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Traumatic Brain InjuryDOD-ADNINCT01687153

A Study of Brain Aging in Vietnam War Veterans

An observational study of Traumatic Brain Injury and Post Traumatic Stress Disorder, run by University of Southern California at 19 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Traumatic brain injury (TBI) and post traumatic stress disorder (PTSD) are common combat related problems and may be associated with a greater risk of Alzheimer's disease (AD). The purpose of this study is to examine the possible connections between TBI and PTSD, and the signs and symptoms of AD on Veterans as they… Read more about this study

Who is it for?
Ages 50 to 90 yearsHealthy volunteers can take part
How many people
289 participants
Where
19 sitesUnited States
Study dates
Oct 2012to 21 Sep 2021
Phase
Observational
Are there results?
None posted in the registry

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 50 to 90 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Study population: Vietnam Veterans

Who may be able to join

  • General (applies to each cohort):
  • Subjects must be Veterans of the Vietnam War, 50-90 years of age. (Subjects 60-80 years of age will be selected first, while subjects <60 or >80 years of age will be added if recruitment numbers are too low in the 60-80 age range);
  • Must live within 150 miles of the closest ADNI clinic in subject's area.
  • Specific Inclusion Criteria for Controls:
  • Comparable in age, gender, and education with TBI and PTSD groups;
  • May be receiving Veterans Affairs (VA) disability payments for something other than TBI or PTSD - or no disability at all.
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  • Specific Inclusion Criteria for TBI:
  • Subjects must have a documented history of moderate-severe non-penetrating TBI, which occurred during military service in Vietnam (identified from the Department of Defense or VA records);
  • TBI will be defined as:
  • Loss of consciousness,
  • Post-traumatic amnesia >24 hours, OR
  • Alteration of consciousness or mental state >24 hours
  • Specific Inclusion Criteria for PTSD:
  • Subjects who meet the Structured Clinical Interview 1 of the Diagnositic and Statistical Manual of Mental Disorders, Version IV, (Axis 1) - Text Revision [SCID-I of the DSM-IV-TR] criteria for current/chronic PTSD (identified by records, and verified by our telephone assessments);
  • In addition to meeting DSM-IV-TR criteria for current/chronic PTSD, subjects must have a minimum current Clinician Administered PTSD Scale (CAPS) score of 50 as determined by telephone assessment;
  • The PTSD symptoms contributing to the PTSD Diagnosis and Current CAPS score must be related to a Vietnam War related trauma.

Who cannot join

  • General (applies to each cohort):
  • MCI/dementia;
  • History of psychosis or bipolar affective disorder;
  • History of alcohol or substance abuse/dependence within the past 5 years (by DSM-IV-TR criteria) or a prior prolonged history of abuse;
  • MRI-related exclusions: aneurysm clips, metal implants that are determined to be unsafe for MRI; and/or claustrophobia;
  • Contraindications for lumbar puncture, PET scan, or other procedures in this study;
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  • Any major medical condition must be stable for at least 4 months prior to enrollment. These include but are not limited to clinically significant hepatic, renal, pulmonary, metabolic or endocrine disease, cancer, HIV infection and AIDS, as well as cardiovascular disease, including:
  • cardiac surgery or myocardial infarction within the last 4 weeks;
  • unstable angina;
  • acute decompensated congestive heart failure or class IV heart failures;
  • current significant cardiac arrhythmia or conduction disturbance particularly those resulting in ventricular fibrillation, or causing syncope, or near syncope;
  • Uncontrolled high blood pressure
  • Seizure disorder or any systemic illness affecting brain function during the past 5 years will be exclusionary;
  • Clinical evidence of stroke;
  • Have a history of relevant severe drug allergy or hypersensitivity;
  • Subjects with current clinically significant unstable medical comorbidities, as indicated by history or physical exam, that pose a potential safety risk to the subject.
  • Specific Exclusion Criteria for Controls:
  • Exclusionary criteria applied to TBI/PTSD (outlined below) will be applied to controls.
  • Specific Exclusion Criteria for TBI:
  • Presence of PTSD by SCID-I for DSM-IV-TR criteria, or a CAPS score of >30 (Both current and/or a history of PTSD will be excluded).
  • Specific Exclusion Criteria for PTSD:
  • Documented or self report history of mild/moderate severe TBI;
  • Any history of head trauma associated with injury onset cognitive complaints; or
  • Loss of consciousness for >5 minutes.

Trial locations and contacts

19 sites in 1 country.

19 sites in 1 country

United States19 sites
  • Brigham and Women's Hospital

    Boston, Massachusetts, 02115

  • Roper St Francis Healthcare

    Charleston, South Carolina, 29401

  • Rush University Medical Center

    Chicago, Illinois, 60612

  • Duke University Medical Center

    Durham, North Carolina, 27710

  • University of California, Irvine

    Irvine, California, 92697

  • University of California, San Diego

    La Jolla, California, 92093

  • University of Southern California

    Los Angeles, California, 90033

  • University of Wisconsin

    Madison, Wisconsin, 53705

  • Wien Center for Clinical Research

    Miami Beach, Florida, 33140

  • Cornell Medical Center

    New York, New York, 10021

  • Columbia University

    New York, New York, 10032

  • VA Palo Alto HSC / Stanford School of Medicine

    Palo Alto, California, 94304

  • University of Rochester Medical Center

    Rochester, New York, 14620

  • University of California, San Francisco

    San Francisco, California, 94117

  • U of WA / VA Puget Sound Alzheimer's Disease Research Center

    Seattle, Washington, 98108

  • Banner Sun Health Research Institute

    Sun City, Arizona, 85351

  • Georgetown University

    Washington D.C., District of Columbia, 20057

  • Howard University

    Washington D.C., District of Columbia, 20060

  • Premiere Research Institute

    West Palm Beach, Florida, 33407

Other trials in United States

About this study

Official title: Effects of Traumatic Brain Injury and Post Traumatic Stress Disorder on Alzheimer's Disease (AD) in Veterans Using Alzheimer's Disease Neuroimaging Initiative (ADNI)

Traumatic brain injury (TBI) and post traumatic stress disorder (PTSD) are common combat related problems and may be associated with a greater risk of Alzheimer's disease (AD). The purpose of this study is to examine the possible connections between TBI and PTSD, and the signs and symptoms of AD on Veterans as they age.

The information collected will help to learn more about how these injuries may affect Veterans of the Vietnam War as they grow older, as well as Veterans of the current wars in Iraq and Afghanistan, who also have these types of combat related injuries.

Read the detailed description

The overall long-term goal of this project is to prevent AD, which affects almost 50% of the US population over 85 years of age, and is the most common cause of dementia. Clinical signs and symptoms of AD include cognitive impairments, especially memory and emotional disturbances. In order to accomplish this goal of prevention, a population at risk must be identified. Evidence suggests that both TBI and PTSD increase risk for cognitive decline, AD, and dementia.

TBI and PTSD are common problems resulting from military service. Thus far, there have been no prospective studies using imaging and biomarkers, which directly measure changes in the brain and AD pathology to study the effects of TBI and PTSD. This proposed study will provide novel data to test these hypotheses. The results will have major implications for identifying, subjects at increased risk for AD, a possible need for early detection of AD in military Veterans with histories of TBI and PTSD, and a possible need to employ prevention and treatment measures to avoid accelerated development of AD in US military Veterans. This study is a first step toward a larger, more comprehensive study of dementia risk factors in Veterans. The results will lead to a design and statistical powering of a prevention trial. Therefore, this project could be the first step toward the prevention of AD in Veterans, and in the general population.

Keywords
traumatic brain injury (TBI), post traumatic stress disorder (PTSD), Alzheimer's disease (AD), mild cognitive impairment (MCI), dementia, biomarkers, amyloid, neuroimaging, cognition disorder, tau
Medical subject headings
Brain Injuries, Traumatic, Stress Disorders, Post-Traumatic, Alzheimer Disease, Cognitive Dysfunction, Dementia, Cognition Disorders, Pick Disease of the Brain

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Study groups in NCT01687153
Study groupRoleWhat they receive
Traumatic Brain Injury (TBI)65-100 Vietnam Veterans with Traumatic Brain Injury (TBI), but without PTSD, mild cognitive impairment (MCI)/dementia
Post Traumatic Stress Disorder (PTSD)65-100 Vietnam Veterans with PTSD, but without TBI, MCI/dementia
Controls65-100 Vietnam Veteran Controls without TBI or PTSD and comparable in age, gender, and education to the other cohorts
TBI w/ MCI65-100 Vietnam Veterans with TBI but without PTSD who meet the criteria for MCI but not dementia
PTSD w/ MCI65-100 Vietnam Veterans with PTSD but without TBI who meet the criteria for MCI but not dementia
Controls w/ MCI65-100 Vietnam Veteran Controls without TBI or PTSD who meet the criteria for MCI but not dementia, and are comparable in age, gender, and education to the other cohorts

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Rates of change in brain regions based on neuroimaging

    Rates of change in brain regions based on neuroimaging (magnetic resonance imaging [MRI] and amyloid positron-emission tomography [PET]) to show that those with TBI and/or PTSD have increased evidence for AD compared to Veteran controls

    Measured: 1 year

  2. Rates of change in CSF amyloid beta and CSF tau/P tau levels based on biomarkers

    Rates of change in CSF amyloid beta and CSF tau/P tau levels based on biomarkers such as cerebrospinal fluid (CSF) to show that those with TBI and/or PTSD have increased evidence for AD compared to Veteran controls

    Measured: 1 year

  3. Rates of change in neuropsychological measures of memory and general cognitive performance

    Rates of change in neuropsychological measures of memory and general cognitive performance based on cognitive measures to show that those with TBI and/or PTSD have increased evidence for AD compared to Veteran controls

    Measured: 1 Year

Secondary outcomes (4)
  1. Correlations within each group (TBI and PTSD) to assess whether baseline levels or rates of atrophy or cognitive decline are associated with severity of TBI or PTSD

    Measured: 1 year

  2. Group differences in the patterns of amyloid deposition (from Florbetapir F 18) and brain atrophy

    Group differences may give insight into whether TBI or PTSD is associated with reduced brain reserve causing greater cognitive impairments as indicated by neuropsychological test performance.

    Measured: 1 year

  3. Group differences in white matter integrity as assessed with Diffusion Tension Imaging (DTI)

    Group differences in axonal damage as indicated by white matter integrity measured with DTI to determine if axonal injury resulting from TBI is associated with greater amyloid accumulation or whether brain regions with axonal damage have less amyloid accumulation due to disconnection and reduced brain activity.

    Measured: 1 year

  4. Rate of change of tau deposition as measured by 18F-AV-1451

    Rates of change in brain regions based on Tau PET neuroimaging to show that those with TBI and/or PTSD have increased evidence for AD compared to Veteran controls

    Measured: 1 year

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted18 Sep 2012 (estimated)
  2. Study startOct 2012
  3. Primary completion21 Sep 2021
  4. Study completion21 Sep 2021

Resources

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
Cohort
Time perspective
Prospective
Enrolment
289 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01687153
Sponsor's protocol ID
ADC-044
Other IDs
W81XWH-12-2-0012, W81XWH-13-1-0259, W81XWH-14-1-0462
Acronym
DOD-ADNI
Status last verified
Nov 2021
First submitted
31 Aug 2012
Last updated
29 Nov 2021
Results posted
No
Data monitoring committee
Yes

Publications

  • Mueller SG, Weiner MW, Thal LJ, Petersen RC, Jack CR, Jagust W, Trojanowski JQ, Toga AW, Beckett L. Ways toward an early diagnosis in Alzheimer's disease: the Alzheimer's Disease Neuroimaging Initiative (ADNI). Alzheimers Dement. 2005 Jul;1(1):55-66. doi: 10.1016/j.jalz.2005.06.003.

    PubMed 17476317
  • Weiner MW, Aisen PS, Jack CR Jr, Jagust WJ, Trojanowski JQ, Shaw L, Saykin AJ, Morris JC, Cairns N, Beckett LA, Toga A, Green R, Walter S, Soares H, Snyder P, Siemers E, Potter W, Cole PE, Schmidt M; Alzheimer's Disease Neuroimaging Initiative. The Alzheimer's disease neuroimaging initiative: progress report and future plans. Alzheimers Dement. 2010 May;6(3):202-11.e7. doi: 10.1016/j.jalz.2010.03.007.

    PubMed 20451868
  • Jack CR Jr, Knopman DS, Jagust WJ, Shaw LM, Aisen PS, Weiner MW, Petersen RC, Trojanowski JQ. Hypothetical model of dynamic biomarkers of the Alzheimer's pathological cascade. Lancet Neurol. 2010 Jan;9(1):119-28. doi: 10.1016/S1474-4422(09)70299-6.

    PubMed 20083042
  • Vemuri P, Wiste HJ, Weigand SD, Shaw LM, Trojanowski JQ, Weiner MW, Knopman DS, Petersen RC, Jack CR Jr; Alzheimer's Disease Neuroimaging Initiative. MRI and CSF biomarkers in normal, MCI, and AD subjects: predicting future clinical change. Neurology. 2009 Jul 28;73(4):294-301. doi: 10.1212/WNL.0b013e3181af79fb.

    PubMed 19636049

Questions about this trial

What is this clinical trial studying?

An observational study of Traumatic Brain Injury and Post Traumatic Stress Disorder, run by University of Southern California at 19 sites 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 16 inclusion and 24 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 29 Nov 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 19 sites 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?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

Rates of change in brain regions based on neuroimaging (time frame: 1 year). The study lists 3 primary outcomes in all. 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 NCT01687153, which also lists 4 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 29 Nov 2021.

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