The Effects of Fish Oil Supplementation on the Brain Health of Collegiate Football Athletes

Traumatic Brain Injury (TBI) Clinical Trial

Official title:

Study of Effect of Docosahexaenoic Acid (DHA) and Eicosapentaenoic Acid (EPA) Supplementation on Biomarkers of Sub-Concussion Injuries in American Football

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04796207
• Other study ID #: IRB1904553365
• Status: Completed
• Phase: N/A
• Start date: May 28, 2019
• Est. completion date: January 28, 2020

Study information

• Verified date: March 2021
• Source: University of Arizona
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Determine if the daily docosahexaenoic acid (DHA)/eicosapentaenoic acid (EPA) supplement will reduce serum levels of biomarkers of sub-concussion injuries over a course of American football season among collegiate football athletes.

Description:

American football is one of the most popular sports in the U.S. Yet this sport is associated with increased risk of concussion (also known as mild traumatic brain injury, or mTBI) and sub-concussive injury from repeated head impacts (RHI) due to the aggressive and high-speed nature of the game. Current protective equipment used by players are not sufficient to reduce concussion incidence and severity, nor are there any therapeutics available to prevent concussion. This study is a randomized, double-blind, placebo controlled trial to determine if an omega-3 polyunsaturated fatty acid (PUFA) fish oil supplement containing 3.0 grams of docosahexaenoic acid (DHA; 22:6n-3) and eicosapentaenoic acid (EPA; 20:5n-3) can reduce blood biomarkers of sub-concussion injuries compared to placebo (high-oleic safflower oil) over a course of the American football season among collegiate football athletes. The dosage of DHA/EPA used in this study is generally safe, and procedures involved, monthly blood draws, surveys, and Magnetic Resonance Imaging (MRI), pose minimal risks to participants. While this study provides no direct benefit to participants, successful outcomes of this study can benefit the society by shedding light on development of potential preventative therapeutics for sports-induced mTBI and brain injury from RHI. The risk-benefit profile is appropriate for conducting this study. Based on preclinical studies and previous clinical study results, the investigators expect that in comparison to placebo treatment, DHA and EPA treatment throughout the course of one American football season can maintain lower levels of sub-concussion associated biomarkers, inflammatory cytokines, and cardiovascular risk markers. The investigators also expect participants treated with DHA and EPA to have lower brain MRI imaging markers of sub concussion injury.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 38
• Est. completion date: January 28, 2020
• Est. primary completion date: January 28, 2020
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: Male
• Age group: 18 Years to 25 Years

Eligibility

Inclusion Criteria:

1) University of Arizona National Collegiate Athletic Association (NCAA) Division I American football athletes cleared to participate in university athletics as determined by the team physician.

Exclusion Criteria:

1. Chronic daily anti-inflammatory drugs (>20 d).

2. Medications for blood lipids.

3. Active fish oil or omega-3 fatty acid supplementation.

4. Consumption of more than two servings of fish per week.

5. Injured and unable to participate in regularly schedule conditioning or competitions.

6. Acute concussion experienced within 30 days of starting the study.

7. Fish allergies.

Related Conditions & MeSH terms

• Brain Diseases
• Brain Injuries
• Brain Injuries, Traumatic
• Chronic Traumatic Encephalopathy
• Chronic Traumatic Encephalopathy (CTE)
• Traumatic Brain Injury (TBI)

Intervention

Dietary Supplement:
• Fish Oil (DPA+EPA 2:1 ratio) Capsules
The Treatment Arm intervention consists of providing participants with 3 grams of DHA and EPA (2:1 weight ratio) in capsular form. In order to meet the required 3 grams of DHA and EPA, participants were given 6 capsules to be taken with meals (preferably breakfast, although capsules were provided at lunch when they couldn't be provided at breakfast). Capsules were given 3 times a week during the regular football season.
• High Oleic Safflower Oil Capsules
The Placebo Arm intervention consists of providing participants with 3 grams of high-oleic safflower oil in a 1:1 allocation ratio in capsular form. In order to maintain the "study masking", participants in the Placebo Arm were given 6 capsules (the same as the Treatment Arm) to be taken with meals (preferably breakfast, although capsules were provided at lunch when they couldn't be provided at breakfast). Capsules were given 3 times a week during the regular football season.

Locations

Country	Name	City	State
United States	University of Arizona	Tucson	Arizona

Sponsors (1)

Lead Sponsor	Collaborator
University of Arizona

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Changes in brain biomarkers due to sub-concussion injury - Nf-L	This primary outcome covers the change in the plasma brain biomarker Neurofilament Light Chains (Nf-L) due to sub-concussion injury from baseline to predetermined measurement time points. Nf-L (neuron specific intermediate proteins) are released upon injury to neurons and axons. Measured in picograms per milliliter (pg/ml)	Baseline; then once a month until the end of the study, up to 8 months.
Primary	Changes in brain biomarkers due to sub-concussion injury - Tau	This primary outcome covers the change in the plasma brain biomarker Tau protein due to sub-concussion injury from baseline to predetermined measurement time points. Tau protein accumulates in the brain after injury. Tau protein is measured in picograms per milliliter (pg/ml)	Baseline; then once a month until the end of the study, up to 8 months.
Primary	Changes in brain biomarkers due to sub-concussion injury - UCH-L1	This primary outcome covers the change in the plasma brain biomarker Ubiquitin C-Terminal Hydrolase L1 (UCH-L1) due to sub-concussion injury from baseline to predetermined measurement time points. UCH-L1 levels are elevated in the cerebrospinal fluid (CSF) and serum for several days after severe traumatic brain injury. UCH-L1 is measured in nanograms per milliliter (ng/ml)	Baseline; then once a month until the end of the study, up to 8 months.
Primary	Changes in sub-concussion injury related inflammation biomarkers - CRP	This primary outcome covers the change in the plasma inflammation biomarker C-reactive Protein (CRP), a marker of general inflammation, due to sub-concussion injury from baseline to predetermined measurement time points. CRP is measured in milligrams per liter (mg/L)/	Baseline; then once a month until the end of the study, up to 8 months.
Primary	Changes in sub-concussion injury related inflammation biomarkers - TNF-a	This primary outcome covers the change in the plasma inflammation biomarker Tumor Necrosis Factor-alpha (TNF-a), a cytokine and mediator of inflammation, due to sub-concussion injury from baseline to predetermined measurement time points. TNF-a is measured in picograms per milliliter (pg/ml).	Baseline; then once a month until the end of the study, up to 8 months.
Primary	Changes in sub-concussion injury related inflammation biomarkers - IL-6	This primary outcome covers the change in the plasma inflammation biomarker Interleukin-6 (IL-6), a cytokine and mediator of inflammation, due to sub-concussion injury from baseline to predetermined measurement time points. IL-6 is measured in picograms per milliliter (pg/ml)	Baseline; then once a month until the end of the study, up to 8 months.