Trial Outcomes & Findings for Memantine for Neuroprotection and Cognitive Enhancement Following Traumatic Brain Injury (NCT NCT02240589)

NCT ID: NCT02240589

Last Updated: 2017-08-30

Results Overview

Neuropsychological test used to assess an individual's verbal memory abilities. The California Verbal Learning Test-Second Edition (CVLT-II) Long Delay Free Recall measures total word list items recalled after a 20-minute delay. The raw score is converted to a Z-score (Mean=0; SD=1) which was used for statistical analysis. Higher scores reflect worse performance (i.e., more recall errors) on this variable.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

11 participants

Primary outcome timeframe

Week 24

Results posted on

2017-08-30

Participant Flow

Participant milestones

Participant milestones
Measure
Memantine
24 weeks of memantine with accelerated titration, beginning within 48 hours of injury. Memantine: Day 1 to 3: 10 mg bid memantine. Day 3 to 21: 20 mg bid memantine. Day 21 to 168: 10 mg bid memantine.
Placebo
24 weeks of placebo matched to memantine formulation, beginning within 48 hours of injury. Placebo: Day 1 to 3: 10 mg bid placebo. Day 3 to 21: 20 mg bid placebo. Day 21 to 168: 10 mg bid placebo.
Overall Study
STARTED
5
6
Overall Study
COMPLETED
3
4
Overall Study
NOT COMPLETED
2
2

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Memantine for Neuroprotection and Cognitive Enhancement Following Traumatic Brain Injury

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Memantine
n=5 Participants
24 weeks of memantine with accelerated titration, beginning within 48 hours of injury. Memantine: Day 1 to 3: 10 mg bid memantine. Day 3 to 21: 20 mg bid memantine. Day 21 to 168: 10 mg bid memantine.
Placebo
n=6 Participants
24 weeks of placebo matched to memantine formulation, beginning within 48 hours of injury. Placebo: Day 1 to 3: 10 mg bid placebo. Day 3 to 21: 20 mg bid placebo. Day 21 to 168: 10 mg bid placebo.
Total
n=11 Participants
Total of all reporting groups
Age, Continuous
25.4 years
STANDARD_DEVIATION 2.3 • n=5 Participants
40.83 years
STANDARD_DEVIATION 6.52 • n=7 Participants
33.82 years
STANDARD_DEVIATION 14.29 • n=5 Participants
Sex: Female, Male
Female
0 Participants
n=5 Participants
4 Participants
n=7 Participants
4 Participants
n=5 Participants
Sex: Female, Male
Male
5 Participants
n=5 Participants
2 Participants
n=7 Participants
7 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
5 Participants
n=5 Participants
6 Participants
n=7 Participants
11 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
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
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 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
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
White
5 Participants
n=5 Participants
6 Participants
n=7 Participants
11 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

PRIMARY outcome

Timeframe: Week 24

Neuropsychological test used to assess an individual's verbal memory abilities. The California Verbal Learning Test-Second Edition (CVLT-II) Long Delay Free Recall measures total word list items recalled after a 20-minute delay. The raw score is converted to a Z-score (Mean=0; SD=1) which was used for statistical analysis. Higher scores reflect worse performance (i.e., more recall errors) on this variable.

Outcome measures

Outcome measures
Measure
Memantine
n=3 Participants
24 weeks of memantine with accelerated titration, beginning within 48 hours of injury. Memantine: Day 1 to 3: 10 mg bid memantine. Day 3 to 21: 20 mg bid memantine. Day 21 to 168: 10 mg bid memantine.
Placebo
n=4 Participants
24 weeks of placebo matched to memantine formulation, beginning within 48 hours of injury. Placebo: Day 1 to 3: 10 mg bid placebo. Day 3 to 21: 20 mg bid placebo. Day 21 to 168: 10 mg bid placebo.
California Verbal Learning Test - Second Edition (CVLT-II) - Long Delay Free Recall
-2.000 z-score
Standard Deviation 1.000
-1.375 z-score
Standard Deviation 2.016

SECONDARY outcome

Timeframe: Week 24

Neuropsychological test used to assess an individual's verbal memory abilities. California Verbal Learning Test-Second Edition (CVLT-II) Trials 1-5 Free Recall Total measures the sum of all word list items correctly recalled on learning trials 1 through 5. This raw score is converted to a T-score (Mean=50; SD=10) which was used for statistical analysis. The total A1-5T score reflects accurate recall over the five learning trials of the first list, and is most often used as a summary index of learning on the CVLT-II, with higher scores reflecting better performance.

Outcome measures

Outcome measures
Measure
Memantine
n=3 Participants
24 weeks of memantine with accelerated titration, beginning within 48 hours of injury. Memantine: Day 1 to 3: 10 mg bid memantine. Day 3 to 21: 20 mg bid memantine. Day 21 to 168: 10 mg bid memantine.
Placebo
n=4 Participants
24 weeks of placebo matched to memantine formulation, beginning within 48 hours of injury. Placebo: Day 1 to 3: 10 mg bid placebo. Day 3 to 21: 20 mg bid placebo. Day 21 to 168: 10 mg bid placebo.
CVLT-II Trials 1-5 Free Recall Total
31.000 t-score
Standard Deviation 10.817
37.250 t-score
Standard Deviation 15.262

SECONDARY outcome

Timeframe: Week 24

Brief Visuospatial Memory Test-Revised (BVMT-R) Delayed Recall measures the correctly recalled designs (i.e., standard scoring of accuracy and location as described in the manual) after a 25 minute delay. The delayed recall raw score ranges from 0 to 12 with 12 being the highest and best possible score. The raw score is converted to a T-score (Mean=50; SD=10) which was used for statistical analysis.

Outcome measures

Outcome measures
Measure
Memantine
n=3 Participants
24 weeks of memantine with accelerated titration, beginning within 48 hours of injury. Memantine: Day 1 to 3: 10 mg bid memantine. Day 3 to 21: 20 mg bid memantine. Day 21 to 168: 10 mg bid memantine.
Placebo
n=4 Participants
24 weeks of placebo matched to memantine formulation, beginning within 48 hours of injury. Placebo: Day 1 to 3: 10 mg bid placebo. Day 3 to 21: 20 mg bid placebo. Day 21 to 168: 10 mg bid placebo.
Brief Visuospatial Memory Test - Revised (BVMT-R) Delayed Recall
47.00 t-score
Standard Deviation 4.583
45.50 t-score
Standard Deviation 11.561

SECONDARY outcome

Timeframe: Week 24

Brief Visuospatial Memory Test-Revised (BVMT-R) Learning measures the correctly recalled designs (i.e., standard scoring of accuracy and location as described in the manual) over 3 learning trials. The Learning raw score is the sum of the higher number of correctly recalled designs on either Trial 2 or Trial 3 minus the number of correctly recalled designs on Trial 1. A higher score is a better score. The raw score was converted to a T-score (Mean=50; SD=10) for analysis.

Outcome measures

Outcome measures
Measure
Memantine
n=3 Participants
24 weeks of memantine with accelerated titration, beginning within 48 hours of injury. Memantine: Day 1 to 3: 10 mg bid memantine. Day 3 to 21: 20 mg bid memantine. Day 21 to 168: 10 mg bid memantine.
Placebo
n=4 Participants
24 weeks of placebo matched to memantine formulation, beginning within 48 hours of injury. Placebo: Day 1 to 3: 10 mg bid placebo. Day 3 to 21: 20 mg bid placebo. Day 21 to 168: 10 mg bid placebo.
BVMT-R Learning
60.00 t-score
Standard Deviation 8.266
46.50 t-score
Standard Deviation 1.000

SECONDARY outcome

Timeframe: Week 24

Neuropsychological test of visual attention and executive functioning. The trail making tests are thought to reflect a variety of cognitive processes including attention, visual search and scanning, sequencing and shifting, psychomotor speed, abstraction, flexibility, ability to execute and modify a plan of action, and ability to maintain two trains of thought simultaneously. In Trails B, the participant is instructed to draw lines to connect numbers and letters in an alternating numeric and alphabetic sequence as rapidly as possible. Lower scores are better scores and the range of scores can be from 0 to no limit for Trail Making Test part B. This is a timed test and the number of seconds to complete the task is recorded. The unit of measure in seconds is converted to a scaled score (mean =10, SD = 3) using the Heaton et al. norms with lower scores indicating better performance.

Outcome measures

Outcome measures
Measure
Memantine
n=3 Participants
24 weeks of memantine with accelerated titration, beginning within 48 hours of injury. Memantine: Day 1 to 3: 10 mg bid memantine. Day 3 to 21: 20 mg bid memantine. Day 21 to 168: 10 mg bid memantine.
Placebo
n=4 Participants
24 weeks of placebo matched to memantine formulation, beginning within 48 hours of injury. Placebo: Day 1 to 3: 10 mg bid placebo. Day 3 to 21: 20 mg bid placebo. Day 21 to 168: 10 mg bid placebo.
Trail Making Part B
11.67 scaled score
Standard Deviation 6.351
13.25 scaled score
Standard Deviation 4.349

SECONDARY outcome

Timeframe: Week 24

Stroop Interference Test is a neuropsychological test to assess a person's executive function. Specifically, the test is thought to reflect selective attention, cognitive flexibility and processing speed. The raw score for this measure is the number of items correctly identified within 45 seconds. The raw score was converted to a T-score (mean=50; SD=10) for analysis. Higher scores reflect better performance and less interference on reading ability.

Outcome measures

Outcome measures
Measure
Memantine
n=3 Participants
24 weeks of memantine with accelerated titration, beginning within 48 hours of injury. Memantine: Day 1 to 3: 10 mg bid memantine. Day 3 to 21: 20 mg bid memantine. Day 21 to 168: 10 mg bid memantine.
Placebo
n=4 Participants
24 weeks of placebo matched to memantine formulation, beginning within 48 hours of injury. Placebo: Day 1 to 3: 10 mg bid placebo. Day 3 to 21: 20 mg bid placebo. Day 21 to 168: 10 mg bid placebo.
Stroop Interference
51.67 t-score
Standard Deviation 6.807
52.25 t-score
Standard Deviation 7.320

SECONDARY outcome

Timeframe: Week 24

The Behavior Rating Inventory of Executive Function (BRIEF) Inhibit subscale is a rating scale completed by the participant and independently by an observer that assesses the ability to control impulses (inhibitory control) and to stop engaging in a behavior. The frequency of behaviors indicated by items is rated on a 3-point scale (never, sometimes, often). The raw score for the Inhibit subscale is the sum of ratings for the 8 items included in this measure. This sum was converted to a T-score (mean=50; SD=10) for analysis. Higher scores suggest a higher level of dysfunction in a specific domain of executive functions.

Outcome measures

Outcome measures
Measure
Memantine
n=3 Participants
24 weeks of memantine with accelerated titration, beginning within 48 hours of injury. Memantine: Day 1 to 3: 10 mg bid memantine. Day 3 to 21: 20 mg bid memantine. Day 21 to 168: 10 mg bid memantine.
Placebo
n=4 Participants
24 weeks of placebo matched to memantine formulation, beginning within 48 hours of injury. Placebo: Day 1 to 3: 10 mg bid placebo. Day 3 to 21: 20 mg bid placebo. Day 21 to 168: 10 mg bid placebo.
Behavior Rating Inventory of Executive Function (BRIEF) Inhibit
46.00 t-score
Standard Deviation 9.416
61.00 t-score
Standard Deviation 17.569

SECONDARY outcome

Timeframe: Week 24

The TBI-QOL Anger item bank includes 38 hierarchically ordered items designed to measure the full continuum of anger in a way which is both sensitive and appropriate for TBI. The TBI-QOL Anger item bank can be administered as a computer-adaptive test (CAT), allowing precise measurement of self-reported anger using only 4-8 adaptively selected items. Using CAT technology, an individual participant's responses to the TBIQoL Anger scale generated a T-score (Mean=50; SD=10) with a range of 0 (lowest anger) to 100 (greatest anger).

Outcome measures

Outcome measures
Measure
Memantine
n=3 Participants
24 weeks of memantine with accelerated titration, beginning within 48 hours of injury. Memantine: Day 1 to 3: 10 mg bid memantine. Day 3 to 21: 20 mg bid memantine. Day 21 to 168: 10 mg bid memantine.
Placebo
n=4 Participants
24 weeks of placebo matched to memantine formulation, beginning within 48 hours of injury. Placebo: Day 1 to 3: 10 mg bid placebo. Day 3 to 21: 20 mg bid placebo. Day 21 to 168: 10 mg bid placebo.
Traumatic Brain Injury Quality of Life Anger (TBI QOL Anger)
49.725 scaled score
Standard Deviation 8.684
45.375 scaled score
Standard Deviation 9.854

Adverse Events

Memantine

Serious events: 0 serious events
Other events: 5 other events
Deaths: 0 deaths

Placebo

Serious events: 1 serious events
Other events: 6 other events
Deaths: 1 deaths

Serious adverse events

Serious adverse events
Measure
Memantine
n=5 participants at risk
24 weeks of memantine with accelerated titration, beginning within 48 hours of injury. Memantine: Day 1 to 3: 10 mg bid memantine. Day 3 to 21: 20 mg bid memantine. Day 21 to 168: 10 mg bid memantine.
Placebo
n=6 participants at risk
24 weeks of placebo matched to memantine formulation, beginning within 48 hours of injury. Placebo: Day 1 to 3: 10 mg bid placebo. Day 3 to 21: 20 mg bid placebo. Day 21 to 168: 10 mg bid placebo.
Nervous system disorders
Death due to withdrawal of care
0.00%
0/5 • 6 months
16.7%
1/6 • Number of events 1 • 6 months

Other adverse events

Other adverse events
Measure
Memantine
n=5 participants at risk
24 weeks of memantine with accelerated titration, beginning within 48 hours of injury. Memantine: Day 1 to 3: 10 mg bid memantine. Day 3 to 21: 20 mg bid memantine. Day 21 to 168: 10 mg bid memantine.
Placebo
n=6 participants at risk
24 weeks of placebo matched to memantine formulation, beginning within 48 hours of injury. Placebo: Day 1 to 3: 10 mg bid placebo. Day 3 to 21: 20 mg bid placebo. Day 21 to 168: 10 mg bid placebo.
Nervous system disorders
Agitation
40.0%
2/5 • Number of events 2 • 6 months
33.3%
2/6 • Number of events 2 • 6 months
Nervous system disorders
Headache
40.0%
2/5 • Number of events 2 • 6 months
33.3%
2/6 • Number of events 2 • 6 months
Nervous system disorders
Intracranial hypertension
20.0%
1/5 • Number of events 1 • 6 months
0.00%
0/6 • 6 months
Infections and infestations
Pneumonia
60.0%
3/5 • Number of events 3 • 6 months
50.0%
3/6 • Number of events 3 • 6 months
Infections and infestations
Conjuectivitis
20.0%
1/5 • Number of events 1 • 6 months
0.00%
0/6 • 6 months
Infections and infestations
Wound infection
0.00%
0/5 • 6 months
16.7%
1/6 • Number of events 1 • 6 months
Infections and infestations
Other, infection
0.00%
0/5 • 6 months
33.3%
2/6 • Number of events 2 • 6 months
Gastrointestinal disorders
Constipation
20.0%
1/5 • Number of events 1 • 6 months
16.7%
1/6 • Number of events 1 • 6 months
Gastrointestinal disorders
diarrhea
20.0%
1/5 • Number of events 1 • 6 months
16.7%
1/6 • Number of events 1 • 6 months
Blood and lymphatic system disorders
anemia
20.0%
1/5 • Number of events 1 • 6 months
0.00%
0/6 • 6 months
Gastrointestinal disorders
emesis
40.0%
2/5 • Number of events 2 • 6 months
0.00%
0/6 • 6 months
Nervous system disorders
Neurostorming
60.0%
3/5 • Number of events 3 • 6 months
33.3%
2/6 • Number of events 2 • 6 months
Nervous system disorders
seizures
20.0%
1/5 • Number of events 1 • 6 months
0.00%
0/6 • 6 months
Skin and subcutaneous tissue disorders
rash
20.0%
1/5 • Number of events 1 • 6 months
16.7%
1/6 • Number of events 1 • 6 months
Psychiatric disorders
anxiety
0.00%
0/5 • 6 months
16.7%
1/6 • Number of events 1 • 6 months
Nervous system disorders
lethargy
0.00%
0/5 • 6 months
16.7%
1/6 • Number of events 1 • 6 months
Nervous system disorders
fatigue
20.0%
1/5 • Number of events 1 • 6 months
0.00%
0/6 • 6 months
Nervous system disorders
insomnia
20.0%
1/5 • Number of events 1 • 6 months
33.3%
2/6 • Number of events 2 • 6 months
Metabolism and nutrition disorders
dehydration
60.0%
3/5 • Number of events 3 • 6 months
0.00%
0/6 • 6 months
Injury, poisoning and procedural complications
fall
0.00%
0/5 • 6 months
33.3%
2/6 • Number of events 3 • 6 months
Nervous system disorders
pain
40.0%
2/5 • Number of events 2 • 6 months
16.7%
1/6 • Number of events 1 • 6 months
Psychiatric disorders
depression
0.00%
0/5 • 6 months
16.7%
1/6 • Number of events 1 • 6 months
Metabolism and nutrition disorders
hyponatremia
20.0%
1/5 • Number of events 1 • 6 months
0.00%
0/6 • 6 months
Metabolism and nutrition disorders
hypokalemia
0.00%
0/5 • 6 months
16.7%
1/6 • Number of events 1 • 6 months
Metabolism and nutrition disorders
hypophosphotemia
0.00%
0/5 • 6 months
16.7%
1/6 • Number of events 1 • 6 months
Vascular disorders
hypertension
0.00%
0/5 • 6 months
16.7%
1/6 • Number of events 1 • 6 months
Gastrointestinal disorders
indigestion
0.00%
0/5 • 6 months
16.7%
1/6 • Number of events 1 • 6 months

Additional Information

Flora Hammond, MD

Indiana University School of Medicine

Phone: 317-329-2106

Results disclosure agreements

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