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Amantadine and Functional Improvement Following ABI Measured by MRI Tractography; A Pilot Study

10. desember 2015 oppdatert av: Hamilton Health Sciences Corporation

Mechanism of Amantadine and Functional Improvement Following Acquired Brain Injury as Measured by MRI Tractography; A Pilot Study

This is a pilot study. The objective is to further understand the mechanism by which amantadine improves function in patients with persistent vegetative state and minimally conscious state. Specifically, the investigators will measure the size of the nerve fibers that mediate arousal (reticular activating system, or RAS) pre and post treatment on MRI tractography. MRI findings will be correlated with the Disability Rating Scale (DRS) score. The information gathered from this study will be used to formulate a larger clinical trial.

Studieoversikt

Status

Ukjent

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

Primary Aim:

To determine the size of the RAS tracts as measured by MRI tractography. Specifically, the investigators will be measuring the fiber tracts that project through the posterior thalamus. The RAS is involved in mediating arousal and consciousness. The size of fiber tracts will be measured prior to initiating treatment and near the time of discharge from the rehabilitation hospital or at approximately ninety-days. It is hypothesized that treatment will result in an increase in the size of these fiber tracts.

As a pilot study, the investigators will be determining the feasibility of recruiting and retaining patients in this type of study. This will allow the clarification and understanding of the technical standards for MRI tractography related to the assessment of the reticular activating system.

Secondary Aim:

To determine and monitor changes in function following acquired brain injury as measured by the Disability Rating Scale (DRS) score. The DRS score will be obtained prior to initiating treatment and at termination of the study. It is hypothesized that treatment with amantadine in addition to standard medical treatment, will be associated with an improvement in function.

Studietype

Intervensjonell

Registrering (Forventet)

10

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

  • Canada
    • Ontario
      • Hamilton, Ontario, Canada
        • Hamilton Health Sciences

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år til 65 år (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

Inclusion Criteria:

  • Age 18 years - 65 years
  • Nonpenetrating acquired brain injury (ABI)
  • Persistent vegetative or minimally conscious state (as indicated by DRS score greater than 11)
  • Consent from substitute decision maker

Exclusion Criteria:

  • Contraindication to MRI (such as metal in the body, pacemaker, implanted nerve stimulator)
  • Anticipated neurosurgical intervention
  • Medical instability including uncontrolled hypertension, fever, or infection
  • Seizure disorder prior to acquired brain injury or uncontrolled seizures subsequent to acquired brain injury
  • Parkinson's disease
  • History of heart failure or pre-existing peripheral oedema
  • History of eczematoid dermatitis
  • History of angle-closure glaucoma
  • History of neuroleptic malignant syndrome
  • Current treatment with Amantadine
  • Impairment related to other neurologic disease other than ABI
  • Allergy to Amantadine
  • Pregnancy or lactation
  • Impairment of renal function (creatinine clearance less than 60ml/min)

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Tildeling: N/A
  • Intervensjonsmodell: Enkeltgruppeoppdrag
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Annen: Treatment and MRI scanning
After informed consent has been obtained, the subjects will be examined by a physician and assigned a Disability Ratings Scale (DRS) score. Subjects will undergo MRI tractography study, which does not require the administration of contrast. All participants will receive oral amantadine at escalating doses to ensure tolerance (50mg twice daily for 7 days, then 100mg twice daily for 1 week, then 150mg twice daily, then 200mg twice daily). The usual length of stay on the inpatient brain injury program is ninety days. The MRI tractography study and DRS score will be repeated near the time of discharge or ninety days from enrollment.
Legemiddel: Amantadine
Participants will initially receive amantadine at the starting dose of 50mg twice daily either by mouth or feeding tube. The dosage will increase every week by 50mg twice daily (100mg total dose increase) up to the target dose of 200mg twice daily. These are the usual doses and rate of increase that are offered to patients with brain injury.
Andre navn:
  • amantadine hydrochloride
Fremgangsmåte: MRI Tractography Study
Participants will initially receive a baseline MRI Tractography scan. The size of RAS fiber tracts will be measured prior to initiating treatment and near the time of discharge from the rehabilitation hospital or at approximately ninety-days.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Radiographic Changes
Tidsramme: At baseline and ninety days or at time of discharge from hospital if occurs earlier.
MRI Tractography will be performed to measure the size the of reticular activating system fiber tracts. Specifically, the tracts that project through the posterior thalamus.
At baseline and ninety days or at time of discharge from hospital if occurs earlier.

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Functional Improvement
Tidsramme: At ninety days or at time of discharge from hospital if occurs earlier.
Disability Rating Scale Score (at enrolment and at completion of the study).
At ninety days or at time of discharge from hospital if occurs earlier.

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Hamilton Health Sciences Corporation

Etterforskere

  • Hovedetterforsker: Pankaj E Bansal, MD, Hamilton Health Sciences Corporation
  • Hovedetterforsker: Seyed Hosseini, MD, Hamilton Health Sciences Corporation

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart

1. januar 2016

Primær fullføring (Forventet)

1. desember 2016

Studiet fullført (Forventet)

1. juni 2017

Datoer for studieregistrering

Først innsendt

23. september 2015

Først innsendt som oppfylte QC-kriteriene

30. september 2015

Først lagt ut (Anslag)

2. oktober 2015

Oppdateringer av studieposter

Sist oppdatering lagt ut (Anslag)

11. desember 2015

Siste oppdatering sendt inn som oppfylte QC-kriteriene

10. desember 2015

Sist bekreftet

1. desember 2015

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • 0452

Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .

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