CONCUSS: Omega-3 Treatment for Concussion in Adolescents

Sponsor
University of Manitoba (Other)
Overall Status
Not yet recruiting
CT.gov ID
NCT05847608
Collaborator
(none)
140
1
2
18
7.8

Study Details

Study Description

Brief Summary

The goal of this clinical trial is to test omega-3 fatty acid supplementation as a treatment in adolescents with a concussion. The main questions it aims to answer are:

  • Does supplementing with omega-3 fatty acids improve time to recovery following sport related concussion.

  • Does supplementing with omega-3 fatty acids improve health related quality of life following concussion.

  • Does supplementing with omega-3 fatty acids change post-concussion symptoms following concussion.

  • Does supplementing with omega-3 fatty acids change saliva concentrations of interleukin-6 following concussion.

  • Does supplementing with omega-3 fatty acids change saliva concentrations of cortisol following concussion.

Participants will be randomized to receive either an omega-3 supplement or placebo after they have been diagnosed with a concussion. Researchers will compare the omega-3 supplement group and placebo group to see if omega-3 fatty acids, consumed as a treatment, can improve time to recovery, health related quality of life and symptom burden, and whether omega-3 fatty acids alter interleukin-6 and cortisol concentrations in saliva following a concussion.

Condition or Disease Intervention/Treatment Phase
  • Dietary Supplement: Omega-3
  • Dietary Supplement: Placebo
N/A

Detailed Description

Following mild traumatic brain injury, a neurometabolic cascade occurs with concurrent neuronal disruptions, metabolic changes, excitotoxicity, and changes in cerebral blood flow. Omega-3 fatty acids have been postulated as a possible nutritional supplement which could aid in recovery following a concussion. The omega-3 fatty acids docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) are derived from alpha-linolenic acid (ALA) which is an essential fatty acid. DHA is present at high concentrations in neuronal cells and contributes to the regulation of cell membranes, neurotransmitter release, neurogenesis, and neuroinflammation. EPA is converted to E-series resolvins which act in an anti-inflammatory manner.

Pre-clinical research supports the potential benefits of omega-3 fatty acids following a TBI. There has recently been one pilot study in human adolescents which also supports the need for large randomized controlled trials to fully understand the impact omega-3 fatty acids may have on recovery following concussion. The current evidence suggests that omega-3 supplementation may ameliorate neuroinflammation and neuronal apoptosis, and decrease reactive oxygen species associated with TBI. It has been suggested that following TBI, omega-3 supplementation may improve neural plasticity and signaling related molecules which can improve cognitive function following TBI.

Based on these previous mentioned studies it appears that omega-3 fatty acids could potentially benefit those recovering from a concussion. However, to date there have not been any appropriately powered randomized controlled trials evaluating the efficacy of omega-3 supplementation following sport related concussion.

Study Design

Study Type:
Interventional
Anticipated Enrollment :
140 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Masking:
Triple (Participant, Care Provider, Outcomes Assessor)
Primary Purpose:
Treatment
Official Title:
Concussion and Omega-3s - New Consideration for the Therapeutic Use of Nutritional Supplements in Adolescents
Anticipated Study Start Date :
Jun 1, 2023
Anticipated Primary Completion Date :
Dec 1, 2024
Anticipated Study Completion Date :
Dec 1, 2024

Arms and Interventions

Arm Intervention/Treatment
Experimental: Omega-3 Supplementation

This groups will supplement their regular diet with 1 tsp of fish oil containing 1.5 grams combined omega-3 fatty acid (EPA/DHA) supplement in liquid form on a daily basis until they are recovered or have been enrolled for 6 weeks.

Dietary Supplement: Omega-3
Daily consumption of 500 mg DHA and 750 mg EPA in liquid form
Other Names:
  • eicosapentaenoic acid (EPA) and docosohexaenoic acid (DHA)
  • Placebo Comparator: Placebo

    This group will supplement their regular diet with 1 tsp olive oil in liquid form on a daily basis until they are recovered or have been enrolled for 6 weeks.

    Dietary Supplement: Placebo
    Oleic Acid, Linoleic Acid
    Other Names:
  • Olive Oil
  • Outcome Measures

    Primary Outcome Measures

    1. Time to clinical recovery [Maximum of 6 weeks]

      Time to clinical recovery will be determined by the patients treating physician. This will be defined as: 1) symptoms have returned to baseline or resolved, 2) normal medical examination, 3) tolerating school full-time without symptoms, and 4) tolerating appropriate return to play steps and are cleared to participate in full sport activities.

    Secondary Outcome Measures

    1. Quality of Life Inventory [Maximum of 6 weeks]

      Participants and their parent/guardian will complete the paediatric quality of life inventory (https://www.pedsql.org/index.html) each week until they are determined to be clinically recovered or have not recovered by 6 weeks.

    2. Post-Concussion Symptom Inventory [Maximum of 6 weeks]

      Participants will report their symptoms using the post-concussion symptom scale ((PCSS; version from the Sport Concussion Assessment Tool-5) each week until they are determined to be clinically recovered or have not recovered by 6 weeks.

    3. Interleukin-6 [Maximum of 6 weeks]

      Interleukin-6 will be analyzed via enzyme-linked immunosorbent assay (ELISA) to determine changes in inflammatory status.

    4. Cortisol [Maximum of 6 weeks]

      Cortisol will be analyzed via enzyme-linked immunosorbent assay (ELISA) to determine changes in stress status.

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    14 Years to 17 Years
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    No
    Inclusion Criteria:
    1. Provide a signed and dated informed consent form;

    2. State their willingness to comply with all study procedures and availability for the duration of the study;

    3. Be between 14 and 17 years of age or older;

    4. Meet the diagnostic criteria of a concussion set forth by the Consensus Statement on Concussion in Sport 5th Annual Conference of Concussion in Sport, 2017 as determined by the treating physician;

    5. Present with a sport related concussion within 7 days from injury; and

    6. Assigned a Glasgow coma scale (GCS) score = 15.

    Exclusion Criteria:
    1. Patients with a history of moderate or severe traumatic brain injury, epilepsy, or stroke;

    2. Patients who have been diagnosed with a skull fracture, traumatic subarachnoid hemorrhage, subdural hematoma, epidural hematoma, intraparenchymal hemorrhage or cerebral contusion on previous neuro-imaging studies;

    3. Pregnant patients;

    4. Patients with a GCS score less than or equal to 14;

    5. Patients for whom parental/guardian consent cannot be obtained;

    6. Patients who have consumed an omega-3 fatty acid containing supplement within the past month;

    7. Patients with a fish or shell fish allergy.

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 Applied Research Centre, Faculty of Kinesiology, University of Manitoba Winnipeg Manitoba Canada R3T2N2

    Sponsors and Collaborators

    • University of Manitoba

    Investigators

    • Principal Investigator: Stephen Cornish, PhD, University of Manitoba

    Study Documents (Full-Text)

    None provided.

    More Information

    Publications

    None provided.
    Responsible Party:
    University of Manitoba
    ClinicalTrials.gov Identifier:
    NCT05847608
    Other Study ID Numbers:
    • B2023:018
    First Posted:
    May 6, 2023
    Last Update Posted:
    May 6, 2023
    Last Verified:
    Apr 1, 2023
    Individual Participant Data (IPD) Sharing Statement:
    No
    Plan to Share IPD:
    No
    Studies a U.S. FDA-regulated Drug Product:
    No
    Studies a U.S. FDA-regulated Device Product:
    No
    Keywords provided by University of Manitoba
    Additional relevant MeSH terms:

    Study Results

    No Results Posted as of May 6, 2023