NCT02723344

Brief Summary

Exaggerated inflammation in the body and brain is thought to play a role in the vulnerability to and aggravation and perpetuation of adverse consequences among those with co-occurring mild TBI (mTBI) and post-traumatic stress disorder (PTSD). The proposed study begins the process of investigating the use of a natural immunoregulatory/anti-inflammatory probiotic to treat chronic symptoms associated with co-occurring mTBI and PTSD among Veterans. By looking at the impact of probiotic supplementation on biological signatures of increased inflammation, as reflected by the gut microbiota, gut permeability, and biomarkers of peripheral inflammation, this study may lead to the identification of a novel intervention for the treatment of symptoms associated with these frequently co-occurring conditions.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
75

participants targeted

Target at P75+ for phase_1

Timeline
Completed

Started Aug 2016

Typical duration for phase_1

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

March 1, 2016

Completed
29 days until next milestone

First Posted

Study publicly available on registry

March 30, 2016

Completed
4 months until next milestone

Study Start

First participant enrolled

August 1, 2016

Completed
2.8 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

May 31, 2019

Completed
1 day until next milestone

Study Completion

Last participant's last visit for all outcomes

June 1, 2019

Completed
1.2 years until next milestone

Results Posted

Study results publicly available

July 28, 2020

Completed
Last Updated

August 18, 2020

Status Verified

August 1, 2020

Enrollment Period

2.8 years

First QC Date

March 1, 2016

Results QC Date

May 21, 2020

Last Update Submit

August 7, 2020

Conditions

Keywords

PTSDMild TBIProbioticInflammation

Outcome Measures

Primary Outcomes (1)

  • C-Reactive Protein Change

    Inflammation - Biological Signature (Blood)

    Baseline and approximately 10 weeks

Secondary Outcomes (1)

  • Tumor Necrosis Factor Change

    2 weeks and approximately 10 weeks

Other Outcomes (6)

  • Visual Analog Scale

    Approximately 10 weeks

  • Interleukin 6 Change

    2 weeks and approximately 10 weeks

  • Interleukin 10 Change

    2 weeks and approximately 10 weeks

  • +3 more other outcomes

Study Arms (2)

L. reuteri

EXPERIMENTAL

Commercially available L. reuteri (deposited in the Deutsche Sammlung von Mikroorganismen und Zellkulturen (DSMZ) and referenced as DSM 17938; Gerber Soothe Colic Drops, 100 million CFU/5 drops; formerly known as L. reuteri ATCC 55730) will be used in the proposed study. L. reuteri (phylum Firmicutes) is a gram-positive anaerobic commensal bacteria found in the gut microbiome of humans. Independent testing of the viability of the commercial product will be conducted in our laboratories by diluting drops, plating on agar in triplicate, and anaerobic culturing at 37 oC. The commercial strain (DSM 17938) has been used to improve intestinal functions in infants and reduce symptoms of infantile colic.

Dietary Supplement: of Lactobacillus reuteri (L. reuteri; DSM 17938)

Sunflower and medium chain triglyceride oils

PLACEBO COMPARATOR

Sunflower and medium chain triglyceride oils

Other: Sunflower and medium chain triglyceride oils

Interventions

Commercially available L. reuteri (deposited in the Deutsche Sammlung von Mikroorganismen und Zellkulturen (DSMZ) and referenced as DSM 17938; Gerber Soothe Colic Drops, 100 million CFU/5 drops; formerly known as L. reuteri ATCC 55730) will be used in the proposed study. L. reuteri (phylum Firmicutes) is a gram-positive anaerobic commensal bacteria found in the gut microbiome of humans. Independent testing of the viability of the commercial product will be conducted in our laboratories by diluting drops, plating on agar in triplicate, and anaerobic culturing at 37 oC. The commercial strain (DSM 17938) has been used to improve intestinal functions in infants and reduce symptoms of infantile colic.

L. reuteri

Placebo

Also known as: Placebo
Sunflower and medium chain triglyceride oils

Eligibility Criteria

Age18 Years - 50 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64)

You may qualify if:

  • History of at least one deployment in support of Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF)/Operation New Dawn (OND)
  • History of mTBI per the Ohio State University (OSU) TBI-ID85 with any endorsement of post concussive symptoms (PCS) associated with an mTBI, which occurred at least 6 months prior to the baseline assessment
  • Current symptoms in 3 or more of the following ICD-10 Post Concussive Symptom86 categories as measured by the Rivermead Post Concussive Symptom Questionnaire (RPCSQ87; score of 2 or greater per symptom to qualify):
  • headache
  • dizziness
  • malaise
  • fatigue
  • noise intolerance
  • irritability
  • depression
  • anxiety
  • emotional lability
  • subjective concentration
  • memory
  • intellectual difficulties
  • +7 more criteria

You may not qualify if:

  • Inability to adequately respond to questions regarding the informed consent procedure
  • Currently involved in the criminal justice system as a prisoner or ward of the state
  • Non-English speaking
  • Current (past month) alcohol or substance abuse or dependence
  • Lifetime history of bipolar disorder or psychosis or anxiety disorders (excluding PTSD)
  • Current major depressive disorder (MDD)
  • Consistent (e.g., 5x/week or greater) probiotic supplementation within the last month, including probiotic food products such as yogurt, as determined by phone screen interview and Probiotic Food Check List
  • Receiving antibiotics within the last month; use of topical antibiotics or topical steroids on the face, scalp, or neck or on arms, forearms, or hands within the previous 7 days
  • Receiving medications that interfere with gut motility (opiates, loperamide, stool softeners)
  • Presence of central venous catheters (CVCs)
  • Gastrointestinal (GI) barriers as identified by the 2-week run-in period as determined by the study team (e.g., daily GI discomfort with frequent diarrhea prior to supplementation)
  • Participation in conflicting interventional research protocol
  • Body mass index (BMI) greater than or equal to 35 or less than or equal to 18
  • Vital signs outside of acceptable range, i.e., blood pressure \>160/100, oral temperature \>100 F, pulse \>100
  • Use of any of the following drugs within the last 6 months:
  • +21 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Rocky Mountain Regional VA Medical Center, Aurora, CO

Aurora, Colorado, 80045, United States

Location

Related Publications (1)

  • Brenner LA, Forster JE, Stearns-Yoder KA, Stamper CE, Hoisington AJ, Brostow DP, Mealer M, Wortzel HS, Postolache TT, Lowry CA. Evaluation of an Immunomodulatory Probiotic Intervention for Veterans With Co-occurring Mild Traumatic Brain Injury and Posttraumatic Stress Disorder: A Pilot Study. Front Neurol. 2020 Oct 20;11:1015. doi: 10.3389/fneur.2020.01015. eCollection 2020.

Related Links

MeSH Terms

Conditions

Brain ConcussionStress Disorders, Post-TraumaticInflammation

Condition Hierarchy (Ancestors)

Brain Injuries, TraumaticBrain InjuriesBrain DiseasesCentral Nervous System DiseasesNervous System DiseasesCraniocerebral TraumaTrauma, Nervous SystemHead Injuries, ClosedWounds and InjuriesWounds, NonpenetratingStress Disorders, TraumaticTrauma and Stressor Related DisordersMental DisordersPathologic ProcessesPathological Conditions, Signs and Symptoms

Results Point of Contact

Title
Dr. Lisa A Brenner
Organization
Eastern Colorado Health Care System, Rocky Mountain MIRECC

Study Officials

  • Lisa A Brenner, PhD

    Rocky Mountain Regional VA Medical Center, Aurora, CO

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
Yes

Study Design

Study Type
interventional
Phase
phase 1
Allocation
RANDOMIZED
Masking
QUADRUPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
OTHER
Intervention Model
PARALLEL
Model Details: Biologic
Sponsor Type
FED
Responsible Party
SPONSOR

Study Record Dates

First Submitted

March 1, 2016

First Posted

March 30, 2016

Study Start

August 1, 2016

Primary Completion

May 31, 2019

Study Completion

June 1, 2019

Last Updated

August 18, 2020

Results First Posted

July 28, 2020

Record last verified: 2020-08

Data Sharing

IPD Sharing
Will not share

Locations