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

10 december 2015 uppdaterad 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.

Studieöversikt

Status

Okänd

Betingelser

Intervention / Behandling

Detaljerad beskrivning

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.

Studietyp

Interventionell

Inskrivning (Förväntat)

10

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

  • Kanada
    • Ontario
      • Hamilton, Ontario, Kanada
        • Hamilton Health Sciences

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år till 65 år (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

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

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Tilldelning: N/A
  • Interventionsmodell: Enskild gruppuppgift
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Övrig: 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.
Läkemedel: 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.
Andra namn:
  • amantadine hydrochloride
Procedur: 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.

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Radiographic Changes
Tidsram: 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.

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Functional Improvement
Tidsram: 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.

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Hamilton Health Sciences Corporation

Utredare

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

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart

1 januari 2016

Primärt slutförande (Förväntat)

1 december 2016

Avslutad studie (Förväntat)

1 juni 2017

Studieregistreringsdatum

Först inskickad

23 september 2015

Först inskickad som uppfyllde QC-kriterierna

30 september 2015

Första postat (Uppskatta)

2 oktober 2015

Uppdateringar av studier

Senaste uppdatering publicerad (Uppskatta)

11 december 2015

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

10 december 2015

Senast verifierad

1 december 2015

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • 0452

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