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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Withdrawn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
Robert W. Alexander, MD, FICS
About
Eligibility
Locations
Arms
Outcomes
Full info

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

16 Years - 70 Years (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

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

First Posted
November 7, 2016
Last Updated
February 14, 2021
Sponsor
Robert W. Alexander, MD, FICS
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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
Citations:
PubMed Identifier
18635021
Citation
Maas AI, Stocchetti N, Bullock R. Moderate and severe traumatic brain injury in adults. Lancet Neurol. 2008 Aug;7(8):728-41. doi: 10.1016/S1474-4422(08)70164-9.
Results Reference
background
PubMed Identifier
17622833
Citation
Parikh S, Koch M, Narayan RK. Traumatic brain injury. Int Anesthesiol Clin. 2007 Summer;45(3):119-35. doi: 10.1097/AIA.0b013e318078cfe7. No abstract available.
Results Reference
background
PubMed Identifier
18627252
Citation
Saatman KE, Duhaime AC, Bullock R, Maas AI, Valadka A, Manley GT; Workshop Scientific Team and Advisory Panel Members. Classification of traumatic brain injury for targeted therapies. J Neurotrauma. 2008 Jul;25(7):719-38. doi: 10.1089/neu.2008.0586.
Results Reference
background
PubMed Identifier
19196176
Citation
Kumar R, Husain M, Gupta RK, Hasan KM, Haris M, Agarwal AK, Pandey CM, Narayana PA. Serial changes in the white matter diffusion tensor imaging metrics in moderate traumatic brain injury and correlation with neuro-cognitive function. J Neurotrauma. 2009 Apr;26(4):481-95. doi: 10.1089/neu.2008.0461.
Results Reference
background
PubMed Identifier
17112190
Citation
Pellman EJ, Viano DC; National Football League's Committee on Mild Traumatic Brain Injury. Concussion in professional football: summary of the research conducted by the National Football League's Committee on Mild Traumatic Brain Injury. Neurosurg Focus. 2006 Oct 15;21(4):E12. doi: 10.3171/foc.2006.21.4.13.
Results Reference
background
PubMed Identifier
17826211
Citation
Heegaard W, Biros M. Traumatic brain injury. Emerg Med Clin North Am. 2007 Aug;25(3):655-78, viii. doi: 10.1016/j.emc.2007.07.001.
Results Reference
background
PubMed Identifier
18057896
Citation
Pearce JM. Observations on concussion. A review. Eur Neurol. 2008;59(3-4):113-9. doi: 10.1159/000111872. Epub 2007 Nov 30.
Results Reference
background
PubMed Identifier
16286874
Citation
Concussion (mild traumatic brain injury) and the team physician: a consensus statement. Med Sci Sports Exerc. 2005 Nov;37(11):2012-6. doi: 10.1249/01.mss.0000186726.18341.70. No abstract available.
Results Reference
background
PubMed Identifier
15883140
Citation
Hall RC, Hall RC, Chapman MJ. Definition, diagnosis, and forensic implications of postconcussional syndrome. Psychosomatics. 2005 May-Jun;46(3):195-202. doi: 10.1176/appi.psy.46.3.195.
Results Reference
background
PubMed Identifier
10981754
Citation
Maroon JC, Lovell MR, Norwig J, Podell K, Powell JW, Hartl R. Cerebral concussion in athletes: evaluation and neuropsychological testing. Neurosurgery. 2000 Sep;47(3):659-69; discussion 669-72. doi: 10.1097/00006123-200009000-00027.
Results Reference
background
PubMed Identifier
21228656
Citation
Randolph C. Baseline neuropsychological testing in managing sport-related concussion: does it modify risk? Curr Sports Med Rep. 2011 Jan-Feb;10(1):21-6. doi: 10.1249/JSR.0b013e318207831d.
Results Reference
background
PubMed Identifier
3091631
Citation
Binder LM. Persisting symptoms after mild head injury: a review of the postconcussive syndrome. J Clin Exp Neuropsychol. 1986 Aug;8(4):323-46. doi: 10.1080/01688638608401325.
Results Reference
background
PubMed Identifier
18551365
Citation
Thornton KE, Carmody DP. Efficacy of traumatic brain injury rehabilitation: interventions of QEEG-guided biofeedback, computers, strategies, and medications. Appl Psychophysiol Biofeedback. 2008 Jun;33(2):101-24. doi: 10.1007/s10484-008-9056-z. Epub 2008 Jun 13.
Results Reference
background
PubMed Identifier
7617178
Citation
Alexander MP. Mild traumatic brain injury: pathophysiology, natural history, and clinical management. Neurology. 1995 Jul;45(7):1253-60. doi: 10.1212/wnl.45.7.1253. No abstract available.
Results Reference
background
PubMed Identifier
19176544
Citation
De Beaumont L, Theoret H, Mongeon D, Messier J, Leclerc S, Tremblay S, Ellemberg D, Lassonde M. Brain function decline in healthy retired athletes who sustained their last sports concussion in early adulthood. Brain. 2009 Mar;132(Pt 3):695-708. doi: 10.1093/brain/awn347. Epub 2009 Jan 28.
Results Reference
background
PubMed Identifier
17762733
Citation
Cantu RC. Chronic traumatic encephalopathy in the National Football League. Neurosurgery. 2007 Aug;61(2):223-5. doi: 10.1227/01.NEU.0000255514.73967.90. No abstract available.
Results Reference
background
PubMed Identifier
10946737
Citation
Jordan BD. Chronic traumatic brain injury associated with boxing. Semin Neurol. 2000;20(2):179-85. doi: 10.1055/s-2000-9826.
Results Reference
background
PubMed Identifier
16983222
Citation
Langlois JA, Rutland-Brown W, Wald MM. The epidemiology and impact of traumatic brain injury: a brief overview. J Head Trauma Rehabil. 2006 Sep-Oct;21(5):375-8. doi: 10.1097/00001199-200609000-00001.
Results Reference
background
PubMed Identifier
9475969
Citation
Cantu RC. Second-impact syndrome. Clin Sports Med. 1998 Jan;17(1):37-44. doi: 10.1016/s0278-5919(05)70059-4.
Results Reference
background
PubMed Identifier
15083872
Citation
Borg J, Holm L, Peloso PM, Cassidy JD, Carroll LJ, von Holst H, Paniak C, Yates D; WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury. Non-surgical intervention and cost for mild traumatic brain injury: results of the WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury. J Rehabil Med. 2004 Feb;(43 Suppl):76-83. doi: 10.1080/16501960410023840.
Results Reference
background

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Use of Adipose-Derived Stem/Stromal Cells in Concussion and Traumatic Brain Injuries

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