Adjunctive Pregnenolone in Veterans With Mild TBI
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Purpose
Mild traumatic brain injury (TBI) is common among veterans who have served in OEF/OIF (Operation Enduring Freedom in Afghanistan/Operation Iraqi Freedom) and other theatres. Delayed symptoms may occur following TBI, including cognitive symptoms (impaired attention, processing speed, executive functioning), as well as behavioral symptoms such as anxiety, depression, and irritability (Fann et al. 2004; Holsinger et al. 2002). Neuroactive steroids have neuroprotective effects in rodent models of TBI (Djebaili et al. 2005; Djebaili et al. 2004; He et al. 2004; Pettus et al. 2005; Roof et al. 1997) and the neuroactive steroid pregnenolone and its sulfated derivative also markedly enhance learning and memory in rats (Akwa et al. 2001; Flood et al. 1992; Flood et al. 1995; Vallee et al. 1997; Vallee et al. 2003). In humans, reductions in pregnenolone (George et al. 1994) and its GABAergic metabolite allopregnanolone (Uzunova et al. 1998) have been associated with depressive symptoms. Pharmacological intervention with the neuroactive steroid pregnenolone could therefore result in a multi-targeted treatment approach, potentially improving cognitive deficits as well as anxiety and depression symptoms following TBI.
| Condition | Intervention |
|---|---|
|
Traumatic Brain Injury |
Drug: Pregnenolone Drug: Placebo |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Adjunctive Pregnenolone in Veterans With Mild TBI |
- The primary endpoints will be changes in cognitive symptoms over the course of the study (BAC-A) [ Time Frame: 10 weeks ] [ Designated as safety issue: No ]
- Secondary outcome measures will be PTSD symptoms (CAPS), depressive symptoms (QIDS), and other cognitive scales (CPT, Trail Making, and WCST) [ Time Frame: 10 weeks ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 40 |
| Study Start Date: | January 2008 |
| Estimated Study Completion Date: | November 2012 |
| Primary Completion Date: | August 2009 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: 1
Pregnenolone
|
Drug: Pregnenolone
Pregnenolone 100 mg in divided doses (50 mg, PO, BID) Pregnenolone 300 mg in divided doses (150 mg, PO, BID) Pregnenolone 500 mg in divided doses (250 mg, PO, BID)
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|
Placebo Comparator: 2
Placebo
|
Drug: Placebo
Pregnenolone 100 mg in divided doses (50 mg, PO, BID) Pregnenolone 300 mg in divided doses (150 mg, PO, BID) Pregnenolone 500 mg in divided doses (250 mg, PO, BID)
|
Detailed Description:
See brief summary
Eligibility| Ages Eligible for Study: | 18 Years to 55 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- 18-55 years of age, any ethnic group, either sex
- History of mild TBI since September 2001. TBI occurring at age 18 or older.
- We will adhere to the operational definition of mild TBI suggested by the World Health Organization Task Force (Holm et al.2005), with the exception of the Glasgow Coma Scale Score criteria (not available for these participants).
- Ability to participate fully in the informed consent process.
- No anticipated need to alter medications for the 10-week duration of the study.
Exclusion Criteria:
- For this pilot study, we will exclude patients who report a history of seizures.
- Serious unstable medical illness. History of cerebrovascular accident, prostate, uterine, or breast cancer. Use of oral contraceptives or other hormonal supplementation such as estrogen.
- Current active suicidal and/or homicidal ideation, intent or plan.
- Concomitant medications for medical conditions will be addressed on a case-by-case base and determined if exclusionary.
- Current DSM-IV diagnosis of bipolar disorder, schizophrenia or other psychotic disorder, or cognitive disorder due to a general medical condition other than TBI.
- Female patients who are pregnant or breast-feeding.
- Known allergy to study medication.
Contacts and Locations| United States, North Carolina | |
| Durham VA Medical Center | |
| Durham, North Carolina, United States, 27705 | |
| Principal Investigator: | Christine E Marx, MD, MA | Durham VAMC |
More Information
No publications provided
| Responsible Party: | Durham VA Medical Center |
| ClinicalTrials.gov Identifier: | NCT00623506 History of Changes |
| Other Study ID Numbers: | VA IRB# 01209, VA IRB# 01209 |
| Study First Received: | February 15, 2008 |
| Last Updated: | August 13, 2012 |
| Health Authority: | United States: Food and Drug Administration United States: Federal Government |
Keywords provided by Durham VA Medical Center:
|
TBI Pregnenolone Cognition |
Additional relevant MeSH terms:
|
Brain Injuries Brain Diseases Central Nervous System Diseases Nervous System Diseases |
Craniocerebral Trauma Trauma, Nervous System Wounds and Injuries |
ClinicalTrials.gov processed this record on June 18, 2013