Brain Concussion
Conditions
Brief summary
Concussions are one of the most complex conditions to manage in sport medicine due to the individualized clinical presentation, caused by a complex neurometabolic cascade, and the lack of a diagnostic standard. There is currently no objective measurement for concussion and the reliance on subjective reporting and clinical judgement is imperfect. In previous clinical studies the investigators determined cutoff values of plasma phosphatidylcholines that provided strong indication that a concussion had occurred. Based on this data, the investigators have developed a custom assay, which will work together with a capillary blood collection device. The current clinical trial will be conducted in two parts. Part A will allow the investigators to determine precise AUC cut-off values for the propriety, novel custom assay, and in Part B the investigators will assess the safety and efficacy of this device for concussion diagnosis in adolescent athletes aged 13-17.
Interventions
Capillary blood sample will be collected on a dried plasma sample (DPS) filter paper. The sample will be sent to a central laboratory where they will undergo metabolite extraction and analysis via mass spectrometry.
Sponsors
Study design
Intervention model description
Participants will enrol into the Baseline Arm of the study. Participants will attend all Baseline Visits unless they experience a concussion at which point, they will transition to the Concussion Arm for further follow-up.
Eligibility
Inclusion criteria
1. Provision of signed and dated informed consent/assent form 2. Stated willingness to comply with all study procedures and availability for the duration of the study 3. Male or female athletes, aged 13-17 inclusive
Exclusion criteria
1. Individuals who have suffered a known concussion within the 6 months prior to enrollment 2. Individuals who suffer from an acute neurological disorder 3. Known pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Part B: Determine safety of the Neurolytixs assay kit for adolescent sports concussion | Through study completion, up to 1 year | Calculate the number of false negatives (concussions that are not captured by the assay |
| Part A: Calculate population reference ranges for 10 phosphatidylcholines (PC) specific to Neurolytixs assay kit. | End of Part A (4-6 months) | Population reference values will be determined with the standard definition of a reference range as the interval between which 95% of values of a reference population fall into, in such a way that 2.5% of the time a value will be less than the lower limit of this interval, and 2.5% of the time it will be larger than the upper limit of this interval, whatever the distribution of these values. Measured PC values will be plotted against both sex and the age of participants to which the PCs were measured. |
| Part A: Generate Area Under the Curve (AUC) values specific to the Neurolytixs assay kit | End of Part A (4-6 months) | Generate AUC values for 10 phosphatidylcholines (PCs) for use in Part B |
| Part B: Determine efficacy of Neurolytixs assay kit for diagnosing adolescent sports concussion | 12-72 hours post-injury | The change of at least 1 PC below the cutoff threshold (determined in Part A) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Part B: Determine whether repeated plasma PC measurements over time correlate with injury symptom resolution or clinical recovery | 12 weeks post-injury | Sensitivity and specificity of the assay compared to diagnosis via the SCAT5 |
Other
| Measure | Time frame | Description |
|---|---|---|
| Part B: Compare proportion of males and females with a change in PC6 | 12 weeks post-injury | Comparison between proportions of sexes diagnosed with concussion and their corresponding PC levels |
| Part B: Compare proportion of males and females with a change in PC7 | 12 weeks post-injury | Comparison between proportions of sexes diagnosed with concussion and their corresponding PC levels |
| Part B: Compare proportion of males and females with a change in PC8 | 12 weeks post-injury | Comparison between proportions of sexes diagnosed with concussion and their corresponding PC levels |
| Part B: Compare proportion of males and females with a change in PC1 | 12 weeks post-injury | Comparison between proportions of sexes diagnosed with concussion and their corresponding PC levels |
| Part B: Compare proportion of males and females with a change in PC10 | 12 weeks post-injury | Comparison between proportions of sexes diagnosed with concussion and their corresponding PC levels |
| Number of Unanticipated Adverse Device Effects | Through study completion, up to 1 year | Frequency of UADEs |
| Part B: Compare proportion of males and females with a change in PC9 | 12 weeks post-injury | Comparison between proportions of sexes diagnosed with concussion and their corresponding PC levels |
| Part B: Compare proportion of males and females with a change in PC2 | 12 weeks post-injury | Comparison between proportions of sexes diagnosed with concussion and their corresponding PC levels |
| Part B: Compare proportion of males and females with a change in PC3 | 12 weeks post-injury | Comparison between proportions of sexes diagnosed with concussion and their corresponding PC levels |
| Part B: Compare proportion of males and females with a change in PC4 | 12 weeks post-injury | Comparison between proportions of sexes diagnosed with concussion and their corresponding PC levels |
| Part B: Compare proportion of males and females with a change in PC5 | 12 weeks post-injury | Comparison between proportions of sexes diagnosed with concussion and their corresponding PC levels |
Countries
Canada, United States