NCT04353804

Brief Summary

Millions of patients survive care in medical and surgical Intensive Care Units (ICUs) every year, only to suffer from a new or accelerated dementia-like process, called post-ICU long-term cognitive impairment (ICU-LTCI). ICU-LTCI causes considerable problems with personal relationships, return to work, and everyday tasks, such as managing medicines and money. No treatment for these patients is currently available. Technology using computerized cognitive rehabilitation could improve ICU-LTCI by harnessing the healing potential of the brain (i.e., neuroplasticity). This intervention is scalable, portable, and economical. The investigators will evaluate the effectiveness of computerized cognitive rehabilitation in a randomized controlled trial of 160 ICU survivors. The investigators hypothesize that this intervention could improve cognition. This research has high potential to influence rehabilitation strategies for Veteran and civilian ICU survivors.

Trial Health

77
On Track

Trial Health Score

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

Enrollment
160

participants targeted

Target at P75+ for not_applicable

Timeline
15mo left

Started Oct 2022

Longer than P75 for not_applicable

Geographic Reach
1 country

2 active sites

Status
recruiting

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

Study Progress75%
Oct 2022Jul 2027

First Submitted

Initial submission to the registry

April 16, 2020

Completed
4 days until next milestone

First Posted

Study publicly available on registry

April 20, 2020

Completed
2.5 years until next milestone

Study Start

First participant enrolled

October 3, 2022

Completed
3.8 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

July 31, 2026

Expected
1 year until next milestone

Study Completion

Last participant's last visit for all outcomes

July 31, 2027

Last Updated

March 13, 2026

Status Verified

March 1, 2026

Enrollment Period

3.8 years

First QC Date

April 16, 2020

Last Update Submit

March 11, 2026

Conditions

Keywords

Cognitive RehabilitationICU SurvivorshipIntensive Care UnitICU

Outcome Measures

Primary Outcomes (1)

  • Global Cognitive Composite Score

    Global Cognitive Composite Score derived from the composite score provided by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS, range 40-160). The higher the number, the better the outcome.

    3 months

Study Arms (2)

Computerized Cognitive Rehabilitation

EXPERIMENTAL

Computerized Cognitive Rehabilitation

Other: Treatment Arm: Computerized Cognitive Rehabilitation

Active Control computer games

ACTIVE COMPARATOR

Active Control computer games

Other: Active Control computer games

Interventions

Active Control computer games

Active Control computer games

Treatment Arm: Computerized Cognitive Rehabilitation

Computerized Cognitive Rehabilitation

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Adults with a recent ICU stay (Medical or Surgical) requiring treatment for respiratory failure and/or shock (i.e., high-risk population)
  • No longer requiring ICU-level care

You may not qualify if:

  • History of pre-existing severe cognitive impairment (IQCODE\>=3.8 or documentation in medical record)
  • Unwilling to commit to participation in the intervention
  • Under consideration for hospice
  • Primary residence over 100 miles from enrolling site if the patient is unwilling to return to the enrolling site for follow-up
  • Homeless without a secondary contact available
  • Severe substance abuse or neuropsychiatric disorder of a severity that prevents independent living
  • Active suicidal ideation
  • Any past or present behavior that may be deemed a safety risk for follow-up
  • Blind, deaf, or unable to understand/communicate in English
  • Required ICU level care less than 24 hours
  • Not capable of completing computer-based training
  • Co-enrollment in another study
  • Incarcerated

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

Tennessee Valley Healthcare System Nashville Campus, Nashville, TN

Nashville, Tennessee, 37212-2637, United States

RECRUITING

Vanderbilt University Medical Center

Nashville, Tennessee, 37212, United States

RECRUITING

Study Officials

  • E. Wesley Ely, MD MPH

    Tennessee Valley Healthcare System Nashville Campus, Nashville, TN

    PRINCIPAL INVESTIGATOR
  • Mayur B Patel, MD MPH

    Tennessee Valley Healthcare System Nashville Campus, Nashville, TN

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Mayur B Patel, MD MPH

CONTACT

E. Wesley Ely, MD MPH

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
QUADRUPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
Masking Details
The result of this randomization will be double-blinded, both to the study personnel and participants. All participants will access the computerized cognitive rehabilitation software (or control programs) via the same mechanism. Only specific support staff provided by our industry partner for purposes of training participants on the devices will have knowledge of the participant's randomization category other than the biostatisticians.
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: The RETURN-III study will randomize medical and surgical ICU survivors to either 12-weeks of intervention using Computerized Cognitive Rehabilitation (CCR), or control of non-specific computer games.
Sponsor Type
FED
Responsible Party
SPONSOR

Study Record Dates

First Submitted

April 16, 2020

First Posted

April 20, 2020

Study Start

October 3, 2022

Primary Completion (Estimated)

July 31, 2026

Study Completion (Estimated)

July 31, 2027

Last Updated

March 13, 2026

Record last verified: 2026-03

Data Sharing

IPD Sharing
Will share

The investigators will share data de-identified after study publication in accordance to clinical trial best practices and complying with federal guidelines for research.

Shared Documents
STUDY PROTOCOL, SAP
Time Frame
The investigators will share data de-identified \>12 months after study publication in accordance to clinical trial best practices and complying with federal guidelines for research.
Access Criteria
The investigators will share data de-identified after study publication in accordance to clinical trial best practices and complying with federal guidelines for research for an unlimited period of time.

Locations