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
Descripción general del estudio
Estado
Estado
Condiciones
Condiciones
Intervención / Tratamiento
Intervención / Tratamiento
Descripción detallada
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.
Tipo de estudio
Tipo de estudio
Inscripción (Estimado)
Inscripción
Fase
Fase
- No aplica
Contactos y Ubicaciones
Estudio Contacto
Estudio Contacto
- Nombre: Jumraini Tammasse, Sp.N, Subsp.NRE(K)
- Número de teléfono: +6282188833368
- Correo electrónico: tejayanovi@gmail.com
Ubicaciones de estudio
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South Sulawesi
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Makassar, South Sulawesi, Indonesia, 90245
- Reclutamiento
- Hasanuddin University Hospital
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Contacto:
- Jumraini Tammasse, Sp.N, Subsp.NRE(K)
- Número de teléfono: +6282188833368
- Correo electrónico: tejayanovi@gmail.com
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Contacto:
- Novi Tejaya, MD
- Número de teléfono: +6282126314018
- Correo electrónico: tejayanovi@gmail.com
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Investigador principal:
- Jumraini Tammasse, Sp.N, Subsp.NRE(K)
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Criterios de participación
Criterio de elegibilidad
Criterio de elegibilidad
Edades elegibles para estudiar
- Adulto
- Adulto Mayor
Acepta Voluntarios Saludables
Descripción
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.
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Tratamiento
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Único
Número de brazos
Armas e Intervenciones
Grupo de participantes/brazoGrupo de participantes/brazo |
Intervención / TratamientoIntervención / Tratamiento |
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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.
Otros nombres:
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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Comparador activo: 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.
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¿Qué mide el estudio?
Medidas de resultado primarias
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
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Change in Montreal Cognitive Assessment-Indonesian Version Total Score
Periodo de tiempo: 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
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Medidas de resultado secundarias
Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
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Change in Delta-to-Alpha Ratio on Quantitative Electroencephalography
Periodo de tiempo: 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
Periodo de tiempo: 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
Periodo de tiempo: 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
Periodo de tiempo: 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
Periodo de tiempo: 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
Periodo de tiempo: 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
Periodo de tiempo: 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
Periodo de tiempo: 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
Periodo de tiempo: 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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Colaboradores e Investigadores
Patrocinador
Patrocinador
Investigadores
Investigadores
- Investigador principal: Jumraini Tammasse, Sp.N, Subsp.NRE(K), Hasanuddin University
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio (Actual)
Inicio del estudio
Finalización primaria (Estimado)
Finalización primaria
Finalización del estudio (Estimado)
Finalización del estudio
Fechas de registro del estudio
Enviado por primera vez
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Actual)
Publicado por primera vez
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
Última actualización publicada
Última actualización enviada que cumplió con los criterios de control de calidad
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Última verificación
Más información
Términos relacionados con este estudio
Palabras clave
Términos MeSH relevantes adicionales
- Trastornos cerebrovasculares
- Enfermedades Cerebrales
- Enfermedades del Sistema Nervioso Central
- Enfermedades del Sistema Nervioso
- Enfermedades Vasculares
- Enfermedades cardiovasculares
- Carrera
- Accidente cerebrovascular isquémico
- Terapéutica
- Atención al paciente
- Servicios de salud
- Instalaciones de atención médica Fuerza laboral y servicios
- Cuidado por los convalecientes
- Continuidad de la atención al paciente
- Rehabilitación
Otros números de identificación del estudio
Otros números de identificación del estudio
- UH26060713
- 847/UN4.6.4.5.31/PP36/2026 (Otro identificador: Health Research Ethics Committee, Faculty of Medicine, Hasanuddin University)
Plan de datos de participantes individuales (IPD)
¿Planea compartir datos de participantes individuales (IPD)?
Descripción del plan IPD
Información sobre medicamentos y dispositivos, documentos del estudio
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Estudia un producto de dispositivo regulado por la FDA de EE. UU.
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