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Brain Diseases clinical trials

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NCT ID: NCT05820178 Not yet recruiting - Stroke Clinical Trials

tDCS and rTMS in Patients With Early Disorders of Consciousness

Start date: May 1, 2023
Phase: N/A
Study type: Interventional

A randomized controlled study was conducted to explore the efficacy of early transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS) to promote wakefulness in patients with disorder of consciousness (DOC). In order to improve the prognosis of DOC patients with nontraumatic brain injury, we compared the effects of tDCS and rTMS on clinical behavior and neurophysiological performance, and selected a wake-up technique that could improve the prognosis of DOC patients with nontraumatic brain injury as early as possible, so as to reduce the pain of patients and their loved ones, and to reduce the economic burden of society and families.

NCT ID: NCT05788627 Not yet recruiting - Clinical trials for Hepatic Encephalopathy

Effectiveness of Oral Lactulose Versus Lactulose Enema in Hepatic Encephalopathy

Start date: April 2023
Phase: Phase 4
Study type: Interventional

Patients with chronic liver disease due to hepatitis B or C viruses, Non-alcoholic fatty liver disease, autoimmune hepatitis, wilson disease, cryptogenic hepatitis etc are prone to develop complications. Hepatic encephalopathy is one of such complications. It is graded into four types depending on severity of clinical features, which range through altered sleep pattern to coma. The current study aims to compare the effectiveness of lactulose enema with oral lactulose in time to recovery from higher grade of encephalopathy to lower grade of encephalopathy.

NCT ID: NCT05772585 Not yet recruiting - Clinical trials for Hepatic Encephalopathy

Characterization of Metabolomic Fingerprints in Patients With Acute Liver Failure and Acute-on-chronic Liver Failure With Hepatic Encephalopathy

EH-CASIMIR
Start date: March 2023
Phase:
Study type: Observational

Hepatic encephalopathy is a frequent complication of both acute liver failure (ALF) and acute-on-chronic liver failure (ACLF) and could be responsible among other neurological complications of residual impairment after liver transplantation. Specific metabolomic studies have shed light into pathophysiology. Nevertheless, whether HE metabolomic fingerprints differ between HE in ALF and HE in ACLF and their evolution after liver transplantation (LT) is unknown. The aim of our study is to analyse the metabolomic fingerprint in plasma of 2 different groups of patients before and after LT: - hospitalized patients with ALF and HE - hospitalized patients with ACLF and HE We will analyse metabolomic results to explore if there is any difference in metabolomic fingerprints between these 2 groups and if LT modify the metabolomic fingerprint in plasma in these 2 groups and in the same way. We will collect blood samples in these 2 groups on the day of HE occurring and then on day 1, day 7 and day 30 (+/- 2 days) after LT. We aim to enroll 10 patients in ALF group and 20 patients in ACLF group. Inclusion criteria are defined as age > 18 years, patient presenting with ALF (Synthetic liver failure (INR > 1.5) with hepatic encephalopathy (grade 1-4 of West-Haven classification), without pre-existing hepatopathy, HE beginning within <26 weeks) or ACLF (≥ grade 1 from CANONIC criteria), and clinical HE (grade 1-4 of West-Haven classification) on the day of enrolment. Exclusion criteria are defined as age < 18 years, absence of HE, LT without pre-existing HE, patients who already undergone a LT, legally protected person. An EDTA blood sample will be collected, centrifuged and frozen on the day of enrolment, then on day 1, day 7 and day 30 (+/- 2 days) after LT. Metabolomic analyses will be performed by different techniques but especially with high resolution liquid phase mass spectrometry in collaboration with CEA. Statistical analyses will be both univariate (Mann-Whitney or Wilcoxon tests) and multivariate (with a classical and adapted method for metabolomic studies: Partial Least-Squares Discriminant Analysis (PLS-DA)). We expect to identify different metabolomic fingerprints between HE in both ALF and ACLF patients as well as different kinetics for symptoms resolution after LT. The long-term objective is to target the specific metabolic pathways for each group in order to allow development of new targeted drugs against HE in these 2 different conditions.

NCT ID: NCT05756296 Not yet recruiting - Child Development Clinical Trials

The Long-term Consequences of Neonatal Encephalopathy in the Hypothermia Era

Start date: November 1, 2023
Phase:
Study type: Observational

The goal of this study is to characterize the ability and related brain profiles of children with Neonatal encephalopathy (NE) - Therapeutic hypothermia (TH) at 9 years old. The main questions it aims to answer are: 1. Compare executive function, attention, social cognition, behaviour, anxiety, self-esteem, and peer problems between children with NE-TH and matched peers without NE. 2. Compare brain volumes, cortical and subcortical morphology, white matter microstructure, and myelination between children with NE-TH and matched peers without NE. 3. Evaluate the associations of perinatal risk factors and structural brain integrity with neuropsychological deficits to inform about the potential aggravating and protective factors for neuropsychological functioning. Participants will complete one study visit to perform standardized evaluations and a brain MRI. Parents of participants will be invited to complete a series of questionnaires during this study visit or at a moment of their choice virtually.

NCT ID: NCT05749458 Not yet recruiting - Clinical trials for Hypoxic Ischemic Encephalopathy of Newborn

Maternal and Neonatal Risk Factors of HIE

Start date: November 1, 2023
Phase:
Study type: Observational

The current work aims to: The primary aim in this study was to identify the contribution of maternal, pregnancy, birth and neonatal factors to encephalopathic features in new born infants. The secondary aim of this study is to reduce the burden on the country by decreasing the rate of neonatal encephalopathy, decreasing the different grades of neurodevelopmental impairment and improvement the quality of life.

NCT ID: NCT05648812 Not yet recruiting - Clinical trials for Neonatal Hypoxic Ischemic Encephalopathy

Neonatal Brain Ultrasound With CEUS and Elastography

Start date: May 2023
Phase: Phase 3
Study type: Interventional

The aim of our study is to investigate changes of brain perfusion and elasticity in neonates during the time that a neonate is adapting to live outside the womb and during diseases that are suspected to affect neonatal brain perfusion. We use contrast enhanced ultrasound (sulphur hexafluoride) and ultrasound-assisted elastography to evaluate the state of brain perfusion. We will study neonates recruited from the Neonatal Units of Turku University Hospital.

NCT ID: NCT05514665 Not yet recruiting - Clinical trials for Hypoxic-Ischemic Encephalopathy

Functional Imaging of Baby Brains

FIBB
Start date: March 2024
Phase:
Study type: Observational

Infants are at risk of developing motor and cognitive neurodevelopmental disabilities as a sequelae to hypoxic-ischemic brain injury during the perinatal period. It is an ongoing challenge to predict the severity and extent of future developmental impairment during the neonatal period. This study will help test the feasibility of conducting a large-scale study that evaluates the role of diffuse optical tomography as a bedside neuroimaging tool in complementing the prognostic value of conventional and diffusion weighted MRI for predicting neurodevelopmental outcome in neonates with perinatal hypoxic-ischemic brain injury.

NCT ID: NCT05462054 Not yet recruiting - Clinical trials for STXBP1 Encephalopathy With Epilepsy

Natural History Study in Pediatric Patients With STXBP1 Encephalopathy With Epilepsy

Start date: July 2023
Phase:
Study type: Observational

This is a prospective, non-interventional, longitudinal study designed to characterize the natural history of STXBP1 related encephalopathy with epilepsy, in participants ≤ <5 years of age.

NCT ID: NCT05451537 Not yet recruiting - Clinical trials for Sepsis-Associated Encephalopathy

Correlation of Formyl Peptide Receptor 1 With Sepsis-related Encephalopathy

Start date: September 1, 2022
Phase:
Study type: Observational

The pathogenesis of sepsis-associated encephalopathy (SAE) is unclear, Formylpeptide receptor 1 (FPR1) is a cell membrane receptor that recruits leukocytes and mediates inflammatory responses after activation, but its role and mechanism in SAE are unknown. This project intends to clarify the relationship between FPR1 activation and SAE from the clinical. The investigators enrolled 100 patients with sepsis in ICU. Patients were divided into two groups according to diagnostic criteria: SAE group and none-SAE group. Whole blood was collected. The serum FPR1 protein level was measured using a commercial enzyme-linked immunosorbent assay. After whole blood RNA was extracted, the expressions of FPR1 and a reference gene were quantified by an automated one-step Taqman RT-PCR assay. Multiple logistical regression analysis was used to identify the independent factors (including FPR1 activation) for the prediction of SAE outcomes.

NCT ID: NCT05375240 Not yet recruiting - Stroke Clinical Trials

Propranolol on Post Stroke Immune Status and Infection

Start date: June 2022
Phase: Phase 2
Study type: Interventional

Stroke-associated pneumonia (SAP) is one of the important risk factors influencing poor outcomes and death in stroke patients. Over the past two decades, accumulating evidence suggests that post-stroke brain injury mobilizes the adrenergic system, which induces post-stroke immunosuppression and SAP. This study is designed to test the safety and efficacy of an adrenergic β-receptor blocker, propranolol, with or without combination of antibiotics, in reducing SAP in stroke patients. The underlying immune mechanisms will be investigated.