Traumatic Brain Injury, Traumatic Brain Injury (TBI); Concussion, Initial Encounter, Traumatic Brain Injury (TBI); Concussion, Subsequent Encounter, Traumatic Brain Injury (TBI) Patients, Traumatic Brain Injury With Brief Loss of Consciousness, Traumatic Brain Injury With Persistent Cognitive Deficits
Conditions
Keywords
MUSE Cells, Stem Cell Therapy, Regenerative Medicine, Traumatic Brain Injury, Chronic Brain Injury, Acquired Brain Injury, Cell-Based Therapy, Neuroregeneration, Adult Neurorehabilitation, Medical Tourism, Observational Study, Real-World Evidence, Healing Hope International, Functional Recovery, Compassionate Use Registry
Brief summary
This prospective observational study evaluates the safety profile and patient-reported outcomes associated with MUSE (Multilineage-differentiating Stress-Enduring) stem cell therapy in individuals aged 6 to 75 with chronic traumatic brain injury (TBI). Participants independently elect to receive MUSE cell treatment through international clinical programs, and this study aims to capture real-world evidence on the potential therapeutic effects and risks of this emerging regenerative approach. The study does not administer any intervention. Instead, it follows participants who have received, or plan to receive, MUSE cell infusions outside the United States. Over a 12-month follow-up period, data will be collected on neurological functioning, quality of life, activities of daily living, and any reported adverse events or complications. Information will be gathered through remote interviews, structured digital surveys, and review of medical documentation when available. This research is sponsored by Healing Hope International and is intended to contribute to the ethical and responsible advancement of novel cell-based therapies by generating real-world evidence that may guide future clinical trial development and inform patient care practices.
Detailed description
This observational study is designed to systematically evaluate the safety, tolerability, and potential neurological outcomes associated with MUSE (Multilineage-differentiating Stress-Enduring) stem cell therapy in individuals with chronic traumatic brain injury (TBI) who independently obtain treatment through international clinical programs. MUSE cells are a distinct subpopulation of mesenchymal stem cells characterized by stress resilience, spontaneous triploblastic differentiation, and the capacity to home to sites of tissue injury. Preclinical research suggests that MUSE cells may contribute to neuroregeneration through differentiation into neural and glial lineages, modulation of inflammatory pathways, and repair of damaged central nervous system structures. While early findings are promising, clinical evidence remains limited, highlighting the need for structured real-world data. This study does not randomize participants or administer any treatment. Instead, it functions as a registry-style, real-world evidence platform following individuals who have elected to receive MUSE cell therapy at licensed facilities outside the United States. Collected data will include baseline demographics, TBI history, details of the stem cell procedure (such as cell source, administered dose, and route of delivery), and longitudinal follow-up over 12 months. Primary domains of interest include: Neurological function, assessed with validated clinical instruments (e.g., Glasgow Outcome Scale-Extended). Quality of life, measured using standardized patient-reported outcome tools (e.g., PROMIS-29, EQ-5D). Functional abilities and activities of daily living, to assess practical day-to-day impact. Safety and tolerability, including documentation of adverse events, patient-reported symptoms, and any medical complications. Data will be obtained through remote telemedicine visits, structured digital surveys, and review of available medical records. This study does not collect biospecimens and does not involve the administration of any investigational product. The overarching objective is to generate high-quality real-world evidence regarding the use of MUSE stem cells in chronic TBI, supporting the scientific foundation needed for future controlled clinical trials and potential compassionate use pathways. The study is conducted by Healing Hope International, a nonprofit organization dedicated to advancing ethical access and research in regenerative medicine.
Interventions
BIOLOGICALMUSE Stem Cell Therapy
MUSE (Multilineage-differentiating Stress-Enduring) stem cell therapy refers to the use of a naturally occurring subpopulation of mesenchymal lineage cells characterized by stress tolerance, expression of SSEA-3, and the capacity to differentiate into multiple cell types. Preclinical studies have shown that MUSE cells can migrate to sites of tissue injury, including the central nervous system, and may contribute to tissue repair through paracrine and regenerative mechanisms. In this observational study, participants independently obtain MUSE stem cell therapy at licensed treatment facilities outside the United States as part of their personal medical care. The study team does not provide, administer, manufacture, or direct the therapy.
Sponsors
Healing Hope International
Study design
Observational model
ECOLOGIC_OR_COMMUNITY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
6 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
Individuals aged 6 to 75 years at the time of enrollment. Documented history of traumatic brain injury (TBI) occurring at least 6 months prior to enrollment (chronic phase). Participant has independently elected to receive MUSE (Multilineage-differentiating Stress-Enduring) stem cell therapy at a licensed treatment facility outside the United States. Ability of the participant or legally authorized representative to provide informed consent for participation in an observational study. Willingness to participate in remote or in-person follow-up assessments for up to 12 months. Ability to provide medical records, laboratory reports, or treatment documentation when available.
Exclusion criteria
Individuals who have not received, and do not plan to receive, MUSE cell therapy as part of their independent medical care. Inability or unwillingness to complete study assessments (e.g., severe communication barriers not manageable through caregiver assistance or technology). Any condition that, in the opinion of the study team, would make participation in an observational registry unsafe or infeasible (e.g., inability to provide minimal required data). Planned participation in another research study that would prevent collection of observational outcomes for this registry. Individuals currently incarcerated or in institutional settings where research participation is restricted. \-
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in global functional outcome (Glasgow Outcome Scale-Extended) | Baseline (pre-MUSE cell treatment) and 12 months after first MUSE cell treatment | The Glasgow Outcome Scale-Extended (GOSE) is an 8-point ordinal scale (1 = Death, 8 = Upper Good Recovery) used to evaluate global functional status following traumatic brain injury. Higher scores reflect better functional outcome. This observational study will measure the change in GOSE score from baseline to 12 months after the participant's first independently obtained MUSE cell therapy session. Assessments will be conducted through structured interviews via in-person visits or telehealth, following standardized GOSE scoring procedures. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in post-concussive symptoms (Rivermead Post-Concussion Symptoms Questionnaire) | Baseline; 3, 6, and 12 months after first MUSE cell treatment | The Rivermead Post-Concussion Symptoms Questionnaire (RPQ) is a patient-reported outcome measure used to assess the severity of common post-concussive symptoms. The RPQ includes 16 items, each scored from 0 to 4, producing a total score range of 0-64, with higher scores indicating greater symptom severity. This study will evaluate the change in RPQ total score from baseline to each follow-up time point. Assessments will be conducted remotely using standardized RPQ administration procedures. |
| Change in cognitive function (Montreal Cognitive Assessment) | Baseline; 6 and 12 months after first MUSE cell treatment | The Montreal Cognitive Assessment (MoCA) is a 30-point screening instrument used to evaluate global cognitive function across multiple domains, including attention, memory, executive functioning, language, and visuospatial abilities. Higher scores indicate better cognitive performance. This study will assess change in total MoCA score from baseline to 6- and 12-month follow-up visits. Assessments will be conducted using standardized MoCA administration procedures via in-person or telehealth formats. |
| Change in Health-Related Quality of Life Measured by EQ-5D-5L Index Score | Baseline; 6 and 12 months after first MUSE cell treatment | Health related quality of life will be assessed using the EuroQol 5-Dimension 5-Level Questionnaire (EQ-5D-5L). The EQ-5D-5L measures health status across five domains: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Responses are converted into a single summary health utility index score using country-specific value sets. Scale range: Typically less than 0 (health states worse than death) to 1.0 (perfect health) Interpretation: Higher EQ-5D-5L index scores indicate better overall health-related quality of life Changes in EQ-5D-5L index scores will be evaluated from baseline to follow-up assessments. |
| Change in functional independence (Functional Independence Measure) | Baseline; 6 and 12 months after first MUSE cell treatment | Functional independence will be assessed using the Functional Independence Measure (FIM), an 18-item scale with total scores ranging from 18 to 126, higher scores indicating greater independence in activities of daily living. The outcome will be change in FIM total score from baseline to 6 and 12 months. |
| Change in mood and anxiety symptoms (HADS) | Baseline; 6 and 12 months after first MUSE cell treatment | The Hospital Anxiety and Depression Scale (HADS) is a 14-item self-report questionnaire with two subscales-HADS-Anxiety and HADS-Depression-each scored from 0 to 21, with higher scores indicating more severe symptoms. This study will evaluate changes in HADS-Anxiety and HADS-Depression subscale scores from baseline to 6- and 12-month follow-up assessments. The HADS will be administered using standardized procedures through remote or in-person data collection. |
| Change in Interleukin-6 (IL-6) Serum Concentration | Baseline; 3 and 6 months after first MUSE cell treatment | Serum concentrations of Interleukin-6 (IL-6), a pro-inflammatory cytokine associated with chronic traumatic brain injury, will be obtained when available from participants' independently ordered clinical laboratory tests. IL-6 values will be abstracted from medical records or participant-provided laboratory reports. The study team does not order laboratory testing, collect biospecimens, or perform assays. Unit of measure: picograms per milliliter (pg/mL) Interpretation: Higher IL-6 concentrations indicate greater systemic inflammation Changes in IL-6 concentrations will be evaluated between baseline and follow-up time points. |
| Incidence of treatment-emergent serious adverse events | From first MUSE cell treatment through 12 months of follow-up | Serious adverse events (SAEs) will be documented using participant reports and available medical records. SAEs will be classified according to ICH and FDA definitions, including events resulting in death, life-threatening conditions, hospitalization or its prolongation, persistent or significant disability/incapacity, or other medically significant events. This study will record the number and proportion of participants experiencing at least one SAE, as well as the total number of SAEs reported during the observation period. |
| Change in Self-Rated Health Measured by Visual Analogue Scale (EQ-VAS) | Baseline, 6 months, and 12 months after first MUSE cell treatment | Self-perceived overall health status will be assessed using the EuroQol Visual Analogue Scale (EQ-VAS). The EQ-VAS is a validated vertical visual analogue scale on which participants rate their current health status. Scale range: 0 to 100 0 = Worst imaginable health state 100 = Best imaginable health state Interpretation: Higher EQ-VAS scores indicate better self-rated health Changes in EQ-VAS scores will be evaluated from baseline to follow-up assessments. Proxy-reported responses will be permitted when participants are unable to self-report due to neurological impairment. |
| Change in Tumor Necrosis Factor Alpha (TNF-α) Serum Concentration | Baseline, 3 months, and 6 months after first MUSE cell treatment | Serum concentrations of Tumor Necrosis Factor Alpha (TNF-α), a pro-inflammatory cytokine implicated in neuroinflammation and secondary injury following traumatic brain injury, will be obtained when available from participants' independently ordered clinical laboratory tests. TNF-α values will be abstracted from medical records or participant-provided laboratory reports. No laboratory testing or biospecimen collection is performed by the study team. Unit of measure: picograms per milliliter (pg/mL) Interpretation: Higher TNF-α concentrations indicate greater inflammatory activity Changes in TNF-α concentrations will be evaluated between baseline and follow-up time points. |
| Change in C-Reactive Protein (CRP) Serum Concentration | Time Frame: Baseline, 3 months, and 6 months after first MUSE cell treatment | Serum concentrations of C-Reactive Protein (CRP), a systemic inflammatory biomarker commonly associated with chronic inflammation and injury response, will be obtained when available from participants' independently ordered clinical laboratory tests. CRP values will be abstracted from medical records or participant-provided laboratory reports. The study does not order laboratory testing or collect biospecimens. Unit of measure: milligrams per liter (mg/L) Interpretation: Higher CRP concentrations indicate greater systemic inflammation Changes in CRP concentrations will be evaluated between baseline and follow-up time points. |
Countries
Mexico, United States
Contacts
CONTACTTamara C Director of Clinical Research, MS. Biopharmaceutical RA
PRINCIPAL_INVESTIGATORDr. Lambert Abeyatunge, MD: Regenerative Medicine
Outcome results
None listed