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- Essai clinique NCT07731087
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
Aperçu de l'étude
Statut
Les conditions
Description détaillée
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.
Type d'étude
Inscription (Estimé)
Phase
- N'est pas applicable
Contacts et emplacements
Coordonnées de l'étude
- Nom: Jumraini Tammasse, Sp.N, Subsp.NRE(K)
- Numéro de téléphone: +6282188833368
- E-mail: tejayanovi@gmail.com
Lieux d'étude
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South Sulawesi
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Makassar, South Sulawesi, Indonésie, 90245
- Recrutement
- Hasanuddin University Hospital
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Contact:
- Jumraini Tammasse, Sp.N, Subsp.NRE(K)
- Numéro de téléphone: +6282188833368
- E-mail: tejayanovi@gmail.com
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Contact:
- Novi Tejaya, MD
- Numéro de téléphone: +6282126314018
- E-mail: tejayanovi@gmail.com
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Chercheur principal:
- Jumraini Tammasse, Sp.N, Subsp.NRE(K)
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
- Adulte
- Adulte plus âgé
Accepte les volontaires sains
La 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.
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Seul
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
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Expérimental: 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.
Autres noms:
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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Comparateur actif: 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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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Change in Montreal Cognitive Assessment-Indonesian Version Total Score
Délai: 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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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Change in Delta-to-Alpha Ratio on Quantitative Electroencephalography
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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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Collaborateurs et enquêteurs
Parrainer
Les enquêteurs
- Chercheur principal: Jumraini Tammasse, Sp.N, Subsp.NRE(K), Hasanuddin University
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Réel)
Achèvement primaire (Estimé)
Achèvement de l'étude (Estimé)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
- Troubles cérébrovasculaires
- Maladies du cerveau
- Maladies du système nerveux central
- Maladies du système nerveux
- Maladies vasculaires
- Maladies cardiovasculaires
- Accident vasculaire cérébral
- AVC ischémique
- Thérapeutique
- Soins aux patients
- Services de santé
- Conseils de soins de santé
- Suivi
- Continuité des soins aux patients
- Réhabilitation
Autres numéros d'identification d'étude
- UH26060713
- 847/UN4.6.4.5.31/PP36/2026 (Autre identifiant: Health Research Ethics Committee, Faculty of Medicine, Hasanuddin University)
Plan pour les données individuelles des participants (IPD)
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Description du régime IPD
Informations sur les médicaments et les dispositifs, documents d'étude
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