Functional and Anatomical Magnetic Resonance Imaging (MRI) of Chronic Brain Injury and Hyperbaric Oxygen (HBO2) Study Subjects (HYBOBI-MRI)

July 27, 2020 updated by: Lindell Weaver, Intermountain Health Care, Inc.

MRI & CT Angiogram and Hyperbaric Oxygen in Chronic Stable Brain Injury

The purpose of this study is to evaluate Brain MRI (Magnetic Resonance Imaging), and Brain CT (Computed Tomography) Angiogram data in subjects who participate in the "Hyperbaric Oxygen for Chronic Stable Brain Injury" (HYBOBI) study. Including information from MRI and CT studies provide information about whether hyperbaric oxygen improves brain function in subjects who have had a brain injury. Subjects will complete MR and CT scans twice during the study. The first MR and CT will be performed prior to the first hyperbaric session of the HYBOBI study, and the second will be performed within two weeks following the last hyperbaric session.

Study Overview

Detailed Description

In an ongoing feasibility study (HYBOBI), brain-injured subjects are exposed to hyperbaric oxygen at 1.5 atmospheres for 60 minutes. They receive this exposure five days per week, and receive 60 total sessions. Prior to hyperbaric oxygen, these study subjects have neurologic, cognitive, and functional measures. The measures are repeated at the conclusion of 60 hyperbaric oxygen sessions, and again six months later. The goal of the HYBOBI feasibility study is to learn about these patients and determine possible hyperbaric oxygen effects, if any, to prepare for a blinded randomized controlled clinical trial.

This study adds an imaging component to the HYBOBI study, further investigating brain changes in participants. Participants will undergo Brain MRI (Magnetic Resonance Imaging) using a 3 tesla magnet, and Brain CT (Computed Tomography) Angiogram. Subjects will undergo imaging before receiving hyperbaric oxygen and within 2 weeks of completion of the 60 hyperbaric sessions.

Study Type

Observational

Enrollment (Actual)

17

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Utah
      • Salt Lake City, Utah, United States, 84143
        • LDS Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 80 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

Adults with chronic brain injury who are enrolled in the HYBOBI study.

Description

Inclusion Criteria:

  • Subject has had a brain injury > 12 months
  • Subject is >18 years old
  • Etiology of brain injury:

    • stroke
    • carbon monoxide
    • anoxia
    • trauma
  • Must be able to equalize ears, or have tympanostomy tubes
  • Willingness to complete outcome measures and comply with the research protocols
  • Commitment to pay the hospital for hyperbaric oxygen
  • Subject is enrolled in Hyperbaric Oxygen and Chronic Stable Brain Injury study-clinical trials government ID# NCT00830453.

Exclusion Criteria:

  • Glasgow Coma Score <13 at the time of consent
  • Poorly controlled seizures
  • Inability to participate in outcome assessments (eg: blindness, quadraplegia); Claustrophobia
  • Inability to equalize ears
  • Inability to protect airway, or requiring frequent suctioning
  • Tracheostomy
  • Women of child-bearing potential or currently pregnant
  • Severe psychiatric disorders
  • Taking lithium
  • Degenerative mental disease
  • Chronic debilitating disease
  • Heart failure with ejection fraction <50% or inability to lay supine
  • Active malignancy, or prior treatment with cisplatin or bleomycin
  • Current recreational drug use
  • Consumption of more than the equivalent of 12 beers/week habitually
  • Prior treatment with hyperbaric oxygen for chronic brain injury within the last year
  • Implanted device that is a contra-indication to MRI
  • Inability to travel to Las Vegas, either by car or by air
  • Serum creatinine greater than the Intermountain Central Lab normal limit
  • Unwillingness or inability to have intravenous contrast.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Hyperbaric oxygen
In this open-label feasibility study, all subjects will receive 60 hyperbaric oxygen sessions (100% oxygen, 1.5 atmospheres absolute (atm abs), for 60 minutes), delivered daily, five days per week.
Imaging of the brain without gadolinium will be performed with a 3 Tesla magnetic resonance (MR) System (Intera Achieva 3T; Philips Medical Systems). The protocol will include anatomical sequences, a diffusion tensor imaging sequence with fiber tracking, and auditory, visual, and motor functional magnetic resonance imaging (MRI).
Other Names:
  • MRI
  • fMRI
Computed tomography angiography (CTA) with intravenous (IV) contrast will be performed on a 320 head computed tomography (CT) scanner, assessing brain perfusion.
Other Names:
  • CT
  • CTA

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Auditory functional magnetic resonance imaging (fMRI) activation
Time Frame: Within 2 weeks of final hyperbaric session
The first prime outcome measure will be auditory functional magnetic resonance imaging (fMRI) activation, comparing post-hyperbaric oxygen to pre-hyperbaric oxygen. This is a categorical variable: absent, mild, moderate, normal, and increasing. We will look at the difference between pre-hyperbaric (pre-HBO2) and post-hyperbaric (post-HBO2) scans graphically and descriptively, with the percentage of patients who show any improvement (any change towards normal).
Within 2 weeks of final hyperbaric session
Computed tomography angiography (CTA) Brain Perfusion
Time Frame: Within 2 weeks of the final hyperbaric session
Pre-hyperbaric (pre-HBO2) computed tomography angiography (CTA) results will be determined to be normal or abnormal, and then compared to the post-hyperbaric (post-HBO2) scan, which will be scored as better, worse, or no change.
Within 2 weeks of the final hyperbaric session

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
MRI Results
Time Frame: Within 2 weeks of the final hyperbaric session
  1. Cortical activation (amount and location) for motor, visual, and olfactory fMRI.
  2. Diffusion tensor imaging (fractional anisotropy differences, number of fiber tracts) within the Corpus Callosum
Within 2 weeks of the final hyperbaric session

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Collaborators

Investigators

  • Principal Investigator: Susan K Churchill, APRN-NP, Intermountain Health Care, Inc.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

July 1, 2007

Primary Completion (Actual)

June 1, 2010

Study Completion (Actual)

June 1, 2010

Study Registration Dates

First Submitted

March 1, 2010

First Submitted That Met QC Criteria

May 18, 2010

First Posted (Estimate)

May 19, 2010

Study Record Updates

Last Update Posted (Actual)

July 29, 2020

Last Update Submitted That Met QC Criteria

July 27, 2020

Last Verified

July 1, 2020

More Information

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

Clinical Trials on Stroke

Clinical Trials on Magnetic Resonance Imaging

3
Subscribe