Traumatic Brain InjuryQALDNCT01022307
Quantitative Automated Lesion Detection of Traumatic Brain Injury
An observational study of Traumatic Brain Injury, run by VA Office of Research and Development at 1 site in United States.
Trial summary
The investigators propose to develop quantitative automated lesion detection (QALD) procedures to identify brain damage following traumatic brain injury more accurately than is possible with a normal magnetic resonance imaging (MRI) scans. These procedures require about 1 hour of imaging in an MRI scanner. Read more about this study
- Who is it for?
- Ages 18 to 50 yearsHealthy volunteers can take part
- Conditions the study is for
- Traumatic Brain Injury
- How many people
- 212 participants
- Where
- 1 siteUnited States
- Study dates
- May 2009to Oct 2014
- Phase
- Observational
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 50 years
- All sexes
- Healthy volunteers accepted
- Adult
Study population: Our targeted population is veterans from OEF/OIF. Other subjects will be recruited as needed to fulfill recruitment targets.
Who may be able to join
- Control subjects from 18-50.
- Patients from 18-50 who have suffered TBI.
Who cannot join
- Substance abuse.
- Irremedial sensory deficits (blindness, deafness).
- Primary psychiatric disorder.
- Neurological disease unrelated to TBI.
Trial locations and contacts
1 site in 1 country.
United States1 site
VA Northern California HCS
Martinez, California, 94553
About this study
Official title: Quantitative Automated Lesion Detection of TBI
The investigators propose to develop quantitative automated lesion detection (QALD) procedures to identify brain damage following traumatic brain injury more accurately than is possible with a normal magnetic resonance imaging (MRI) scans. These procedures require about 1 hour of imaging in an MRI scanner. Subjects will also undergo about 2 hours of cognitive tests. The investigators will compare the results of the cognitive tests with those from MRI scanning to determine what brain regions are responsible for superior performance and for performance decrements.
Read the detailed description
Because of their non-focal nature, TBI-related brain lesions are difficult to detect and quantify with traditional MRI. In the current research program the investigators propose to develop quantitative automated lesion detection (QALD) procedures to (1) clarify the nature and distribution of tissue damage following mild, moderate and severe TBI (2) improve the capability of detecting, quantifying, and localizing TBI brain damage in individual patients and (3) correlate quantitative measures of brain damage in individual TBI patients with neuropsychological deficits in attention, memory, and executive function.
QALD detects abnormal tissue parameters in the diseased brain through statistical comparisons with a normative database. Preliminary results show that QALD is capable of detecting highly significant abnormalities in the brains of TBI patients with normal clinical MRI scans. QALD will be further enhanced and tested with a larger database and including brain images acquired with four different imaging sequences (T1, T2, DTI and fluid-attenuated inversion recovery or FLAIR) from 100 control subjects. Data analysis will incorporate advanced cortical surface mapping techniques to quantify gray matter tissue parameters and thickness in 34 distinct cortical regions in each hemisphere. In addition, cortical fiber projections will be quantified with DTI and FLAIR analysis of white matter lying below the cortical surface. Subcortical fiber tracts critical for complex cognitive operations will be analyzed with voxel-based morphometry and with improved region of interest algorithms to define fiber tract boundaries. Tissue properties in critical subcortical structures (e.g., the hippocampus) will be quantified after automatic parcellation of these brain regions. The investigators will also test the control subjects on a battery of neuropsychological tests (NPTs) and correlate variations in the size, myelination, and tissue properties of normal cortical and subcortical structures with cognitive performance. Then, the investigators will gather identical imaging data in 99 TBI patients divided into three groups (mild, moderate and severe TBI) in order to characterize the average pattern of damage caused by TBIs of different severity. Next, the investigators will quantify lesions in individual TBI patients and describe the variability of lesion patterns in the different severity groups. In parallel, the investigators will develop further multimodal analysis techniques to combine statistical information from different imaging sequences to improve lesion-detection sensitivity to co-localized abnormalities evident with different imaging protocols. In addition, the investigators will test patients with NPTs and analyze the relationship between brain damage, cognitive performance and self-assessments of outcome in order to improve the prognostic value of neuroradiological studies of TBI.
- Conditions
- Traumatic Brain Injury
- Keywords
- behavioral data acquisition, MRI
- Medical subject headings
- Brain Injuries, Traumatic
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
| Study group | Role | What they receive |
|---|---|---|
| Group 1: no history of TBI | 184 participants with no history of traumatic brain injury (TBI). | |
| Group 2: with a history of TBI | 28 patients with a history of TBI. Most of these patients had suffered mild TBI. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Performance on Trail-making Test, Part B
z-score based on response time, regressed for age and computer use
Measured: Single session generally several years after TBI depending on time of recruitment of subjects.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted1 Dec 2009 (estimated)
- Study startMay 2009
- Primary completionOct 2014
- Study completionOct 2014
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (18)Papers the sponsor has linked to this study.
- Other trials for Traumatic Brain InjuryStudies of the same condition, open and under way.
- More trials run by VA Office of Research and DevelopmentThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Case-control
- Time perspective
- Retrospective
- Enrolment
- 212 participants (actual)
Sponsor and investigators
- Lead sponsor
- VA Office of Research and Development
- Sponsor type
- US federal agency
- Responsible party
- Sponsor
- Investigators
- David L. Woods, PhD, Principal investigator, VA Northern California HCS
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01022307
- Sponsor's protocol ID
- B6120-R
- Acronym
- QALD
- Status last verified
- Dec 2015
- First submitted
- 8 May 2009
- Last updated
- 14 Jan 2016
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
Publications
Alho K, Rinne T, Herron TJ, Woods DL. Stimulus-dependent activations and attention-related modulations in the auditory cortex: a meta-analysis of fMRI studies. Hear Res. 2014 Jan;307:29-41. doi: 10.1016/j.heares.2013.08.001. Epub 2013 Aug 11.
PubMed 23938208Kang X, Herron TJ, Woods DL. Validation of the anisotropy index ellipsoidal area ratio in diffusion tensor imaging. Magn Reson Imaging. 2010 May;28(4):546-56. doi: 10.1016/j.mri.2009.12.015. Epub 2010 Jan 21.
PubMed 20096529Woods DL, Herron TJ, Cate AD, Yund EW, Stecker GC, Rinne T, Kang X. Functional properties of human auditory cortical fields. Front Syst Neurosci. 2010 Dec 3;4:155. doi: 10.3389/fnsys.2010.00155. eCollection 2010.
PubMed 21160558Cate AD, Herron TJ, Kang X, Yund EW, Woods DL. Intermodal attention modulates visual processing in dorsal and ventral streams. Neuroimage. 2012 Nov 15;63(3):1295-304. doi: 10.1016/j.neuroimage.2012.08.026. Epub 2012 Aug 16.
PubMed 22917986Woods DL, Herron TJ, Cate AD, Kang X, Yund EW. Phonological processing in human auditory cortical fields. Front Hum Neurosci. 2011 Apr 20;5:42. doi: 10.3389/fnhum.2011.00042. eCollection 2011.
PubMed 21541252Woods DL, Yund EW, Wyma JM, Ruff R, Herron TJ. Measuring executive function in control subjects and TBI patients with question completion time (QCT). Front Hum Neurosci. 2015 May 19;9:288. doi: 10.3389/fnhum.2015.00288. eCollection 2015.
PubMed 26042021Woods DL, Wyma JM, Herron TJ, Yund EW. An improved spatial span test of visuospatial memory. Memory. 2016 Sep;24(8):1142-55. doi: 10.1080/09658211.2015.1076849. Epub 2015 Sep 11.
PubMed 26357906Turken AU, Herron TJ, Kang X, O'Connor LE, Sorenson DJ, Baldo JV, Woods DL. Multimodal surface-based morphometry reveals diffuse cortical atrophy in traumatic brain injury. BMC Med Imaging. 2009 Dec 31;9:20. doi: 10.1186/1471-2342-9-20.
PubMed 20043859Kang X, Herron TJ, Cate AD, Yund EW, Woods DL. Hemispherically-unified surface maps of human cerebral cortex: reliability and hemispheric asymmetries. PLoS One. 2012;7(9):e45582. doi: 10.1371/journal.pone.0045582. Epub 2012 Sep 18.
PubMed 23029115Herron TJ, Kang X, Woods DL. Automated measurement of the human corpus callosum using MRI. Front Neuroinform. 2012 Sep 12;6:25. doi: 10.3389/fninf.2012.00025. eCollection 2012.
PubMed 22988433Kang X, Herron TJ, Turken AU, Woods DL. Diffusion properties of cortical and pericortical tissue: regional variations, reliability and methodological issues. Magn Reson Imaging. 2012 Oct;30(8):1111-22. doi: 10.1016/j.mri.2012.04.004. Epub 2012 Jun 12.
PubMed 22698767Kang X, Herron TJ, Woods DL. Regional variation, hemispheric asymmetries and gender differences in pericortical white matter. Neuroimage. 2011 Jun 15;56(4):2011-23. doi: 10.1016/j.neuroimage.2011.03.016. Epub 2011 Mar 22.
PubMed 21397700Whitaker KJ, Kang X, Herron TJ, Woods DL, Robertson LC, Alvarez BD. White matter microstructure throughout the brain correlates with visual imagery in grapheme-color synesthesia. Neuroimage. 2014 Apr 15;90:52-9. doi: 10.1016/j.neuroimage.2013.12.054. Epub 2014 Jan 7.
PubMed 24406309Zhang S, Cate AD, Herron TJ, Kang X, Yund EW, Bao S, Woods DL. Functional and anatomical properties of human visual cortical fields. Vision Res. 2015 Apr;109(Pt A):107-21. doi: 10.1016/j.visres.2015.01.015. Epub 2015 Feb 4.
PubMed 25661165Kang X, Herron TJ, Ettlinger M, Woods DL. Hemispheric asymmetries in cortical and subcortical anatomy. Laterality. 2015;20(6):658-84. doi: 10.1080/1357650X.2015.1032975. Epub 2015 Apr 20.
PubMed 25894493
Study at a glance
From the registry record, last updated by the sponsor on 14 Jan 2016. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Quantitative Automated Lesion Detection of TBI
- ClinicalTrials.gov ID
- NCT01022307
- Acronym / sponsor ID
- QALD / B6120-R
- Conditions
- Traumatic Brain Injury
- Keywords
- behavioral data acquisition, MRI
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 212 participants (actual)
- Lead sponsor
- VA Office of Research and DevelopmentUS federal agency
- Study start
- May 2009
- Primary completion
- Oct 2014 (actual)
- Study completion
- Oct 2014 (actual)
- First posted
- 1 Dec 2009 (estimated)
- Results
- Posted 14 Jan 2016
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The investigators propose to develop quantitative automated lesion detection (QALD) procedures to identify brain damage following traumatic brain injury more accurately than is possible with a normal magnetic resonance imaging (MRI) scans. These procedures require about 1 hour of imaging in an MRI scanner. Subjects will also undergo about 2 hours of cognitive tests. The investigators will compare the results of the cognitive tests with those from MRI scanning to determine what brain regions are responsible for superior performance and for performance decrements.
Detailed description
Because of their non-focal nature, TBI-related brain lesions are difficult to detect and quantify with traditional MRI. In the current research program the investigators propose to develop quantitative automated lesion detection (QALD) procedures to (1) clarify the nature and distribution of tissue damage following mild, moderate and severe TBI (2) improve the capability of detecting, quantifying, and localizing TBI brain damage in individual patients and (3) correlate quantitative measures of brain damage in individual TBI patients with neuropsychological deficits in attention, memory, and executive function.
QALD detects abnormal tissue parameters in the diseased brain through statistical comparisons with a normative database. Preliminary results show that QALD is capable of detecting highly significant abnormalities in the brains of TBI patients with normal clinical MRI scans. QALD will be further enhanced and tested with a larger database and including brain images acquired with four different imaging sequences (T1, T2, DTI and fluid-attenuated inversion recovery or FLAIR) from 100 control subjects. Data analysis will incorporate advanced cortical surface mapping techniques to quantify gray matter tissue parameters and thickness in 34 distinct cortical regions in each hemisphere. In addition, cortical fiber projections will be quantified with DTI and FLAIR analysis of white matter lying below the cortical surface. Subcortical fiber tracts critical for complex cognitive operations will be analyzed with voxel-based morphometry and with improved region of interest algorithms to define fiber tract boundaries. Tissue properties in critical subcortical structures (e.g., the hippocampus) will be quantified after automatic parcellation of these brain regions. The investigators will also test the control subjects on a battery of neuropsychological tests (NPTs) and correlate variations in the size, myelination, and tissue properties of normal cortical and subcortical structures with cognitive performance. Then, the investigators will gather identical imaging data in 99 TBI patients divided into three groups (mild, moderate and severe TBI) in order to characterize the average pattern of damage caused by TBIs of different severity. Next, the investigators will quantify lesions in individual TBI patients and describe the variability of lesion patterns in the different severity groups. In parallel, the investigators will develop further multimodal analysis techniques to combine statistical information from different imaging sequences to improve lesion-detection sensitivity to co-localized abnormalities evident with different imaging protocols. In addition, the investigators will test patients with NPTs and analyze the relationship between brain damage, cognitive performance and self-assessments of outcome in order to improve the prognostic value of neuroradiological studies of TBI.
Study design
- Observational model
- Case-control
- Time perspective
- Retrospective
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Group 1: no history of TBI | – | –184 participants with no history of traumatic brain injury (TBI). |
| Group 2: with a history of TBI | – | –28 patients with a history of TBI. Most of these patients had suffered mild TBI. |
Who may qualify
- Ages
- 18 to 50 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult
- Study population
- Our targeted population is veterans from OEF/OIF. Other subjects will be recruited as needed to fulfill recruitment targets.
Key inclusion criteria (2 listed)
- Control subjects from 18-50.
- Patients from 18-50 who have suffered TBI.
Key exclusion criteria (4 listed)
- Substance abuse.
- Irremedial sensory deficits (blindness, deafness).
- Primary psychiatric disorder.
- Neurological disease unrelated to TBI.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Performance on Trail-making Test, Part B
Time frame: Single session generally several years after TBI depending on time of recruitment of subjects.
z-score based on response time, regressed for age and computer use
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 14 Jan 2016.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Background: PubMed 23938208Alho K, Rinne T, Herron TJ, Woods DL. Stimulus-dependent activations and attention-related modulations in the auditory cortex: a meta-analysis of fMRI studies. Hear Res. 2014 Jan;307:29-41. doi: 10.1016/j.heares.2013.08.001. Epub 2013 Aug 11.
- Background: PubMed 20096529Kang X, Herron TJ, Woods DL. Validation of the anisotropy index ellipsoidal area ratio in diffusion tensor imaging. Magn Reson Imaging. 2010 May;28(4):546-56. doi: 10.1016/j.mri.2009.12.015. Epub 2010 Jan 21.
- Background: PubMed 21160558Woods DL, Herron TJ, Cate AD, Yund EW, Stecker GC, Rinne T, Kang X. Functional properties of human auditory cortical fields. Front Syst Neurosci. 2010 Dec 3;4:155. doi: 10.3389/fnsys.2010.00155. eCollection 2010.
- Background: PubMed 22917986Cate AD, Herron TJ, Kang X, Yund EW, Woods DL. Intermodal attention modulates visual processing in dorsal and ventral streams. Neuroimage. 2012 Nov 15;63(3):1295-304. doi: 10.1016/j.neuroimage.2012.08.026. Epub 2012 Aug 16.
- Background: PubMed 21541252Woods DL, Herron TJ, Cate AD, Kang X, Yund EW. Phonological processing in human auditory cortical fields. Front Hum Neurosci. 2011 Apr 20;5:42. doi: 10.3389/fnhum.2011.00042. eCollection 2011.
- Background: PubMed 26042021Woods DL, Yund EW, Wyma JM, Ruff R, Herron TJ. Measuring executive function in control subjects and TBI patients with question completion time (QCT). Front Hum Neurosci. 2015 May 19;9:288. doi: 10.3389/fnhum.2015.00288. eCollection 2015.
- Background: PubMed 26357906Woods DL, Wyma JM, Herron TJ, Yund EW. An improved spatial span test of visuospatial memory. Memory. 2016 Sep;24(8):1142-55. doi: 10.1080/09658211.2015.1076849. Epub 2015 Sep 11.
- Results publication: PubMed 20043859Turken AU, Herron TJ, Kang X, O'Connor LE, Sorenson DJ, Baldo JV, Woods DL. Multimodal surface-based morphometry reveals diffuse cortical atrophy in traumatic brain injury. BMC Med Imaging. 2009 Dec 31;9:20. doi: 10.1186/1471-2342-9-20.
- Results publication: PubMed 23029115Kang X, Herron TJ, Cate AD, Yund EW, Woods DL. Hemispherically-unified surface maps of human cerebral cortex: reliability and hemispheric asymmetries. PLoS One. 2012;7(9):e45582. doi: 10.1371/journal.pone.0045582. Epub 2012 Sep 18.
- Results publication: PubMed 22988433Herron TJ, Kang X, Woods DL. Automated measurement of the human corpus callosum using MRI. Front Neuroinform. 2012 Sep 12;6:25. doi: 10.3389/fninf.2012.00025. eCollection 2012.
- Results publication: PubMed 22698767Kang X, Herron TJ, Turken AU, Woods DL. Diffusion properties of cortical and pericortical tissue: regional variations, reliability and methodological issues. Magn Reson Imaging. 2012 Oct;30(8):1111-22. doi: 10.1016/j.mri.2012.04.004. Epub 2012 Jun 12.
- Results publication: PubMed 21397700Kang X, Herron TJ, Woods DL. Regional variation, hemispheric asymmetries and gender differences in pericortical white matter. Neuroimage. 2011 Jun 15;56(4):2011-23. doi: 10.1016/j.neuroimage.2011.03.016. Epub 2011 Mar 22.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
David L. Woods, PhD principal investigator
VA Northern California HCS
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Traumatic Brain Injury, run by VA Office of Research and Development at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 2 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 14 Jan 2016. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Yes. Results are posted in the registry (first posted 14 Jan 2016). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Performance on Trail-making Test, Part B (time frame: Single session generally several years after TBI depending on time of recruitment of subjects.). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT01022307, which also lists 18 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 Jan 2016.