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

NCT ID: NCT02959294

Last Updated: 2021-02-16

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

WITHDRAWN

Clinical Phase

EARLY_PHASE1

Study Classification

INTERVENTIONAL

Study Start Date

2018-11-30

Study Completion Date

2024-03-31

Brief Summary

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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

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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.

Conditions

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Traumatic Encephalopathies, Chronic Concussion, Mild Concussion, Intermediate Concussion, Severe Concussion, Brain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Microcannula Harvest Adipose

Acquisition Adipose-Derived Tissue Stromal Vascular Fraction (AD-tSVF) via close syringe microcannula harvest from subdermal fat deposits

Group Type EXPERIMENTAL

Microcannula Harvest Adipose

Intervention Type PROCEDURE

Use of Closed Syringe Microcannula Harvest Autologous Adipose-Derived Stem/Stromal Cells

Centricyte 1000

Autologous AD-tSVF via enzymatic isolation/concentration via Centricyte 1000 Closed System to create AD-cSVF

Group Type EXPERIMENTAL

Centricyte 1000

Intervention Type DEVICE

Use of Centricyte 1000 Closed System Digestion Autologous AD-tSVF to create AD-cSVF

Sterile Normal Saline

Re-suspension of AD-cSVF pellet in Normal Saline deployment via IV

Group Type EXPERIMENTAL

Sterile Normal Saline IV deployment AD-cSVF

Intervention Type PROCEDURE

Sterile Normal Saline Suspension AD-cSVF in 500 cc IV use

Interventions

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Microcannula Harvest Adipose

Use of Closed Syringe Microcannula Harvest Autologous Adipose-Derived Stem/Stromal Cells

Intervention Type PROCEDURE

Centricyte 1000

Use of Centricyte 1000 Closed System Digestion Autologous AD-tSVF to create AD-cSVF

Intervention Type DEVICE

Sterile Normal Saline IV deployment AD-cSVF

Sterile Normal Saline Suspension AD-cSVF in 500 cc IV use

Intervention Type PROCEDURE

Eligibility Criteria

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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
Minimum Eligible Age

16 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Robert W. Alexander, MD, FICS

INDUSTRY

Sponsor Role lead

Responsible Party

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Robert W. Alexander, MD, FICS

Principal Investigator

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Robert W. Alexander, MD

Role: PRINCIPAL_INVESTIGATOR

GARM International and GARM USA

Glenn C Terry, MD

Role: PRINCIPAL_INVESTIGATOR

GARM

Locations

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Regenevita LLC

Stevensville, Montana, United States

Site Status

Countries

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United States

References

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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.

Reference Type BACKGROUND
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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.

Reference Type BACKGROUND
PMID: 17622833 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 18627252 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 19196176 (View on PubMed)

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.

Reference Type BACKGROUND
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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.

Reference Type BACKGROUND
PMID: 17826211 (View on PubMed)

Pearce JM. Observations on concussion. A review. Eur Neurol. 2008;59(3-4):113-9. doi: 10.1159/000111872. Epub 2007 Nov 30.

Reference Type BACKGROUND
PMID: 18057896 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 16286874 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 15883140 (View on PubMed)

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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.

Reference Type BACKGROUND
PMID: 21228656 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 3091631 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 18551365 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 7617178 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 19176544 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 17762733 (View on PubMed)

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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.

Reference Type BACKGROUND
PMID: 16983222 (View on PubMed)

Cantu RC. Second-impact syndrome. Clin Sports Med. 1998 Jan;17(1):37-44. doi: 10.1016/s0278-5919(05)70059-4.

Reference Type BACKGROUND
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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.

Reference Type BACKGROUND
PMID: 15083872 (View on PubMed)

Other Identifiers

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RGV GARM 5

Identifier Type: -

Identifier Source: org_study_id

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