Actively Recruiting

Phase 2
Age: 18Years - 90Years
All Genders
ID06003166

Pharmaco-Diagnostic Crossover Trial for Peripheral Nerve Continuity After Trauma

Led by University of Arizona · Updated on 2025-08-05

68

Participants Needed

1

Research Sites

30 weeks

Total Duration

On this page

Sponsors

U

University of Arizona

Lead Sponsor

N

National Institute of Neurological Disorders and Stroke (NINDS)

Collaborating Sponsor

AI-Summary

What this Trial Is About

Researchers are evaluating the role of a single dose of 4-aminopyridine (4-AP) to help diagnose whether nerve injuries from peripheral nerve traction or crush are complete or incomplete. The study aims to speed up the identification of nerve continuity compared to standard electrodiagnostic and clinical assessments. This is a phase 2, randomized, double-blind crossover trial conducted at a single center. Participants will be randomized to receive either a 10 mg dose of 4-aminopyridine followed by a placebo, or placebo followed by the drug, with the order determined randomly. Each participant undergoes baseline sensory and motor testing, blood sampling, and then hourly testing for three hours after each dose to assess sensory and motor function, electrodiagnostic results, and serum 4-AP levels. After completing both treatment arms, testing concludes. Following initial testing, participants will be monitored for 20 weeks with follow-up visits at 2, 6, 12, 18, and 20 weeks, including physical exams and phone interviews at 9 and 15 weeks to assess subjective motor and sensory function. The main outcome measured is the subjective return of sensation during dosing and at various post-injury time points. Each visit or call lasts about 30 minutes.

CONDITIONS

Brief Title

4-AP Peripheral Nerve Crossover Trial

Who Can Participate

Age: 18Years - 90Years
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • Patients with trauma involving two or fewer limbs where nerve continuity is unclear on physical exam
  • Closed soft tissue covering the affected nerve
  • Ability to report sensory and motor changes during exam
  • Eligible for standard monitoring versus surgical nerve exploration
  • Adults aged 18 to 90 years
  • Known limb trauma causing nerve injury or post-operative/post-intervention nerve injury
  • Ability to provide written informed consent
  • Availability for all testing days and main trial day
Not Eligible

You will not qualify if you...

  • Distracting injuries preventing proper examination
  • Planned surgical nerve exploration within 48 hours
  • Planned nerve exploration as part of another surgery within 48 hours
  • Intoxication or cognitive deficits during exam
  • History of multiple sclerosis, stroke, or other neurological disorders
  • Allergy to AMPYRA® or 4-aminopyridine
  • Current use of aminopyridine medications
  • Renal impairment with estimated GFR below 80 mL/min
  • History of poor follow-up compliance or plans to seek care elsewhere
  • Outside age range or unable to consent
  • History of seizure disorder
  • Concomitant traumatic brain injury
  • Unable to communicate sensory changes
  • Unable to move affected limb at baseline
  • Unwilling to complete study requirements
  • Injuries too extensive to isolate a single nerve
  • Current use of organic cation transporter 2 inhibitors (e.g., Cimetidine)
  • Pregnancy, breastfeeding, or incarceration

AI-Screening

AI-Powered Screening

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Your Study Journey

Screening

Duration - 2 to 4 weeks

Participants are screened for eligibility to participate in the trial.

1 screening and enrollment visit

Treatment

Duration - 1 day

Participants receive a single dose of either the study drug or placebo, followed by the alternate treatment in a crossover design. Hourly sensorimotor exams and blood sampling are conducted for three hours after each dose to monitor effects.

1 main trial day with hourly testing for approximately 6 hours

Follow-up

Duration - 20 weeks

Participants are monitored for recovery and progress after injury through physical exams and telephone interviews assessing motor and sensory function.

5 in-person follow-up visits at 2, 6, 12, 18, and 20 weeks and 2 telephone interviews at 9 and 15 weeks

Trial Site Locations

Total: 1 location

1

Banner University Medical Center

Tucson, Arizona, United States, 85724

Actively Recruiting

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Research Team

A

Andrea Horne

How is the study designed?

Study Type

INTERVENTIONAL

Masking

QUADRUPLE

Allocation

RANDOMIZED

Model

CROSSOVER

Primary Purpose

DIAGNOSTIC

Number of Arms

2

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Published Research Related To This Trial

Primary Exploration of Radial Nerve is Not Required for Radial Nerve Palsy while Treating Humerus Shaft Fractures with Unreamed Humerus Nails (UHN).

G Grass, K Kabir, J Ohse...

https://pubmed.ncbi.nlm.nih.gov/21915231

Approach to radial nerve palsy caused by humerus shaft fracture: is primary exploration necessary?

Anastasios V Korompilias, Marios G Lykissas, Ioannis P Kostas-Agnantis...

https://pubmed.ncbi.nlm.nih.gov/23352153