Peripheral Neuropathy

This research aims to evaluate the outcomes of surgically treated acute traumatic peripheral nerve injuries in the upper extremity, focusing on their long-term effects on sensory and motor functions, overall functional status, and quality of life. The study observes patients with nerve damage resulting from trauma to the nervous system, particularly injuries involving the median, ulnar, radial nerves, or combinations of these. Participants will undergo standard clinical and functional assessments to monitor the status of their nerve injuries. These assessments include evaluating motor and sensory functions and overall hand functionality without being assigned to a specific treatment. The study observes different nerve injury types such as ulnar nerve, median nerve, or combined injuries. During the study, participants will be evaluated at six months after injury using tools like the Michigan Hand Outcomes Questionnaire to assess hand function, grip strength measured by a dynamometer, Semmes-Weinstein monofilament test for sensation, and static two-point discrimination test. The study period involves regular clinical and functional evaluations to track recovery and impact on quality of life over time.

This research aims to evaluate the effectiveness and duration of pain relief provided by a single infusion of 2R,6R-hydroxynorketamine compared with ketamine and saline in adults with chronic neuropathic pain of the extremities lasting longer than three months. The study is a randomized, double-blind, three-way crossover trial designed to compare these treatments on pain intensity, pain qualities, physical function, pain interference, sleep disturbance, and quality of life. Participants will receive each of the three study drugs2R,6R-hydroxynorketamine, ketamine, and salinein a random order, with each infusion given over 45 minutes and spaced five weeks apart, totaling a 15-week treatment period. The study uses a crossover design where participants experience all treatments in different sequences. Safety and efficacy are monitored throughout, with baseline and follow-up assessments including blood tests, ECGs, and physical exams. During the study, participants will undergo quantitative sensory and pain evaluations before the first treatment and on days 7, 14, 21, and 35 after each infusion. They will also complete patient-reported pain outcome questionnaires to assess changes in pain and related symptoms. Researchers will monitor safety, lab results, vital signs, and liver function throughout the trial. Participants are advised to continue their regular pain medications and use additional analgesics only as needed. The total study duration per participant is approximately 15 weeks of treatment plus assessment periods.

Researchers are studying the potential effects of 4-aminopyridine 4-AP on recovery after peripheral nerve injuries caused by traction or crush. The study focuses on men with prostate cancer undergoing robot-assisted radical prostatectomy, as nerve injury during this surgery may lead to erectile dysfunction and urinary continence issues. This research aims to test whether 4-AP can speed up the often slow and unpredictable recovery process after such nerve injuries. Participants will receive either FDA-approved 10 mg 4-aminopyridine tablets or placebo tablets after surgery. The medication is taken orally, with a maximum of two tablets per 24 hours, and must be swallowed whole without breaking or crushing. The treatment period lasts for 60 days following surgery. The placebo is designed to look like the active drug, and participants will be reminded not to take other aminopyridine medications during the study. Throughout the study, participants will be monitored for changes in urinary incontinence and erectile function using standardized questionnaires every seven days for six months. They will also keep a daily drug diary for 90 days and complete sexual activity questionnaires regularly. The study includes follow-up for up to one year to assess recovery progress and safety. The total participation time involves regular assessments and monitoring after the surgery.

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.

Researchers are evaluating the use of 64Cu-DOTATATE PETCTMRI imaging to improve diagnosis and monitoring of Lyme neuroborreliosis LNB, a tick-borne infection affecting the nervous system. This study aims to compare patients clinically suspected and cerebrospinal fluid CSF verified with LNB against those suspected without CSF verification. The goal is to see if this imaging technique can provide more precise diagnosis, prognostic information, and risk assessment for lingering symptoms after treatment. The study involves 50 patients divided into two groups 25 with possible or confirmed neuroborreliosis and 25 investigated but with normal CSF results. Participants will undergo 64Cu-DOTATATE PETCTMRI scans, which target activated macrophages involved in infection. This non-invasive imaging method is being assessed for its diagnostic value and ability to support follow-up six months after treatment, alongside blood biomarker testing including sCD163, NfL, and Tau. During the study, participants will have PETCTMRI scans to measure tracer uptake in the central nervous system and reference organs. Clinical symptoms, laboratory markers, and imaging results will be tracked to evaluate disease activity and prognosis. The primary outcomes focus on diagnostic performance over 2.5 years, with secondary measures also assessed. The study monitors patients without interventions beyond imaging and biomarker collection, lasting from initial evaluation through follow-up visits.

Researchers are investigating the relationship between amylin, a hormone increased in people with Type-2 diabetes, and peripheral neuropathy symptoms in patients with this condition. The study explores whether the amount of amylin in the upper limbs correlates with the severity of nerve damage symptoms. This observational study aims to better understand how diabetes-related vascular damage affects nerve function and may identify biomarkers for disease severity. Participants will provide blood samples and skin biopsies from the forearm to measure amylin deposition in blood vessels and red blood cells. The study also includes nerve conduction velocity tests and sensory assessments of pain and temperature response in the upper extremities. These tests occur at the time of sample collection and follow-up sensory testing one week later. Throughout the study, participants undergo clinical sensory exams, nerve conduction velocity testing, and pain threshold evaluations using pressure, cold, and heat stimuli. Researchers will compare amylin levels to symptom severity and nerve function. The study collects data at single time points and includes follow-up sensory testing to provide preliminary insights for larger trials. Total participation involves initial testing and follow-up assessments one week later.

Researchers are evaluating the safety and efficacy of the study drug LY4065967 for treating diabetic peripheral neuropathic pain DPNP. This trial is part of a larger chronic pain master protocol designed to accelerate the development of new treatments for chronic pain conditions. The study focuses on adults with DPNP related to type 1 or type 2 diabetes. Participants will be randomly assigned to receive either LY4065967 or a placebo, both taken orally. The study is double-blinded, meaning neither participants nor researchers know who receives the active drug or placebo. The treatment period lasts eight weeks, during which participants take the assigned study drug daily. Throughout the trial, participants will report their pain intensity and other symptoms at the start and after eight weeks using various scales, including the Numeric Rating Scale and Brief Pain Inventory. Researchers will also monitor sleep quality, emotional functioning, and the use of rescue medication. Safety and tolerability will be assessed, and the study concludes in July 2027.

Researchers are evaluating the progress of chronic wounds, specifically venous leg ulcers VLU and diabetic foot ulcers DFU, using an absorbent dressing called Mepilex Up. This study is a prospective, open, multi-center, interventional trial designed to observe wound healing over a period of up to six weeks. The goal is to track changes in wound area and condition while participants receive treatment according to local standards of care. Participants will use the Mepilex Up dressing, which is a soft, silicone-based absorbent foam dressing designed to manage wound exudate and protect the skin. The dressing will be applied as the primary dressing and changed weekly for up to six weeks or until the wound heals. The study includes seven visits a baseline visit followed by weekly visits to monitor wound healing and dressing performance. During each visit, researchers will assess wound progress through measurements and evaluations of wound area, volume, tissue quality, exudate, and skin condition. Participants will report on pain, comfort, and quality of life related to wound care. Safety will be monitored at all visits. The total treatment period is a maximum of 44 days or until healing occurs, with detailed tracking of dressing wear time, wound changes, and any adverse events.

The GENESIS clinical study aims to map HLA genetic variation in the Greek population and evaluate possible correlations with selected underlying diseases. It is a multicenter, prospective, non-interventional clinical study targeting 12,000 subjects over an anticipated duration of 36 months, with the goal of creating a pilot HLA map for medical research and possible clinical applications. Each subject will complete one visit at a participating site and provide demographic information, including date of birth, gender, race, ancestry, height, and weight, as well as information about smoking or vaping, alcohol consumption, arterial blood pressure, diagnosed diseases, and current treatments. Recent clinical laboratory results from up to 12 months before sample collection may also be collected when available, including blood count, metabolic, liver enzyme, and biochemical parameters. Two buccal swabs will be collected from each subject for DNA extraction and HLA genotyping analysis. Selected DNA samples will also undergo low-pass whole genome sequencing to further investigate associations between the HLA region and autoimmune diseases. After the analysis is completed, an individualized ancestry report will be securely available to study subjects if they elect to access it.

This trial evaluates treatments for peripheral nerve injuries with gaps between 0.5 and 3.0 cm in adults aged 18 to 80. Researchers compare the efficacy of the NeuroSpan Bridge device against the NeuraGen Nerve Guide and Nerve Autograft in repairing nerve discontinuities. The study is conducted as a multicenter, prospective, randomized, double-blinded clinical trial to assess treatment outcomes and safety. Participants receive one of three nerve repair treatments based on the size of their nerve injury. Those with injuries 0.5 to 1.0 cm receive the NeuraGen Nerve Guide, a resorbable implant that supports nerve repair. Injuries 1.1 to 3.0 cm are repaired using a nerve autograft, transplanting the patients own sensory nerve tissue. The NeuroSpan Bridge, a novel scaffold device designed to mimic natural nerve architecture and support axonal growth across nerve gaps, is also being studied as a treatment option. Throughout the 12-month study period, participants are assessed for nerve function and safety outcomes. Measurements include static two-point discrimination, motor and sensory function grading, moving two-point discrimination, and scores from the Disabilities of the Arm Shoulder and Hand DASH questionnaire. Safety monitoring covers complications such as infections, inflammation, tissue rejection, neuroma formation, chronic pain, and device malfunctions. The trial aims to gather comprehensive data on the effectiveness and safety of these nerve repair methods.