Trial Outcomes & Findings for The Efficacy of Familiar Voice Stimulation During Coma Recovery (NCT NCT00557076)

NCT ID: NCT00557076

Last Updated: 2019-06-06

Results Overview

The primary outcome, the DOCS, is a reliable, valid and precise measure of global neurobehavioral functioning shown to remain stable over six weeks.The DOCS-25 starts with a systematic observation followed by administration of 25 sensory stimuli. Best responses to each stimulus are rated on a scale of 0 to 2 and total raw scores range from 0 (worst) to 50 (best). The DOCS change was calculated as the value at endpoint (6 weeks after Baseline) minus the value at Baseline.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

21 participants

Primary outcome timeframe

Baseline and immediately after treatment ends (6 weeks after Baseline)

Results posted on

2019-06-06

Participant Flow

Subjects were recruited from a large urban community population and two acute rehabilitation hospitals. Community participants included patients not treated at the two acute rehabilitation hospitals. Acute rehabilitation programs included one U.S.

All patients with possible impairment in sound conduction were withdrawn prior to randomization. In total, 5 participants were withdrawn prior to randomization: 1 participant failed the auditory pathway screen, 2 participants recovered full consciousness, and 2 participants were placed in hospice by LAR. Therefore 16 participants were randomized.

Participant milestones

Participant milestones
Measure
FAST
high dose of familiar voice stimulation Familiar Voice Stimulation High Dose: The High Dose intervention is 1,680 minutes of Familiar Vocal Stimulation (FVs) provided in 40 minute daily segments at least 2 hours apart and for 6 weeks. Four CDs with 10 minutes of FVs preceded by the familiar voice calling out the subject's name, will be played (1 at a time) each day for 6 weeks providing 1,680 minutes of FVs.
Sham
sham auditory stimulation Sham Auditory Stimulation: The sham intervention is zero minutes of Familiar Voice Stimulation. Each day for 6 weeks 0 minutes of Familiar voice stimulation will be provided in 10 minute daily segments for 6 weeks. Each 10 minute recording is a digital recording of silence.
Overall Study
STARTED
8
8
Overall Study
COMPLETED
8
7
Overall Study
NOT COMPLETED
0
1

Reasons for withdrawal

Reasons for withdrawal
Measure
FAST
high dose of familiar voice stimulation Familiar Voice Stimulation High Dose: The High Dose intervention is 1,680 minutes of Familiar Vocal Stimulation (FVs) provided in 40 minute daily segments at least 2 hours apart and for 6 weeks. Four CDs with 10 minutes of FVs preceded by the familiar voice calling out the subject's name, will be played (1 at a time) each day for 6 weeks providing 1,680 minutes of FVs.
Sham
sham auditory stimulation Sham Auditory Stimulation: The sham intervention is zero minutes of Familiar Voice Stimulation. Each day for 6 weeks 0 minutes of Familiar voice stimulation will be provided in 10 minute daily segments for 6 weeks. Each 10 minute recording is a digital recording of silence.
Overall Study
Unblinding
0
1

Baseline Characteristics

The Efficacy of Familiar Voice Stimulation During Coma Recovery

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
FAST
n=8 Participants
high dose of familiar voice stimulation Familiar Voice Stimulation High Dose: The High Dose intervention is 1,680 minutes of Familiar Vocal Stimulation (FVs) provided in 40 minute daily segments at least 2 hours apart and for 6 weeks. Four CDs with 10 minutes of FVs preceded by the familiar voice calling out the subject's name, will be played (1 at a time) each day for 6 weeks providing 1,680 minutes of FVs.
Sham
n=7 Participants
sham auditory stimulation Sham Auditory Stimulation: The sham intervention is zero minutes of Familiar Voice Stimulation. Each day for 6 weeks 0 minutes of Familiar voice stimulation will be provided in 10 minute daily segments for 6 weeks. Each 10 minute recording is a digital recording of silence.
Total
n=15 Participants
Total of all reporting groups
Age, Continuous
35.6 years
STANDARD_DEVIATION 11.0 • n=5 Participants
34.4 years
STANDARD_DEVIATION 12.0 • n=7 Participants
35.1 years
STANDARD_DEVIATION 11.0 • n=5 Participants
Sex: Female, Male
Female
2 Participants
n=5 Participants
1 Participants
n=7 Participants
3 Participants
n=5 Participants
Sex: Female, Male
Male
6 Participants
n=5 Participants
6 Participants
n=7 Participants
12 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
1 Participants
n=5 Participants
1 Participants
n=7 Participants
2 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
2 Participants
n=5 Participants
1 Participants
n=7 Participants
3 Participants
n=5 Participants
Race (NIH/OMB)
White
5 Participants
n=5 Participants
5 Participants
n=7 Participants
10 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
2 Participants
n=5 Participants
1 Participants
n=7 Participants
3 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
6 Participants
n=5 Participants
6 Participants
n=7 Participants
12 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Education Achieved at Injury
High School Graduate or GED
4 participants
n=5 Participants
1 participants
n=7 Participants
5 participants
n=5 Participants
Education Achieved at Injury
Some College, No Degree
1 participants
n=5 Participants
3 participants
n=7 Participants
4 participants
n=5 Participants
Education Achieved at Injury
Bachelor Degree
2 participants
n=5 Participants
2 participants
n=7 Participants
4 participants
n=5 Participants
Education Achieved at Injury
Graduate or Professional Degree
1 participants
n=5 Participants
1 participants
n=7 Participants
2 participants
n=5 Participants

PRIMARY outcome

Timeframe: Baseline and immediately after treatment ends (6 weeks after Baseline)

The primary outcome, the DOCS, is a reliable, valid and precise measure of global neurobehavioral functioning shown to remain stable over six weeks.The DOCS-25 starts with a systematic observation followed by administration of 25 sensory stimuli. Best responses to each stimulus are rated on a scale of 0 to 2 and total raw scores range from 0 (worst) to 50 (best). The DOCS change was calculated as the value at endpoint (6 weeks after Baseline) minus the value at Baseline.

Outcome measures

Outcome measures
Measure
FAST
n=8 Participants
familiar voice stimulation FAST is a standardized passive auditory stimulation protocol described elsewhere.8 In brief, the patient is provided with customized recordings of stories told by people well known to the patient at least 1 year prior to injury. The stories represent specific events experienced by both the patient and the storyteller.
Sham
n=7 Participants
sham auditory stimulation Sham Auditory Stimulation: The sham intervention is zero minutes of Familiar Voice Stimulation. Each day for 6 weeks 0 minutes of Familiar voice stimulation will be provided in 10 minute daily segments for 6 weeks. Each 10 minute recording is a digital recording of silence.
DOCS Neurobehavioral Measure (DOCS = Disorders of Consciousness Scale) Change
13.5 units on a scale
Standard Deviation 8.2
18.9 units on a scale
Standard Deviation 15.6

SECONDARY outcome

Timeframe: Baseline and after the 8th CNC assessment (4 weeks after Baseline)

The CNC scale measures arousal and awareness and test stimuli are administered to elicit a specified behavior. Presence/absence of this behavior is scored as 0, 2 or 4. Total raw scores range from 0 (consistently responsive) to 36 (extreme coma). The CNC change score was calculated as the 8th CNC measure minus the Baseline CNC measure. Since 2 CNC measurements were collected per week, the 8th CNC measure occurred in Week 4. To calculate the change, we used the eighth CNC measure because two patients (one per group) recovered full consciousness after the eighth CNC measure. In the second statistical analysis, all CNC measures were used to calculate the slope; this includes the Baseline CNC and CNC measures 2-8. Again, we used the first 8 CNC measures (instead of all 12 collected over 6 weeks of treatment) because two patients recovered full consciousness after the eighth CNC measure.

Outcome measures

Outcome measures
Measure
FAST
n=8 Participants
familiar voice stimulation FAST is a standardized passive auditory stimulation protocol described elsewhere.8 In brief, the patient is provided with customized recordings of stories told by people well known to the patient at least 1 year prior to injury. The stories represent specific events experienced by both the patient and the storyteller.
Sham
n=7 Participants
sham auditory stimulation Sham Auditory Stimulation: The sham intervention is zero minutes of Familiar Voice Stimulation. Each day for 6 weeks 0 minutes of Familiar voice stimulation will be provided in 10 minute daily segments for 6 weeks. Each 10 minute recording is a digital recording of silence.
Coma Near Coma Scale
1.0 units on a scale
Standard Deviation 0.6
0.25 units on a scale
Standard Deviation 0.7

Adverse Events

FAST

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Sham

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Dr. Theresa Pape

Edward Hines, Jr VA Hospital

Phone: 708-202-4953

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place