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RecruitingNCT06283901IMPROVE-DOCUpdated Feb 28, 2024

Improving Diagnosis and Prediction of Outcome in Patients With Severe Disorders of Consciousness

An observational study in Traumatic Brain Injury, Intracranial Hemorrhages and Subarachnoid Hemorrhage, sponsored by Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA). Recruiting at 5 sites in Netherlands. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2024-02-28.

Sponsored by Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA) · Observational

From the registry’s dates

  • Primary completion was expected by Jan 2025, 1 year 10 months ago, but the record still lists the study as recruiting.
  • Started Jan 2023; still recruiting 3 years 10 months later.
Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
160
Ages
18 Years and older
Sex
All
01

Study summary

Patients with acute severe brain injury are usually admitted to the Intensive Care Unit. A substantial proportion of these patients will have disorders of consciousness (DOC) after interruption of sedation. It is difficult to reliably predict neurological outcome in these patients. Dependent on the extent of permanently damaged brain areas, DOC in patients with acute severe brain injury may improve or persist, eventually evolving into a minimal conscious state (MCS) or unresponsive wakefulness syndrome (UWS). These conditions are accompanied by long term severe disability. In current practice, the decision to withdraw life-sustaining support is made by interpreting the results of repeated bedside neurological examination and conventional CT-brain imaging. Reliable identification of patients with a possible good outcome, in whom treatment should not be withdrawn, is difficult. In this prospective observational cohort study we aim to identify patients with a good neurological outcome.

Read the detailed description

In order to identify patients with a good neurological outcome a combination of diagnostic tests is used.

Clinical rating scales

  • Simplified evaluation of consciousness scale (SECONDs) and the full outline of unresponsiveness (FOUR) score
  • Once a week

Blood biomarkers

  • Neuron specific enolase, neurofilament light, glial fibrillary acidic protein
  • Sampling timepoints: 24h, 72h, 7 days and 14 days after brain injury
  • Serum (STG-5) and plasma (EDTA-6) tubes, aliquoted (4 x 0.5ml) and stored at -80°C

EEG with reactivity testing

  • Standard 21-electrode montage
  • Stimuli protocol I: a set of 5 stimuli repeated 3 times

    1. Auditory: clapping in hands, 2. Auditory: calling patients name loudly, 3. Visual: passive eye opening, 4. Tactile: nasal tickle, 5. Noxious: sternal rub Each stimuli is applied for a duration of 5 seconds and an interval between stimuli of 30 seconds
  • Stimuli protocol II: Cognitive-motor dissociation test

MRI-scan

  • Sequences considered essential for patient care i.e.T1, T2, FLAIR, DWI/SWI
  • Preferably, performed between 4-6 weeks after hospital admission
02

Conditions studied

  • Traumatic Brain Injury
  • Intracranial Hemorrhages
  • Subarachnoid Hemorrhage
  • Meningitis
  • Encephalitis
  • Stroke
03

In context

Brain Injuries, Traumatic

1,721 studies on the registry are indexed under Brain Injuries, Traumatic; 447 are open to participants now.

This study's planned enrollment of 160 is above the median of 117 across 557 observational studies indexed under Brain Injuries, Traumatic.

Browse Brain Injuries, Traumatic studies →

Lead sponsor

Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA) is the lead sponsor of 532 studies on the registry; 183 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Sampling method
Non-probability sample

Study population

All patients with acute severe brain injury admitted to the ICU of at least 18 years old.

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

All patients that are admitted to the ICU with the following criteria will be eligible for inclusion:

  1. Severe brain injury (GCS ≤ 8) as a result of:

    1. Traumatic brain injury
    2. Ischemic cerebrovascular accident
    3. Intracranial hemorrhage
    4. Meningo-encephalitis
    5. Subarachnoid hemorrhage
  2. Age ≥ 18 years old
  3. Written from legal representatives

Exclusion criteria

Exclusion Criteria:

A potential subject who meets any of the following criteria will be excluded from participation in this study:

  • Absence of
  • Moribund at ICU admission
  • Progressive neurodegenerative disease
  • Pre-admission ≤ 6 months based on comorbidity
  • GCS has been > 8 prior to inclusion
  • Impossible to include within 24 hours after brain injury
Terms in these criteria, in plain language(2)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Life expectancy

The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.

05

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
160 participants (estimated)
Patient registry
No
06

What researchers measure

Primary outcomes

  1. Glasgow Outcome Scale Extended

    Time frame: 6 months

Secondary outcomes

  1. Glasgow Outcome Scale Extended

    Time frame: 12 months

07

Study locations

3 of 5 sites recruiting
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Feb 28, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT06283901
Responsible party
prof. dr. Janneke Horn (prof. dr. J. Horn, Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)) — Principal investigator
First posted
Feb 28, 2024
Start date
Jan 2, 2023
Primary completion
Jan 1, 2025 (estimated)
Completion
Sep 1, 2025 (estimated)
Last update
Feb 28, 2024

Study contacts

Wolmet Haksteen, MD
Contact
w.e.haksteen@amsterdamumc.nl
+31 020 566 9111
Janneke Horn, Prof. dr.
Contact
j.horn@amsterdamumc.nl

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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