Interhemispheric Anterior Delta Desynchronization in Children Who Present to the Emergency Department With Acute Concussion: A Proof of Concept Study

NCT ID: NCT02916108

Last Updated: 2023-12-08

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Total Enrollment

60 participants

Study Classification

OBSERVATIONAL

Study Start Date

2017-10-01

Study Completion Date

2025-12-31

Brief Summary

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Approximately 150,000 children present each year to emergency departments (EDs) in the US with concussion and many more are treated by primary care physician, or outpatient specialists.

Concussion is defined as a traumatically induced transient disturbance of brain function and involves a complex pathophysiological process. There is a variety of symptoms related to concussion, and the diagnosis of concussion requires the use of symptom-checklist. Since there is a various degree of the severity of those symptoms, the diagnosis is a subjective one and lacks sensitivity.

One major problem is that approximately one-third of the children with concussion experience ongoing somatic, cognitive, and psychological or behavioral symptoms, referred to as persistent post-concussion symptoms. A recent study that investigated the validity a 12-point PPCS risk score revealed that it had modest validity (0.71). Moreover, one of the greatest concerns is the child's schedule return to activity.

Since the basic mechanism for concussion is acceleration/ deceleration movement of axons, it is likely to be expressed in desynchronization of delta wave activity between anterior hemispheres as seen in pathological problems related to attention and/ or working memory).

The aim of this proof-of-concept study is to find-out whether interhemispheric desynchronization of delta waves (IHDD) in the anterior hemispheres can identify acute concussion in children. If the investigators find that IHDD can accurately diagnose acute concussion, a second objective will be to examine whether this index can be a useful tool in the follow up of patients with persistent post-concussion symptoms.

Detailed Description

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Conditions

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Concussion, Mild Traumatic Brain Injury

Keywords

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Concussion Mild traumatic brain injury EEG

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

PROSPECTIVE

Study Groups

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Concussion

Study group include up to 30 children with history of concussion in the last 24 hours before admitting to emergency department.

Reading EEG.

Reading EEG

Intervention Type OTHER

EEG recording for 5 minutes (not an intervention)

Isolated limb injury

Cohort group include up to 30 children with history of isolated limb injury in the last 24 hours before admitting to emergency department.

Reading EEG.

Reading EEG

Intervention Type OTHER

EEG recording for 5 minutes (not an intervention)

Interventions

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Reading EEG

EEG recording for 5 minutes (not an intervention)

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Study group will include children aged 11-18 years with diagnosis of acute concussion based on the RPSQ. (Eisenberg et al., 2013; Harmon et al., 2013)
* Controls will be healthy children who will be admitted to the ED due to an isolated limb injury such as laceration, contusion or fracture and are not painful. Nonverbal or non-cooperative children will be excluded from the study.

Exclusion Criteria

* Nonverbal or non-cooperative children.
* Lack of inform consent.
Minimum Eligible Age

11 Years

Maximum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Rambam Health Care Campus

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Dana Baron Shahaf, MD PhD

Role: PRINCIPAL_INVESTIGATOR

Rambam Health Care Campus

Locations

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Rambam Health Care Campus

Haifa, , Israel

Site Status RECRUITING

Countries

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Israel

Central Contacts

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Dana Baron Shahaf, MD PhD

Role: CONTACT

Phone: +972-4-7772487

Email: [email protected]

Itay Shavit, MD

Role: CONTACT

Phone: +972-4-7774

Email: [email protected]

Facility Contacts

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Dana Baron Shahaf, Dr.

Role: primary

References

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DeMatteo C, McCauley D, Stazyk K, Harper J, Adamich J, Randall S, Missiuna C. Post-concussion return to play and return to school guidelines for children and youth: a scoping methodology. Disabil Rehabil. 2015;37(12):1107-12. doi: 10.3109/09638288.2014.952452. Epub 2014 Aug 21.

Reference Type BACKGROUND
PMID: 25144831 (View on PubMed)

Eisenberg MA, Andrea J, Meehan W, Mannix R. Time interval between concussions and symptom duration. Pediatrics. 2013 Jul;132(1):8-17. doi: 10.1542/peds.2013-0432. Epub 2013 Jun 10.

Reference Type BACKGROUND
PMID: 23753087 (View on PubMed)

Harmon KG, Drezner JA, Gammons M, Guskiewicz KM, Halstead M, Herring SA, Kutcher JS, Pana A, Putukian M, Roberts WO. American Medical Society for Sports Medicine position statement: concussion in sport. Br J Sports Med. 2013 Jan;47(1):15-26. doi: 10.1136/bjsports-2012-091941.

Reference Type BACKGROUND
PMID: 23243113 (View on PubMed)

King NS, Crawford S, Wenden FJ, Moss NE, Wade DT. The Rivermead Post Concussion Symptoms Questionnaire: a measure of symptoms commonly experienced after head injury and its reliability. J Neurol. 1995 Sep;242(9):587-92. doi: 10.1007/BF00868811.

Reference Type BACKGROUND
PMID: 8551320 (View on PubMed)

Baldea JD. In response to: time to re-think the Zurich Guidelines? A critique on the consensus statement on concussion in Sport: the 4th International Conference on Concussion in Sport, held in Zurich, November 2012. Clin J Sport Med. 2014 Nov;24(6):521-2. doi: 10.1097/JSM.0000000000000157. No abstract available.

Reference Type BACKGROUND
PMID: 25347264 (View on PubMed)

Potter S, Leigh E, Wade D, Fleminger S. The Rivermead Post Concussion Symptoms Questionnaire: a confirmatory factor analysis. J Neurol. 2006 Dec;253(12):1603-14. doi: 10.1007/s00415-006-0275-z. Epub 2006 Oct 24.

Reference Type BACKGROUND
PMID: 17063314 (View on PubMed)

Shahaf G. A Possible Common Neurophysiologic Basis for MDD, Bipolar Disorder, and Schizophrenia: Lessons from Electrophysiology. Front Psychiatry. 2016 Jun 1;7:94. doi: 10.3389/fpsyt.2016.00094. eCollection 2016.

Reference Type BACKGROUND
PMID: 27313546 (View on PubMed)

Shahaf G. Migraine as dysfunctional drive reduction: Insight from electrophysiology. Med Hypotheses. 2016 Jun;91:62-66. doi: 10.1016/j.mehy.2016.04.017. Epub 2016 Apr 11.

Reference Type BACKGROUND
PMID: 27142146 (View on PubMed)

Shahaf G, Pratt H. Thorough specification of the neurophysiologic processes underlying behavior and of their manifestation in EEG - demonstration with the go/no-go task. Front Hum Neurosci. 2013 Jun 24;7:305. doi: 10.3389/fnhum.2013.00305. eCollection 2013.

Reference Type BACKGROUND
PMID: 23805094 (View on PubMed)

Vargas G, Rabinowitz A, Meyer J, Arnett PA. Predictors and prevalence of postconcussion depression symptoms in collegiate athletes. J Athl Train. 2015 Mar;50(3):250-5. doi: 10.4085/1062-6050-50.3.02. Epub 2015 Feb 2.

Reference Type BACKGROUND
PMID: 25643158 (View on PubMed)

West TA, Marion DW. Current recommendations for the diagnosis and treatment of concussion in sport: a comparison of three new guidelines. J Neurotrauma. 2014 Jan 15;31(2):159-68. doi: 10.1089/neu.2013.3031. Epub 2013 Oct 16.

Reference Type BACKGROUND
PMID: 23879529 (View on PubMed)

Zemek R, Barrowman N, Freedman SB, Gravel J, Gagnon I, McGahern C, Aglipay M, Sangha G, Boutis K, Beer D, Craig W, Burns E, Farion KJ, Mikrogianakis A, Barlow K, Dubrovsky AS, Meeuwisse W, Gioia G, Meehan WP 3rd, Beauchamp MH, Kamil Y, Grool AM, Hoshizaki B, Anderson P, Brooks BL, Yeates KO, Vassilyadi M, Klassen T, Keightley M, Richer L, DeMatteo C, Osmond MH; Pediatric Emergency Research Canada (PERC) Concussion Team. Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED. JAMA. 2016 Mar 8;315(10):1014-25. doi: 10.1001/jama.2016.1203.

Reference Type BACKGROUND
PMID: 26954410 (View on PubMed)

Other Identifiers

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0333-16-RambamCTIL

Identifier Type: -

Identifier Source: org_study_id