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Trial registered on ANZCTR
Registration number
ACTRN12620000751976
Ethics application status
Approved
Date submitted
5/02/2020
Date registered
21/07/2020
Date last updated
4/08/2023
Date data sharing statement initially provided
21/07/2020
Date results provided
4/08/2023
Type of registration
Prospectively registered
Titles & IDs
Public title
The tolerability and effectiveness of head cooling in healthy volunteers and people who have recovered from stroke
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Scientific title
Tolerability and efficacy of non-invasive head COOLing in normal and HypopErfused brain : A magnetic resonance stuDy (COOLHEAD-1)
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Secondary ID [1]
300366
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Nil known
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Universal Trial Number (UTN)
U1111-1247-2545
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Trial acronym
COOLHEAD-1
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Ischaemic stroke
315979
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Condition category
Condition code
Stroke
315364
315364
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0
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Ischaemic
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
A non-invasive head cooling device* will be applied to the participants' head and neck for up to two hours on two separate study visits.
The first study visit will occur at Auckland City Hospital, and will assess the tolerability of the cooling device. A Numerical Pain Rating Scale will be used to assess discomfort every 15 minutes. Non-invasive blood pressure and axillary or oral temperatures will be measured every 10 and 15 minutes respectively.
The second study visit will occur at the University of Auckland (Centre for Advanced MRI), and will assess the efficacy of the cooling device at reducing brain temperature. Magnetic resonance thermometry will be performed at baseline, and every 30 minutes for up to 120 minutes to measure brain temperature.
The cooling device will be administered by a medical officer with a background in internal medicine/neurology or anaesthesia.
*The non-invasive head cooling device is a thermoregulatory system that automatically reduces and maintains participant temperature. It is comprised of a flexible cap and collar that delivers temperature-controlled coolant ranging between 10°C and 15°C to a patient-contacting cooling pad, resulting in heat exchange between the coolant and the participant.
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Intervention code [1]
316648
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Treatment: Devices
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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The proportion of participants who are able to tolerate non-invasive head cooling, as assessed by a study-specific questionnaire. The Numerical Pain Rating Scale will range from 0 being "no pain/discomfort" to 10 being "intolerable/need to remove the device because of discomfort."
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Assessment method [1]
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Timepoint [1]
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60 minutes following administration of the head cooling device. The Numerical Pain Rating Scale will be administered every 15 minutes during the first study visit.
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Primary outcome [2]
322648
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The mean difference in baseline and post-head cooling brain temperatures (in regions of normal and/or hypoperfused brain as assessed using magnetic resonance thermometry).
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Assessment method [2]
322648
0
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Timepoint [2]
322648
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60 minutes following administration of the head cooling device. Magnetic resonance thermometry measurements will be performed at baseline, 30 minutes, 60 minutes, 90 minutes and 120 minutes during the second study visit.
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Secondary outcome [1]
379175
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The proportion of participants who are able to tolerate non-invasive head cooling, as assessed by a study-specific questionnaire. The Numerical Pain Rating Scale will range from 0 being "no pain/discomfort" to 10 being "intolerable/need to remove the device because of discomfort."
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Assessment method [1]
379175
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Timepoint [1]
379175
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120 minutes following administration of the head cooling device. The Numerical Pain Rating Scale will be administered every 15 minutes during the first study visit.
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Secondary outcome [2]
379176
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The mean difference between brain temperature (as assessed using magnetic resonance thermometry) and body temperature (as assessed using a rectal temperature probe).
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Assessment method [2]
379176
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Timepoint [2]
379176
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60 minutes following administration of the head cooling device. Magnetic resonance thermometry and rectal temperature measurements will be performed during the second study visit.
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Eligibility
Key inclusion criteria
Six participants will be healthy adults who are able to provide informed consent.
Six participants will be adults who are at least three months post-stroke with a modified Rankin Scale score of <3 and are able to provide informed consent.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
1. History of uncontrolled hypertension or unstable cardiovascular disease
2. Known contraindications to hypothermia, such as known haematologic dyscrasias that affect thrombosis (cryoglobulinemia, sickle cell disease, serum cold agglutinins), or vasospastic disorders such as Raynaud's or thrombo-angiitis obliterans
3. Skin lesions not allowing secure application of the non-invasive head cooling device
4. Contraindications to having an MRI scan
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/08/2020
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Actual
9/11/2020
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Date of last participant enrolment
Anticipated
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Actual
13/05/2021
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Date of last data collection
Anticipated
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Actual
13/05/2021
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Sample size
Target
12
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Accrual to date
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Final
12
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Recruitment outside Australia
Country [1]
22270
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New Zealand
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State/province [1]
22270
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Auckland
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Funding & Sponsors
Funding source category [1]
304791
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Other
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Name [1]
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Myrtle Martin Neurology Research Fund
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Address [1]
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Department of Neurology
Level 8, Support Building
Auckland City Hospital
2 Park Road, Grafton
Auckland
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Country [1]
304791
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New Zealand
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Primary sponsor type
Individual
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Name
Professor P. Alan Barber
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Address
University of Auckland
Faculty of Medical and Health Sciences
Private Bag 92019
1142
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Country
New Zealand
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Secondary sponsor category [1]
305110
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None
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Name [1]
305110
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Address [1]
305110
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Country [1]
305110
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
305205
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Northern B Health and Disability Ethics Committee
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Ethics committee address [1]
305205
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Ministry of Health Level 3, Rangitoto Room, Unisys Building 650 Great South Road Penrose Auckland
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Ethics committee country [1]
305205
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New Zealand
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Date submitted for ethics approval [1]
305205
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03/02/2020
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Approval date [1]
305205
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24/04/2020
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Ethics approval number [1]
305205
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20/NTB/31
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Summary
Brief summary
Endovascular thrombectomy improves outcomes in patients with ischaemic stroke. However, thrombectomy is only performed in three centres throughout New Zealand. At Auckland Hospital, 85% of patients treated with thrombectomy require inter-hospital transfer from the Northern half of the North Island. Because inter-hospital transfer increases the time it takes to open the artery causing the stroke, patients from outside of the Auckland Hospital catchment area may have more brain damage and worse outcomes than their Auckland counterparts, despite thrombectomy. Currently, there are no methods to slow brain damage during inter-hospital transfer. Therapeutic hypothermia holds promise as an effective neuroprotective strategy in these patients, and non-invasive head cooling is a pragmatic approach that could be initiated in the pre-hospital setting, and maintained during transfer until the completion of thrombectomy. The overarching purpose of this study is to inform two larger studies that aim to test (1) the feasibility (COOLHEAD-2), and (2) the safety and efficacy (COOLHEAD-3), of non-invasive head cooling in ischaemic stroke patients who need inter-hospital transfer for thrombectomy. In this study, COOLHEAD-1, we aim to test whether awake participants are able to tolerate wearing a proprietary head cooling device for up to 120 minutes. We also aim to test whether a proprietary head cooling device is capable of cooling the brains of awake participants within 60 minutes. MRI scans will be used to measure brain temperature with a technique known as magnetic resonance thermometry. Both healthy volunteers and volunteers who have recovered from stroke will be recruited in order to test whether head cooling will preferentially cool the area of brain affected by stroke, because it has reduced (warm) blood flow to replace the heat that is absorbed by the cooling cap.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Prof P. Alan Barber
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Address
99602
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University of Auckland
Faculty of Medical and Health Sciences
Private Bag 92019
1142
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Country
99602
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New Zealand
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Phone
99602
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+6499236520
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Fax
99602
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Email
99602
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[email protected]
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Contact person for public queries
Name
99603
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P. Alan Barber
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Address
99603
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University of Auckland
Faculty of Medical and Health Sciences
Private Bag 92019
Auckland 1142
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Country
99603
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New Zealand
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Phone
99603
0
+6499236520
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Fax
99603
0
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Email
99603
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[email protected]
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Contact person for scientific queries
Name
99604
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William K Diprose
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Address
99604
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Auckland City Hospital
Department of Neurology
2 Park Road, Grafton
Auckland 1023
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Country
99604
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New Zealand
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Phone
99604
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+6493670000
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Fax
99604
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Email
99604
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
No participant permission to share data outside this study.
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Active conductive head cooling of normal and infarcted brain: A magnetic resonance spectroscopy imaging study.
2022
https://dx.doi.org/10.1177/0271678X221107988
N.B. These documents automatically identified may not have been verified by the study sponsor.
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