
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Baseline, week 4, and week 8
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Change in Delta-Theta-to-Alpha-Beta Ratio on Quantitative Electroencephalography
Time Frame: Baseline, week 4, and week 8
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The delta-theta-to-alpha-beta ratio is calculated from quantitative electroencephalography spectral power measurements.
The outcome is the change in DTABR from baseline to week 4 and week 8.
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Baseline, week 4, and week 8
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Change in Relative Alpha Power on Quantitative Electroencephalography
Time Frame: Baseline, week 4, and week 8
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Relative alpha power is derived from quantitative electroencephalography spectral power analysis.
The outcome is the change in relative alpha power from baseline to week 4 and week 8.
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Baseline, week 4, and week 8
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Change in Relative Theta Power on Quantitative Electroencephalography
Time Frame: Baseline, week 4, and week 8
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Relative theta power is derived from quantitative electroencephalography spectral power analysis.
The outcome is the change in relative theta power from baseline to week 4 and week 8.
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Baseline, week 4, and week 8
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Change in Serum Brain-Derived Neurotrophic Factor Concentration
Time Frame: Baseline and week 8
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Serum brain-derived neurotrophic factor concentration is measured using an enzyme-linked immunosorbent assay.
The outcome is the change in serum BDNF concentration from baseline to week 8.
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Baseline and week 8
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Change in Serum Interleukin-1 Beta Concentration
Time Frame: Baseline and week 8
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Serum interleukin-1 beta concentration is measured using an enzyme-linked immunosorbent assay.
The outcome is the change in serum IL-1 beta concentration from baseline to week 8.
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Baseline and week 8
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Change in National Institutes of Health Stroke Scale Score
Time Frame: Baseline, week 4, and week 8
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The National Institutes of Health Stroke Scale assesses neurological impairment.
Scores range from 0 to 42, with higher scores indicating greater neurological impairment.
The outcome is the change in NIHSS score from baseline to week 4 and week 8.
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Baseline, week 4, and week 8
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Change in Modified Rankin Scale Score
Time Frame: Baseline, week 4, and week 8
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The modified Rankin Scale assesses global disability after stroke.
Scores range from 0 to 6, with higher scores indicating greater disability or death.
The outcome is the change in modified Rankin Scale score from baseline to week 4 and week 8.
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Baseline, week 4, and week 8
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Incidence of Treatment-Emergent Adverse Events
Time Frame: From the first intervention through week 8
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The number and proportion of participants experiencing adverse events, including hypersensitivity reactions, fever, administration-related reactions, hospitalization, seizure, infection, neurological deterioration, and death, will be recorded.
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From the first intervention through week 8
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Jumraini Tammasse, Sp.N, Subsp.NRE(K), Hasanuddin University
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
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
- Cerebrovascular Disorders
- Brain Diseases
- Central Nervous System Diseases
- Nervous System Diseases
- Vascular Diseases
- Cardiovascular Diseases
- Stroke
- Ischemic Stroke
- Therapeutics
- Patient Care
- Health Services
- Health Care Facilities Workforce and Services
- Aftercare
- Continuity of Patient Care
- Rehabilitation
Other Study ID Numbers
Other Study ID Numbers
- UH26060713
- 847/UN4.6.4.5.31/PP36/2026 (Other Identifier: Health Research Ethics Committee, Faculty of Medicine, Hasanuddin University)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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