Traumatic Brain Injury (TBI)

This research aims to evaluate interventions to support family members who act as surrogate decision makers for critically ill patients in Intensive Care Units ICUs. These surrogates often face intense grief and stress that can affect their mental health and the quality of decisions made for their loved ones near end-of-life. The study focuses on reducing symptoms of prolonged grief disorder PGD, post-traumatic stress disorder PTSD, and related emotional challenges through a psychological intervention called EMPOWER. The study compares two approaches the EMPOWER intervention, which is a brief, cognitive-behavioral and acceptance-based treatment delivered by trained mental health professionals, and a Supportive Conversation SC that provides empathetic support without specific skill-building. EMPOWER includes six 15-minute modules and two booster phone sessions, totaling about 90 minutes plus follow-ups, while the Supportive Conversation matches this time with supportive interaction and follow-up calls. Participants are assessed up to four times before and after the intervention within three months. Participants, who are surrogate decision makers of ICU patients near end-of-life, will complete assessments on grief, PTSD, depression, regret, anxiety, and distress before the intervention, immediately after, and at 3 and 12 months follow-up. The study also includes interviews with some participants to better understand the interventions effects and contextual factors during the COVID-19 pandemic. The primary outcomes focus on changes in grief and PTSD symptoms over twelve months, with safety and mental health monitored throughout the study period.

This research aims to explore the clinical significance and causes of generalized vulnerability in older adult men with serious diseases including various cancers and fractures. It seeks to establish how common these causes are among patients with severe non-cancerous diseases, local and advanced cancers, and how these vulnerabilities affect the time to fully palliative care, overall survival, and quality of life. The study also evaluates how well common screening tools used in non-cancer patients detect vulnerability in older adults with cancer. Participants are men diagnosed with conditions such as prostate cancer, lung cancer, brain metastasis, pelvic fracture, chronic subdural hematoma, or those undergoing high-dose chemotherapy and stem cell transplantation. The study is observational and involves tests designed to determine vulnerability. Patients are required to have recent cross-sectional imaging and study procedures within defined timeframes relative to treatment or hospitalization. No experimental treatments are administered. During the study, participants will undergo assessments to detect causes of vulnerability around the time of study procedures. Researchers will monitor survival, timing of palliative care adoption, and patient-reported quality of life. The study will collect clinical data and imaging results. Participation involves observational data collection without additional treatment, with the study continuing until December 2030.

Researchers are studying the development of neural flexibility, measured by MRI, as an indicator of cognitive flexibility in Chinese toddlers aged 32 to 42 months. The study also evaluates executive functions such as inhibition, shifting attention, emotional control, working memory, and planning using the Global Executive Composite score from a standardized rating scale. This research aims to better understand brain development and cognitive abilities during early childhood. Participants are divided into two groups based on their daily milk consumption one group receives S-26 GOLD or ULTIMA GUM formula, while the other consumes cows milk. Parents continue feeding their children these milk products throughout the study, and information about milk consumption is collected starting up to two months before and during the study period. The brain is examined using MRI, a safe and non-invasive imaging technology. During the study, toddlers undergo MRI scans and assessments of brain structure and function at the start and again at 42 months of age. Researchers also evaluate cognitive flexibility, behavior, curiosity, sleep quality, home environment, feeding practices, and fecal microbiota composition over time. Parents provide information through interviews, and the childs development and school readiness are monitored. The study runs from baseline through 42 months of age, with additional home environment data collected at 8 months after baseline.

Researchers are evaluating the CIPHER System in patients undergoing brain tumor removal surgery for newly diagnosed supratentorial glioma. This First-in-Human clinical investigation aims to assess the safety and basic performance of a novel, highly flexible, electrode-dense cortical probe designed for neurophysiological mapping and stimulation during brain tumor resection. The study focuses on how well the device functions and its handling characteristics during short-term use in surgery. Participants will have the CIPHER Probe placed on the surface of the brain during standard tumor removal surgery. Two groups are studied one where only neural activity is recorded and another where both recording and electrical stimulation are performed using the probe. No stimulation is delivered in the recording-only group. The device is tested on the main tumor area and the surrounding tissue margin just before tumor removal. During the study, participants will be monitored through hospital visits during their recovery period, including follow-ups at two and six weeks after surgery. Researchers will collect data on any device or procedure-related adverse events, spontaneous neural activity, signal quality, and device deficiencies. The total study period includes enrollment through the six-week postoperative follow-up to evaluate safety and device performance.

Gliomas are aggressive tumors that originate from glial or stem cells, with patients typically surviving between 12 to 15 months. This research investigates whether a classic ketogenic diet CKD, which restricts carbohydrate intake and increases fat consumption to induce ketosis, can help extend survival in patients with high-grade gliomas and brain metastases. The study compares outcomes to historical controls to evaluate the diets potential therapeutic effect. Participants will follow the CKD for an initial period of 3 months, which is a high-fat, low-carbohydrate diet adjusted to each patients energy needs by dietitians. This diet aims to reduce blood glucose levels and increase ketone bodies to stimulate biochemical changes. Patients and their families will receive training on meal planning and ketoneglucose monitoring, and dietitians will provide ongoing support and follow-up visits. Throughout the study, participants will regularly monitor their urine and blood ketone levels daily and maintain records. Researchers will assess overall survival up to 36 months, tumor size changes, time to progression, quality of life, and functional impairment using established scales and surveys. Follow-up evaluations will occur at baseline and various intervals up to 24 months. The study includes safety assessments and continues monitoring until death or the study endpoint.

Researchers are evaluating a low-cost augmented reality platform for balance training in patients with balance disorders caused by degenerative injuries or cerebrovascular diseases. The study aims to determine if the system is usable, acceptable, safe, and if it improves balance. The trial is a usability study conducted by the Hospital Universitari Vall dHebron Research Institute. The intervention has two phases the first phase lasts four weeks with supervised balance training sessions at the hospital, conducted for 60 minutes, three times a week. If patients meet inclusion criteria, the intervention continues for two additional weeks at home with a family member trained to assist as a training partner. The platform uses different exercise protocols accessed through RGSweb, including balance and sit-to-stand exercises with visual targets and movement tracking. Participants undergo three assessments before treatment Day 0, after the hospital phase Week 4, and after the home phase Week 6. Evaluations include usability scales, adherence measures, balance tests like the Berg Balance Scale, postural sway, sit-to-stand tests, balance confidence, and quality of life questionnaires. Safety is monitored throughout, and adherence is tracked during both hospital and home interventions.

Veterans face a heightened risk of suicide during the first year after leaving military service, especially those not connected to VA healthcare. This research aims to improve reintegration and reduce suicide risk for recently transitioned Veterans by evaluating STEP-Home-SP, a skills-based, video telehealth workshop. It is designed to provide suicide prevention education, support for accessing VA care, and tools to manage the transition effectively during this critical period. The study compares two groups one participating in the STEP-Home-SP workshop and the other receiving Enhanced Usual Care EUC, which includes standard care plus an educational packet on suicide risk and VA care connection. STEP-Home-SP involves weekly 1.5-hour group sessions over 12 weeks, focusing on emotional regulation, problem solving, and attention training, with up to six additional 30-minute individual sessions tailored to each Veterans needs. EUC involves existing transition support programs such as the Transition Assistance Program and VA Solid Start outreach. Participants will be assessed at multiple points over a year, including baseline, 12 weeks, and 24 weeks. Researchers will measure feasibility factors like recruitment and adherence, satisfaction with the program, and changes in reintegration status using the Military-to-Civilian Questionnaire. They will also monitor engagement with VA care and collect qualitative feedback. The study will help inform future larger trials and aims to address social isolation and suicide risk during Veterans transition to civilian life.

Chronic subdural hematoma CSDH is a common condition often treated by neurosurgical evacuation and drainage of the hematoma. This research aims to compare two drainage methods after surgery 24 hours of active subperiosteal drainage versus 24 hours of passive subdural drainage. The study is a nationwide, randomized clinical trial conducted across all neurosurgical units in Denmark to evaluate if active drainage is not worse than passive drainage in terms of safety and recurrence. Participants will be adults with symptomatic unilateral CSDH undergoing single burr hole evacuation. Before surgery, patients will be randomly assigned to receive either 24 hours of active subperiosteal drainage or 24 hours of passive subdural drainage. Both drainage methods are already in use, but a direct comparison has not been done. The trial will monitor patients for 90 days post-surgery to assess outcomes. During the study, participants will be evaluated for mortality and recurrence of CSDH requiring reoperation within 90 days. Other assessments include complications related to surgery, length of hospital stay, and functional outcomes measured by the simplified modified Rankin scale. The study uses a double-blind design for patients and statisticians and plans to enroll 354 participants over approximately two years.

Researchers are evaluating the use of a bioresorbable bone adhesive called Tetranite for improving cranial flap fixation in patients undergoing craniotomy. This pilot clinical study aims to demonstrate the safety and effectiveness of Tetranite compared to current metal fixation methods, with assessments at the time of fixation and after six months. The study focuses on safety outcomes and patient-reported results to support further clinical studies involving more patients. Participants will receive cranial flap fixation using either the standard metal plates and screws with Tetranite applied to fill kerf lines and burr holes, or Tetranite alone for flap fixation. The study includes two groups the first five patients will have metal fixation plus Tetranite augmentation, followed by patients receiving only Tetranite. Treatments are delivered during surgery, with follow-up evaluations extending to twelve months. Participants will be monitored through clinical assessments including CT imaging to evaluate bone healing and flap position, clinical palpation to check flap immobility, and patient surveys measuring pain and quality of life. The primary safety outcome is the rate of serious device or procedure-related adverse effects within six months. Secondary measures include radiolucency changes, device-related events, flap translation, and patient-reported outcomes over a one-year period. The total participation time includes surgery and follow-up visits for up to twelve months.

Researchers are evaluating whether a new active rehabilitation program can improve recovery outcomes for soldiers who have experienced mild traumatic brain injury mTBI, also known as concussion. The study aims to test if this active rehab approach helps soldiers return to duty faster and improves their cognitive and physical function. The research is conducted in a military setting and involves comparing current standard care with the new active rehab method. The study involves two groups of soldiers stationed at Fort Bragg, North Carolina, who have had an mTBI within the past two weeks. One group receives the current progressive return to activity PRA care, while the other group follows the Active Rehab protocol, which includes personalized activities such as low-intensity aerobic exercise, cognitive tasks, balance training, and visualvestibular exercises. This rehab is progressed based on symptoms and duty needs over five phases, aiming to accelerate safe recovery. The intervention is delivered by trained providers, and outcomes from both groups are compared. Participants will be assessed at initial intake, two weeks post-enrollment, when asymptomatic, and upon clearance to return to full duty. Evaluations include military performance, heart rate variability, cognitive tests, coordination, symptom inventories, and quality of life measures. The study will follow participants for up to about a year to track recovery progress. Data collected will help develop a clinical algorithm to guide future active rehab for military personnel after mTBI.