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Disturbance of ConsciousnessMETA-GCANCT06911515

Evaluation of Essential Metal Metabolism

An observational study of Disturbance of Consciousness and Alteration of Metabolism, run by Fondazione Policlinico Universitario Agostino Gemelli IRCCS at 1 site in Italy.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

Disturbance of consciousness (DoC) is a state in which consciousness is altered following brain damage and can manifest in several conditions that result from the loss of regulation of the neural function of the two components of consciousness, alertness and awareness. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
peripheral venous blood samples, these will be performed in order to measure the biological markers in the serum
How many people
120 participants
Where
1 siteItaly
Study dates
17 Mar 2025to 31 Mar 2027
Phase
Observational
Are there results?
Not yet: the study is under way

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 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: Patients of both sexes with DoC being treated at the U.O.C. of High Intensity Neurorehabilitation, Fondazione Policlinico Universitario Gemelli IRCCS of Rome

Who may be able to join

  • Patients who have been in a coma state, documented with a GCS ≤ 8 for at least 24 hours;
  • Presence of a disturbance of consciousness, identified through the Coma Recovery Scale-revised (CRS-r) and classified as coma, vegetative state or minimally conscious state;
  • Latency of the acute event between 15 days and 6 months;
  • Ability of the caregiver/guardian to understand and sign the informed consent.

Who cannot join

  • Age <18 years;
  • Psychiatric or other pathologies;
  • Inflammatory state related to ongoing infections;
  • Refusal or inability to sign the written informed consent to participate in the study.

Trial locations and contacts

1 site in 1 country.

Italy1 site
  • UOC Neuroriabilitazione ad alta intensità , Policlinico "A. Gemelli"

    Roma, RM, 00168

Other trials in Italy

About this study

Official title: Evaluation of Essential Metal Metabolism in Patients With Disorders of Consciousness

Disturbance of consciousness (DoC) is a state in which consciousness is altered following brain damage and can manifest in several conditions that result from the loss of regulation of the neural function of the two components of consciousness, alertness and awareness.

It is known that the main causes of disorders of consciousness have important effects on the disruption of essential metal homeostasis.

Read more

In particular, myocardial infarction and heart failure, ischemic and hemorrhagic stroke and head trauma trigger phenomena of diffuse axonal damage, hypoxia and re-perfusion that profoundly alter the metabolism of cerebral O2 that reacts with essential metals , in Fenton-type reactions whose predominant effect is an extensive production of reactive oxygen species (ROS) and pro-oxidant molecules.

Fe, Cu and zinc (Zn) are essential metals for life: two thirds of the proteins in our body use these metals that play a crucial role as catalysts or structural elements of proteins in various biological processes, such as cellular respiration in mitochondria, the production and maturation of red and white blood cells, the elasticity of connective tissue, the production of myelin and the production of some neurotransmitters. For this reason, the biology of essential metals has a major impact on our health and the disruption of their homeostasis inexorably leads to disease.

These metals are very important for the metabolism of the Central Nervous System (CNS) and Cu, in particular, even in adults, is involved in the production of myelin and in the production of some neurotransmitters of the diffuse modulatory systems . Cu is a cofactor of the enzymes dopamine β-hydroxylase, and monoamine oxidase involved in the balance of catecholamines , and is altered in some disorders of Cu metabolism.

Being tested
peripheral venous blood samples, these will be performed in order to measure the biological markers in the serum
Keywords
patients with disturbance of consciousness, essential metal, metabolism status

What participants receive

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

  • peripheral venous blood samples, these will be performed in order to measure the biological markers in the serumOther

    peripheral venous blood samples, these will be performed in order to measure the biological markers in the serum

Study groups in NCT06911515
Study groupRoleWhat they receive
Experimental: Gruop ADifference in metal concentrations (7 metals) in GCA subjects compared to those in previously acquired sera of healthy controls.
Receives: Other: peripheral venous blood samples, these will be performed in order to measure the biological markers in the serum
Experimental: Group B: Differences and CorrelationDifferences in essential metal concentrations at 30 days compared to baseline in GCA patients. * Baseline differences in essential metal metabolism in subcategories of patients with impaired consciousness (coma/VS vs MCS, traumatic brain injury vs non-traumatic brain injury). * Correlation between clinical scales and essential metal metabolism
Receives: Other: peripheral venous blood samples, these will be performed in order to measure the biological markers in the serum

What is being measured

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

  1. Blood concetration of essential metal in patients with acquired brain injury

    Quantification of blood essential metal levels in peripheral venous blood samples in patients with acquired brain injury (Fe, range: Men: 65-178 µg/dL, Women: 50-170 µg/dL; Zn, range: 75- 110 µg/dL; Cu, range: Men: 60-160 µg/dL, Women: 80-155 µg/dL;non-Cp Cu, range: less than 5 µg/dL) compared to healthy patients.

    Measured: Changes from baseline (T0), after 30 days of treatment (T1)

Secondary outcomes (5)
  1. Differences in essential metal blood concentration in subcategories of patients with impaired consciousness

    Baseline differences in essential metal metabolism in subcategories of patients with disturbance of consciousness (coma/VS vs MCS using CRS-r scale range: 0 to 23).

    Measured: At baseline (T0) and 30 days (T1)

  2. Differences in essential metal blood concentration in subcategories of patients with acquired brain injury (traumatic vs non-traumatic)

    Baseline differences in essential metal blood concentration in subcategories of patients with acquired brain injury ( etiology: traumatic vs non-traumatic).

    Measured: At baseline (T0) and 30 days (T1)

  3. Correlation between clinical outcome related to autonomy and disability and essential metal blood concentration

    The clinical evaluation will be carried out using the following evaluation scales: Barthel Index (mBI) (range 0 to 100), the Disability Rating Scale (DRS) (range 0 to 29). As regards peripheral venous blood sampling, these will be performed in order to measure the following biological markers on serum: Fe, range men 65 and 178 µg/dL, women 50 and 170 µg/dL; Zn, range 75 -110 µg/dL; Cu, range men 60-160 µg/dL, women: 80-155 µg/dL; Ferr, range men 20-200 ng/mL, women 20-120 ng/mL; Tf, range men: 215-365 mg/dL, women: 250-380 mg/dL; Cp, range 20-50 mg/dL: Non-Cp Cu, range less than 5 µg/dL.

    Measured: At baseline (T0) and 30 days (T1)

  4. Correlation between clinical outcome related to motor performance and essential metal blood concentration

    The clinical evaluation will be carried out using the following evaluation scales: Motricity Index (range 0 to 100 points). As regards peripheral venous blood sampling, these will be performed in order to measure the following biological markers on serum: Fe, range men 65 and 178 µg/dL, women 50 and 170 µg/dL; Zn, range 75 -110 µg/dL; Cu, range men 60-160 µg/dL, women: 80-155 µg/dL; Ferr, range men 20-200 ng/mL, women 20-120 ng/mL; Tf, range men: 215-365 mg/dL, women: 250-380 mg/dL; Cp, range 20-50 mg/dL: Non-Cp Cu, range less than 5 µg/dL.

    Measured: At baseline (T0) and 30 days (T1)

  5. Correlation between clinical outcome related to state of consciousness and cognitive level and essential metal blood concentration

    The clinical evaluation will be carried out using the following evaluation scales: Coma Recovery Scale - Journal (CRS-r) (range 0 to 23), the Level of Cognitive Functioning (LCF) (range10 levels) and the Full Outline of UnResponsiveness (FOUR-Score) (range 0 to 16). As regards peripheral venous blood sampling, these will be performed in order to measure the following biological markers on serum: Fe, range men 65 and 178 µg/dL, women 50 and 170 µg/dL; Zn, range 75 -110 µg/dL; Cu, range men 60-160 µg/dL, women: 80-155 µg/dL; Ferr, range men 20-200 ng/mL, women 20-120 ng/mL; Tf, range men: 215-365 mg/dL, women: 250-380 mg/dL; Cp, range 20-50 mg/dL: Non-Cp Cu, range less than 5 µg/dL.

    Measured: At baseline (T0) and 30 days (T1)

Timeline

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

  1. First posted4 Apr 2025
  2. Study start17 Mar 2025
  3. Primary completion31 Mar 2026 (estimated)
  4. Study completion31 Mar 2027 (estimated)

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
Other
Time perspective
Other
Enrolment
120 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06911515
Sponsor's protocol ID
6279
Acronym
META-GCA
Status last verified
Apr 2025
First submitted
17 Mar 2025
Last updated
9 Apr 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Grassi M, Palluzzi F, Tarantino B. SEMgraph: an R package for causal network inference of high-throughput data with structural equation models. Bioinformatics. 2022 Oct 14;38(20):4829-4830. doi: 10.1093/bioinformatics/btac567.

    PubMed 36040154
  • Nicoletti VG, Pajer K, Calcagno D, Pajenda G, Nogradi A. The Role of Metals in the Neuroregenerative Action of BDNF, GDNF, NGF and Other Neurotrophic Factors. Biomolecules. 2022 Jul 22;12(8):1015. doi: 10.3390/biom12081015.

    PubMed 35892326
  • Giacino JT, Kalmar K. Diagnostic and prognostic guidelines for the vegetative and minimally conscious states. Neuropsychol Rehabil. 2005 Jul-Sep;15(3-4):166-74. doi: 10.1080/09602010443000498.

    PubMed 16350959
  • Squitti R, Ventriglia M, Simonelli I, Bonvicini C, Costa A, Perini G, Binetti G, Benussi L, Ghidoni R, Koch G, Borroni B, Albanese A, Sensi SL, Rongioletti M. Copper Imbalance in Alzheimer's Disease: Meta-Analysis of Serum, Plasma, and Brain Specimens, and Replication Study Evaluating ATP7B Gene Variants. Biomolecules. 2021 Jun 29;11(7):960. doi: 10.3390/biom11070960.

    PubMed 34209820
  • Squitti R, Faller P, Hureau C, Granzotto A, White AR, Kepp KP. Copper Imbalance in Alzheimer's Disease and Its Link with the Amyloid Hypothesis: Towards a Combined Clinical, Chemical, and Genetic Etiology. J Alzheimers Dis. 2021;83(1):23-41. doi: 10.3233/JAD-201556.

    PubMed 34219710
  • Cheng L, Cortese D, Monti MM, Wang F, Riganello F, Arcuri F, Di H, Schnakers C. Do Sensory Stimulation Programs Have an Impact on Consciousness Recovery? Front Neurol. 2018 Oct 2;9:826. doi: 10.3389/fneur.2018.00826. eCollection 2018.

    PubMed 30333789
  • Squitti R, Reale G, Tondolo V, Crescenti D, Bellini S, Moci M, Caliandro P, Padua L, Rongioletti M. Imbalance of Essential Metals in Traumatic Brain Injury and Its Possible Link with Disorders of Consciousness. Int J Mol Sci. 2023 Apr 6;24(7):6867. doi: 10.3390/ijms24076867.

    PubMed 37047843
  • Dolce G, Lucca LF, Riganello F, Arcuri F, Quintieri M, Cortese MD, Pignolo L. Advances in the neurorehabilitation of severe disorder of consciousness. Ann Ist Super Sanita. 2014;50(3):234-40. doi: 10.4415/ANN_14_03_06.

    PubMed 25292271
  • von Wild K, Laureys ST, Gerstenbrand F, Dolce G, Onose G. The vegetative state--a syndrome in search of a name. J Med Life. 2012 Feb 22;5(1):3-15. Epub 2012 Mar 5.

    PubMed 22574081
  • Laureys S, Celesia GG, Cohadon F, Lavrijsen J, Leon-Carrion J, Sannita WG, Sazbon L, Schmutzhard E, von Wild KR, Zeman A, Dolce G; European Task Force on Disorders of Consciousness. Unresponsive wakefulness syndrome: a new name for the vegetative state or apallic syndrome. BMC Med. 2010 Nov 1;8:68. doi: 10.1186/1741-7015-8-68.

    PubMed 21040571
  • Davis T, Ings A; National Institute of Health and Care Excellence. Head injury: triage, assessment, investigation and early management of head injury in children, young people and adults (NICE guideline CG 176). Arch Dis Child Educ Pract Ed. 2015 Apr;100(2):97-100. doi: 10.1136/archdischild-2014-306797. Epub 2014 Oct 21. No abstract available.

    PubMed 25335757

Questions about this trial

What is this clinical trial studying?

An observational study of Disturbance of Consciousness and Alteration of Metabolism, run by Fondazione Policlinico Universitario Agostino Gemelli IRCCS at 1 site in Italy.

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 4 inclusion and 4 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: under way, not looking for participants, as of the sponsor's last update on 9 Apr 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Italy. 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?

This study is still under way. Results are not available in the source record yet.

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?

Blood concetration of essential metal in patients with acquired brain injury (time frame: Changes from baseline (T0), after 30 days of treatment (T1)). 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 NCT06911515, which also lists 11 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 9 Apr 2025.

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