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
Visão geral do estudo
Status
Status
Condições
Condições
Intervenção / Tratamento
Intervenção / Tratamento
Descrição detalhada
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 estudo
Tipo de estudo
Inscrição (Estimado)
Inscrição
Estágio
Estágio
- Não aplicável
Contactos e Locais
Contato de estudo
Contato de estudo
- Nome: Jumraini Tammasse, Sp.N, Subsp.NRE(K)
- Número de telefone: +6282188833368
- E-mail: tejayanovi@gmail.com
Locais de estudo
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South Sulawesi
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Makassar, South Sulawesi, Indonésia, 90245
- Recrutamento
- Hasanuddin University Hospital
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Contato:
- Jumraini Tammasse, Sp.N, Subsp.NRE(K)
- Número de telefone: +6282188833368
- E-mail: tejayanovi@gmail.com
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Contato:
- Novi Tejaya, MD
- Número de telefone: +6282126314018
- E-mail: tejayanovi@gmail.com
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Investigador principal:
- Jumraini Tammasse, Sp.N, Subsp.NRE(K)
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Critérios de participação
Critérios de elegibilidade
Critérios de elegibilidade
Idades elegíveis para estudo
- Adulto
- Adulto mais velho
Aceita Voluntários Saudáveis
Descrição
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.
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Tratamento
- Alocação: Randomizado
- Modelo Intervencional: Atribuição Paralela
- Mascaramento: Solteiro
Número de braços
Armas e Intervenções
Grupo de Participantes / BraçoGrupo de Participantes / Braço |
Intervenção / TratamentoIntervenção / Tratamento |
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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.
Outros nomes:
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 Ativo: 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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O que o estudo está medindo?
Medidas de resultados primários
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Change in Montreal Cognitive Assessment-Indonesian Version Total Score
Prazo: 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 resultados secundários
Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Change in Delta-to-Alpha Ratio on Quantitative Electroencephalography
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Real)
Início do estudo
Conclusão Primária (Estimado)
Conclusão Primária
Conclusão do estudo (Estimado)
Conclusão do estudo
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Primeira postagem
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última Atualização Postada
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Última verificação
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
- Distúrbios Cerebrovasculares
- Doenças Cerebrais
- Doenças do Sistema Nervoso Central
- Doenças do Sistema Nervoso
- Doenças Vasculares
- Doenças cardiovasculares
- Derrame
- AVC Isquêmico
- Terapêutica
- Atendimento ao paciente
- Serviços de Saúde
- Instalações de saúde Força e serviços de trabalho
- Cuidados posteriores
- Continuidade do atendimento ao paciente
- Reabilitação
Outros números de identificação do estudo
Outros números de identificação do estudo
- UH26060713
- 847/UN4.6.4.5.31/PP36/2026 (Outro identificador: Health Research Ethics Committee, Faculty of Medicine, Hasanuddin University)
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