Use of Adipose-Derived Stem/Stromal Cells in Concussion and Traumatic Brain Injuries (C-TBI)
Primary Purpose
Traumatic Encephalopathies, Chronic, Concussion, Mild, Concussion, Intermediate
Status
Withdrawn
Phase
Early Phase 1
Locations
United States
Study Type
Interventional
Intervention
Microcannula Harvest Adipose
Centricyte 1000
Sterile Normal Saline IV deployment AD-cSVF
Sponsored by
About this trial
This is an interventional treatment trial for Traumatic Encephalopathies, Chronic focused on measuring TBI, mTBI, Concussion, Brain, Loss Consciousness, Traumatic, Headaches
Eligibility Criteria
Inclusion Criteria:
- Documented history of mTBI or TBI with Correlated MRI or CT
- At least 1 month post mTBI and TBI
- Able and Willing to participate in CT or MRI pre-study and at 3 year, 5 year interval
- Able to provide informed consent to undergo the study
- Depression, Cognitive Disability, Attention Disorders, Headaches or other persistent changes which followed a traumatic brain event (TBI)
- Impaired social or occupational functioning following mTBI or TBI
- History of repetitive events for mTBI and TBI
Exclusion Criteria:
- Documented history of neuro-degenerative illness, seizures, mental illness, or severe medical conditions preceding mTBI or TBI
- Malignances, Bleeding Disorders, Pregnancy or Lactation
- Tumors of Central Nervous System (CNS)
- Lack of adequate donor tissue volume as determined by the primary investigator at their discretion
- Any pre-existing medical condition which, in view of the primary investigator and patient's primary care physician, would prevent participation in study
Sites / Locations
- Regenevita LLC
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm Type
Experimental
Experimental
Experimental
Arm Label
Microcannula Harvest Adipose
Centricyte 1000
Sterile Normal Saline
Arm Description
Acquisition Adipose-Derived Tissue Stromal Vascular Fraction (AD-tSVF) via close syringe microcannula harvest from subdermal fat deposits
Autologous AD-tSVF via enzymatic isolation/concentration via Centricyte 1000 Closed System to create AD-cSVF
Re-suspension of AD-cSVF pellet in Normal Saline deployment via IV
Outcomes
Primary Outcome Measures
Number of participants with adverse events
Activities of Daily Living (ADL)
Cognitive Change in clinical symptoms associated with concussion-TBI
Montreal Cognitive Assessment Scale (MCAS)
Secondary Outcome Measures
Beck's Depression Inventory (BDI)
Multiple choice self reporting measure of depression
Adult Attention Deficit Assessment
Conner's Adult Attention Deficit Disorder Rate Scale (CAADDR)
MRI Brain With & MRI Brain With & Without Contrast
MRI Brain to evaluate progressive changes comparing pre-treatment (0), 3 year and 5 year status
Full Information
NCT ID
NCT02959294
First Posted
November 7, 2016
Last Updated
February 14, 2021
Sponsor
Robert W. Alexander, MD, FICS
1. Study Identification
Unique Protocol Identification Number
NCT02959294
Brief Title
Use of Adipose-Derived Stem/Stromal Cells in Concussion and Traumatic Brain Injuries
Acronym
C-TBI
Official Title
Use of Adipose-Derived Cellular Stromal Vascular Fraction (AD-cSVF) Parenterally in Post-Concussion Injuries and Traumatic Brain Injuries (TBI)
Study Type
Interventional
2. Study Status
Record Verification Date
February 2021
Overall Recruitment Status
Withdrawn
Why Stopped
COVID restrictions prevent patient enrollment or treatment. Clinical Trial facility is being closed due to viral limitations and loss of staff to perform]]
Study Start Date
November 30, 2018 (Actual)
Primary Completion Date
November 2023 (Anticipated)
Study Completion Date
March 2024 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Robert W. Alexander, MD, FICS
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
Concussion is the most common type of brain injury throughout life. Study is seeking improvement of long-term residua following adolescent and adult post-traumatic injuries often associated with contact sports and accidental causes. Typically defined as reversible head injury with temporary loss of brain function. Symptoms range from physical, cognitive, pain (headache) and emotional signs consistent with TBI and Post-Traumatic Stress Syndrome. Use of AD-cSVF parenteral delivery to encourage repair of damage and decreased function following concussion, particularly in contact, repetitive sports injuries. Range of damage is measured in Grade I-III according to graduated severity. Unfortunately, less information is available about repetitive concussions and the long-term health issues.
Detailed Description
Concussion Syndrome (CS) and TBI are common injuries producing temporary and long-term damage to impact brain function. Symptoms are sometimes transient, sometimes long-term depending on severity and/or repetitive damage. Signs varying from recurrent headaches, mental fog, emotional changes to physical signs of loss of consciousness, amnesia to behavioral change (irritability, loss of concentration ability, etc.), cognitive impairment (slow reaction times, memory loss), and recurring sleep disturbances.
Common causes include sports injuries, automobile accidents, falls, blunt trauma to head, and explosive/blast injuries from production of acceleration injuries
Treatment often involves monitoring, physical rest, limiting cognitive activities (such as computing, video games, texting, and studying). Most often a single episode usually resolve or improve (particularly in recurring headaches) within 3-4 weeks. It is estimated that >6/1000 occurrence rate apply. Repetitive injuries seem to make the person more susceptible to additional damage, particularly with injury precedes resolution of an earlier damage. There appears also to make persons to require a lesser impact to produce the same degree of severity. It is becoming more recognized that repeated concussions increase the risks in later life for dementia, Parkinson's and severe depressions.
Most serious signs to evaluate are loss of consciousness, seizures, worsening headache, diplopia/pupil changes, loss of recognition, vomiting, focal neurological problems, and change of personality.
There is no consensus definition of concussion or TBI. Most concussions are considered in the mild TBI (mTBI) group, and are rarely demonstrate structural brain damage when in the acute to subacute state. Late brain MRI changes are difficult to clearly point to or identify the specific areas of presumed damage.
This study is intended to examine safety and efficacy of parenteral introduction of AD-cSVF in cases of CS and TBI, and categorically examine the outcomes according to the elapsed time from original concussive event. No delineation of those having recurrent damage and injuries are made within this study.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Traumatic Encephalopathies, Chronic, Concussion, Mild, Concussion, Intermediate, Concussion, Severe, Concussion, Brain
Keywords
TBI, mTBI, Concussion, Brain, Loss Consciousness, Traumatic, Headaches
7. Study Design
Primary Purpose
Treatment
Study Phase
Early Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
0 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Microcannula Harvest Adipose
Arm Type
Experimental
Arm Description
Acquisition Adipose-Derived Tissue Stromal Vascular Fraction (AD-tSVF) via close syringe microcannula harvest from subdermal fat deposits
Arm Title
Centricyte 1000
Arm Type
Experimental
Arm Description
Autologous AD-tSVF via enzymatic isolation/concentration via Centricyte 1000 Closed System to create AD-cSVF
Arm Title
Sterile Normal Saline
Arm Type
Experimental
Arm Description
Re-suspension of AD-cSVF pellet in Normal Saline deployment via IV
Intervention Type
Procedure
Intervention Name(s)
Microcannula Harvest Adipose
Intervention Description
Use of Closed Syringe Microcannula Harvest Autologous Adipose-Derived Stem/Stromal Cells
Intervention Type
Device
Intervention Name(s)
Centricyte 1000
Intervention Description
Use of Centricyte 1000 Closed System Digestion Autologous AD-tSVF to create AD-cSVF
Intervention Type
Procedure
Intervention Name(s)
Sterile Normal Saline IV deployment AD-cSVF
Intervention Description
Sterile Normal Saline Suspension AD-cSVF in 500 cc IV use
Primary Outcome Measure Information:
Title
Number of participants with adverse events
Description
Activities of Daily Living (ADL)
Time Frame
Outcome measures at baseline at 6 month
Title
Cognitive Change in clinical symptoms associated with concussion-TBI
Description
Montreal Cognitive Assessment Scale (MCAS)
Time Frame
Outcome measures at baseline and reviewed 1 year interval for average time 5 years
Secondary Outcome Measure Information:
Title
Beck's Depression Inventory (BDI)
Description
Multiple choice self reporting measure of depression
Time Frame
Annual for 5 years
Title
Adult Attention Deficit Assessment
Description
Conner's Adult Attention Deficit Disorder Rate Scale (CAADDR)
Time Frame
Annual for 5 years
Title
MRI Brain With & MRI Brain With & Without Contrast
Description
MRI Brain to evaluate progressive changes comparing pre-treatment (0), 3 year and 5 year status
Time Frame
0, 3 years, 5 years
10. Eligibility
Sex
All
Minimum Age & Unit of Time
16 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Documented history of mTBI or TBI with Correlated MRI or CT
At least 1 month post mTBI and TBI
Able and Willing to participate in CT or MRI pre-study and at 3 year, 5 year interval
Able to provide informed consent to undergo the study
Depression, Cognitive Disability, Attention Disorders, Headaches or other persistent changes which followed a traumatic brain event (TBI)
Impaired social or occupational functioning following mTBI or TBI
History of repetitive events for mTBI and TBI
Exclusion Criteria:
Documented history of neuro-degenerative illness, seizures, mental illness, or severe medical conditions preceding mTBI or TBI
Malignances, Bleeding Disorders, Pregnancy or Lactation
Tumors of Central Nervous System (CNS)
Lack of adequate donor tissue volume as determined by the primary investigator at their discretion
Any pre-existing medical condition which, in view of the primary investigator and patient's primary care physician, would prevent participation in study
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Robert W. Alexander, MD
Organizational Affiliation
GARM International and GARM USA
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Glenn C Terry, MD
Organizational Affiliation
GARM
Official's Role
Principal Investigator
Facility Information:
Facility Name
Regenevita LLC
City
Stevensville
State/Province
Montana
ZIP/Postal Code
59870
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
Undecided
IPD Sharing Plan Description
Annual Summary of Case to All Collaborators
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Use of Adipose-Derived Stem/Stromal Cells in Concussion and Traumatic Brain Injuries
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