Trial Outcomes & Findings for Transcranial Direct Current Stimulation as a Neuroprotection in Acute Stroke Before and After Thrombectomy (NCT NCT04061577)

NCT ID: NCT04061577

Last Updated: 2023-07-20

Results Overview

Symptomatic intracranial hemorrhage (SICH) is defined as an increase of 4 or more points on the National Institute of Health Stroke Scale (NIHSS) total score within 24 hours of stimulation associated with parenchymal hematoma type 1 (PH1), parenchymal hematoma type 2 (PH2), remote intraparenchymal hemorrhage (RIH), subarachnoid hemorrhage (SAH), or intraventricular hemorrhage (IVH). The NIHSS is a 15-item neurologic examination stroke scale used to evaluate the effect of acute stroke on the levels of consciousness, language, neglect, visual-field loss, extraocular movement, motor strength, ataxia, dysarthria, and sensory loss. A trained observer rates the patent's ability to answer questions and perform activities. Ratings for each item are scored with 3 to 5 grades with 0 as normal, and there is an allowance for untestable items. Accordingly, 0 is the lowest and 42 is the highest total score possible. In the NIHSS, the higher the score, the more impaired a stroke patient is.

Recruitment status

TERMINATED

Study phase

NA

Target enrollment

1 participants

Primary outcome timeframe

At 24-hour post-stimulation

Results posted on

2023-07-20

Participant Flow

Participant milestones

Participant milestones
Measure
Active Stimulation Arm
Patient received 1 mA of high-definition cathodal transcranial direct current for 5 minutes before endovascular procedure (EVT). Patient did not complete the pre-planned 20 minutes of stimulation due to the initiation of EVT.
Sham Arm
Patients in the sham stimulation arm at all the tiers will have the cap and electrodes in place, and sham switch moved but without delivery of electrical stimulation.
Overall Study
STARTED
1
0
Overall Study
COMPLETED
0
0
Overall Study
NOT COMPLETED
1
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Transcranial Direct Current Stimulation as a Neuroprotection in Acute Stroke Before and After Thrombectomy

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Active Stimulation Arm
n=1 Participants
Patient received 1 mA of high-definition cathodal transcranial direct current for 5 minutes before endovascular procedure (EVT). The pre-planned 20-min stimulation was not completed due to EVT initiation.
Sham Arm
Patients in the sham stimulation arm were planned to have the cap and electrodes in place but without delivery of electrical stimulation. No patient was enrolled in sham arm as the study was stopped early due to slow enrollment rate.
Total
n=1 Participants
Total of all reporting groups
Age, Continuous
95 years
n=99 Participants
95 years
n=206 Participants
Sex: Female, Male
Female
1 Participants
n=99 Participants
1 Participants
n=206 Participants
Sex: Female, Male
Male
0 Participants
n=99 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=99 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Asian
0 Participants
n=99 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=99 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Black or African American
1 Participants
n=99 Participants
1 Participants
n=206 Participants
Race (NIH/OMB)
White
0 Participants
n=99 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=99 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=99 Participants
0 Participants
n=206 Participants

PRIMARY outcome

Timeframe: At 24-hour post-stimulation

Population: The study was stopped early after the enrollment of the first patient.

Symptomatic intracranial hemorrhage (SICH) is defined as an increase of 4 or more points on the National Institute of Health Stroke Scale (NIHSS) total score within 24 hours of stimulation associated with parenchymal hematoma type 1 (PH1), parenchymal hematoma type 2 (PH2), remote intraparenchymal hemorrhage (RIH), subarachnoid hemorrhage (SAH), or intraventricular hemorrhage (IVH). The NIHSS is a 15-item neurologic examination stroke scale used to evaluate the effect of acute stroke on the levels of consciousness, language, neglect, visual-field loss, extraocular movement, motor strength, ataxia, dysarthria, and sensory loss. A trained observer rates the patent's ability to answer questions and perform activities. Ratings for each item are scored with 3 to 5 grades with 0 as normal, and there is an allowance for untestable items. Accordingly, 0 is the lowest and 42 is the highest total score possible. In the NIHSS, the higher the score, the more impaired a stroke patient is.

Outcome measures

Outcome measures
Measure
Active Stimulation Arm
n=1 Participants
Patient received 1 mA of high-definition cathodal transcranial direct current for 5 minutes before endovascular procedure (EVT). The pre-planned 20-min stimulation was not completed due to EVT initiation.
Sham Arm
Patients in the sham stimulation arm were planned to have the cap and electrodes in place, but without delivery of electrical stimulation. No patient was enrolled in the sham arm as the study was stopped early due to slow enrollment rate.
Primary Safety Outcome- Number of Participants With Symptomatic Intracranial Hemorrhage (SICH)
0 Participants
0 Participants

PRIMARY outcome

Timeframe: After 5 minutes of stimulation period

Population: The study was stopped early after the enrollment of the first patient.

The percentage of the patients completing the protocol-assigned stimulation treatment with no intolerability.

Outcome measures

Outcome measures
Measure
Active Stimulation Arm
n=1 Participants
Patient received 1 mA of high-definition cathodal transcranial direct current for 5 minutes before endovascular procedure (EVT). The pre-planned 20-min stimulation was not completed due to EVT initiation.
Sham Arm
Patients in the sham stimulation arm were planned to have the cap and electrodes in place, but without delivery of electrical stimulation. No patient was enrolled in the sham arm as the study was stopped early due to slow enrollment rate.
Primary Tolerability Outcome-Number of Participants Completing the Protocol-assigned Stimulation
1 Participants

PRIMARY outcome

Timeframe: Median time from randomization to tDCS initiation

Population: Study was stopped early after enrollment of first patient. No patient was enrolled in sham arm.

The median times from randomization to bridging C-tDCS initiation and the time form end of endovascular thrombectomy procedure to adjunctive C-tDCS initiation in the last 10 enrolled patients.

Outcome measures

Outcome measures
Measure
Active Stimulation Arm
n=1 Participants
Patient received 1 mA of high-definition cathodal transcranial direct current for 5 minutes before endovascular procedure (EVT). The pre-planned 20-min stimulation was not completed due to EVT initiation.
Sham Arm
Patients in the sham stimulation arm were planned to have the cap and electrodes in place, but without delivery of electrical stimulation. No patient was enrolled in the sham arm as the study was stopped early due to slow enrollment rate.
Primary Feasibility Outcome- Assessing the Speed of Stimulation Implementation From Randomization.
12 minutes

SECONDARY outcome

Timeframe: At 24-hour post-stimulation

Population: One patient was enrolled in the Active arm and no patient in sham arm.

AICH is defined as intracranial hemorrhage not associated with National Institute of Health Stroke Scale (NIHSS) total score worsening of ≥ 4. The NIHSS is a 15-item neurologic examination stroke scale used to evaluate the effect of acute stroke on the levels of consciousness, language, neglect, visual-field loss, extraocular movement, motor strength, ataxia, dysarthria, and sensory loss. A trained observer rates the patent's ability to answer questions and perform activities. Ratings for each item are scored with 3 to 5 grades with 0 as normal, and there is an allowance for untestable items. Accordingly, 0 is the lowest and 42 is the highest total score possible. In the NIHSS, the higher the score, the more impaired a stroke patient is.

Outcome measures

Outcome measures
Measure
Active Stimulation Arm
n=1 Participants
Patient received 1 mA of high-definition cathodal transcranial direct current for 5 minutes before endovascular procedure (EVT). The pre-planned 20-min stimulation was not completed due to EVT initiation.
Sham Arm
Patients in the sham stimulation arm were planned to have the cap and electrodes in place, but without delivery of electrical stimulation. No patient was enrolled in the sham arm as the study was stopped early due to slow enrollment rate.
Secondary Safety Outcome-Number of Participants With Asymptomatic Intracranial Hemorrhage (AICH)
0 participants

SECONDARY outcome

Timeframe: At 24-hour post-stimulation

Population: One patient was enrolled in the Active arm and no patient in sham arm.

Worsening of total score ≥ 4 on NIHSS during the 24-hour period after stimulation, with or without intracranial hemorrhage. The NIHSS is a 15-item neurologic examination stroke scale used to evaluate the effect of acute stroke on the levels of consciousness, language, neglect, visual-field loss, extraocular movement, motor strength, ataxia, dysarthria, and sensory loss. A trained observer rates the patent's ability to answer questions and perform activities. Ratings for each item are scored with 3 to 5 grades with 0 as normal, and there is an allowance for untestable items. Accordingly, 0 is the lowest and 42 is the highest total score possible. In the NIHSS, the higher the score, the more impaired a stroke patient is.

Outcome measures

Outcome measures
Measure
Active Stimulation Arm
n=1 Participants
Patient received 1 mA of high-definition cathodal transcranial direct current for 5 minutes before endovascular procedure (EVT). The pre-planned 20-min stimulation was not completed due to EVT initiation.
Sham Arm
Patients in the sham stimulation arm were planned to have the cap and electrodes in place, but without delivery of electrical stimulation. No patient was enrolled in the sham arm as the study was stopped early due to slow enrollment rate.
Secondary Safety Outcome-Number of Participants With Early Neurologic Deterioration
0 Participants

SECONDARY outcome

Timeframe: At 90 days post-stimulation

Population: One patient was enrolled in the Active arm and no patient in sham arm.

Rate of mortality

Outcome measures

Outcome measures
Measure
Active Stimulation Arm
n=1 Participants
Patient received 1 mA of high-definition cathodal transcranial direct current for 5 minutes before endovascular procedure (EVT). The pre-planned 20-min stimulation was not completed due to EVT initiation.
Sham Arm
Patients in the sham stimulation arm were planned to have the cap and electrodes in place, but without delivery of electrical stimulation. No patient was enrolled in the sham arm as the study was stopped early due to slow enrollment rate.
Secondary Safety Outcome-Number of Participants With Mortality
1 Participants

SECONDARY outcome

Timeframe: At 90 days post-stimulation

Population: One patient was enrolled in the Active arm and no patient in sham arm.

A serious adverse event (SAE) is any adverse event that is fatal, is life-threatening, is permanently or substantially disabling, requires or prolongs hospitalization, or requires medical or surgical intervention to prevent one of the above outcomes. Anticipated serious adverse events were defined as SAEs that are expected and related to acute ischemic stroke complications such as headache, stroke recurrence, pneumonia, systemic blood clots, Family withdrawal of care, etc. An unanticipated serious adverse event is an SAE that is not deemed an ischemic stroke complication and adjudicated as possibly related to study treatment.

Outcome measures

Outcome measures
Measure
Active Stimulation Arm
n=1 Participants
Patient received 1 mA of high-definition cathodal transcranial direct current for 5 minutes before endovascular procedure (EVT). The pre-planned 20-min stimulation was not completed due to EVT initiation.
Sham Arm
Patients in the sham stimulation arm were planned to have the cap and electrodes in place, but without delivery of electrical stimulation. No patient was enrolled in the sham arm as the study was stopped early due to slow enrollment rate.
Secondary Safety Outcome-Number of Participants With All Serious Adverse Events (Anticipated and Unanticipated)
1 Participants

OTHER_PRE_SPECIFIED outcome

Timeframe: Change in the penumbral volume between the timepoints: baseline, 2- hour, and 24-hour post-stimulation

Population: One patient was enrolled in the Active arm and no patient in sham arm. Secondary outcome data were not collected in the one active patient.

By comparing the baseline MR/CT imaging with the MR/CT imaging at 2-hour (early) and 24-hour (final) post-stimulation, the following were planned to be measured: 1) Final penumbra salvage proportion, 2) Final hypoperfusion lesion reduction, 3) Early relative quantitative cerebral blood volume (qrCBV) enhancement.

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: At day-90 post stimulation

Population: One patient was enrolled in the Active arm and no patient in sham arm. Secondary outcome data were not collected in the one active patient.

Examining the clinical outcomes of 3-month modified Rankin Scale. The modified Rankin Scale is a commonly used scale for measuring the degree of disability or dependence in the daily activities of people who have suffered a stroke or other causes of neurological disability.The scale runs from 0-6, running from perfect health without symptoms to death.

Outcome measures

Outcome data not reported

Adverse Events

Active Stimulation Arm

Serious events: 1 serious events
Other events: 0 other events
Deaths: 1 deaths

Sham Arm

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Active Stimulation Arm
n=1 participants at risk
Patient received 1 mA of high-definition cathodal transcranial direct current for 5 minutes before endovascular procedure (EVT). The pre-planned 20-min stimulation was not completed due to EVT initiation.
Sham Arm
Patients in the sham stimulation arm were planned to have the cap and electrodes in place, but without delivery of electrical stimulation. No patient was enrolled in sham arm as the study was stopped early due to slow enrollment rate.
Nervous system disorders
Anticipated serious adverse events
100.0%
1/1 • Number of events 1 • 90 days after enrollment
Study was stopped early, no sham was enrolled
0/0 • 90 days after enrollment
Study was stopped early, no sham was enrolled
Nervous system disorders
Unanticipated serious adverse event
0.00%
0/1 • 90 days after enrollment
Study was stopped early, no sham was enrolled
0/0 • 90 days after enrollment
Study was stopped early, no sham was enrolled

Other adverse events

Adverse event data not reported

Additional Information

Dr. Mersedeh Bahr Hosseini

UCLA

Phone: 3107941195

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place