RECRUITING

VNS Prospective Neuromodulation of Immune and Gastrointestinal Systems

Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

Vagal nerve stimulation is a neurosurgical procedure consisting of implantation of an impulse generator battery with leads placed into the vagus nerve in the neck. This procedure was FDA approved for epilepsy in the 1990s and is commonly performed as an outpatient surgery. The mechanism of action is not well understood; however it is increasingly recognized that electrical stimulation of the vagus nerve may impact other organ systems in the body including the immune and gastrointestinal systems. Concrete characterization of the peripheral effects of VNS in human gut microbiome and immune systems will: (1) elucidate peripheral mechanism of action of chronic VNS therapy, (2) identify peripheral preoperative biomarker of VNS efficacy, and (3) create a foundation for research investigating new GM and IM-related disease indications for VNS. The primary objective of this study is to characterize the pre- and post-operative oral and gut microbiome of patients implanted with vagal nerve stimulator (VNS) for epilepsy. Secondary objectives of this study include: (1) to characterize the pre-operative and post-operative immune profile of patients undergoing VNS implantation for epilepsy, (2) to elucidate whether oral and/or gut microbiota changes are related to VNS efficacy for epilepsy and (3) identification of a biomarker predicting VNS efficacy.

Official Title

Prospective Non-randomized Single-arm Trial of Efferent Neuromodulation Immune and Gastrointestinal Systems by VNS in the Epilepsy Population

Quick Facts

Study Start:2021-04-01
Study Completion:2026-12-31
Study Type:Not specified
Phase:Not Applicable
Enrollment:Not specified
Status:RECRUITING

Study ID

NCT03953768

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Ages Eligible for Study:0 Years to 60 Years
Sexes Eligible for Study:ALL
Accepts Healthy Volunteers:No
Standard Ages:CHILD, ADULT
Inclusion CriteriaExclusion Criteria
  1. 1. Undergoing VNS implantation for the first time as a treatment for epilepsy and
  2. 2. Documented follow up with a Louisville-based neurologist in the past 1 year. If at the University of Utah or Baylor University documented ability to travel to their corresponding neurologist.
  3. 3. Documented ability to travel to Louisville for outpatient medical care. If at the University of Utah or Baylor University documented ability to travel to their facilities.
  1. 1. Previous treatment with VNS (other than the one implanted for this study)
  2. 2. Current pregnancy (contraindication to surgery)
  3. 3. Active infection
  4. 4. History of cancer or treatment with chemotherapy
  5. 5. History of autoimmune disease: Patients who received high effect anticholinergic medication within 30 days of enrollment will be excluded, whereas moderate to low effect anticholinergic medication will be discussed with and decided by the PI.
  6. 6. If any high effect anticholinergic medication is started after enrollment, it will be the PI's decision to drop or postpone the corresponding visit or exclude the patient entirely.
  7. 7. Patients who received high effect corticosteroids within 30 days of enrollment will be excluded, whereas moderate to low effect corticosteroids will be discussed with and decided by the PI.
  8. 8. If any high effect corticosteroid is started after enrollment, it will be the PI's decision to drop or postpone the corresponding visit or exclude the patient entirely.
  9. 9. Treatment with antiarrhythmic or (heart) rate controlling medication,
  10. 10. Pre-existing cardiac arrhythmia or presence of cardiac pacemaker / defibrillator

Contacts and Locations

Study Contact

Ian S Mutchnick, MD
CONTACT
5026295512
ianmutchnick@gmail.com
Meena A Vessell, MD
CONTACT
mavessel@texaschildrens.org

Study Locations (Sites)

Norton Healthcare
Louisville, Kentucky, 40202
United States
University of Louisville
Louisville, Kentucky, 40202
United States
Texas Children's Hospital
Houston, Texas, 77030
United States
Primary Children's Hospital/University of Utah
Salt Lake City, Utah, 84113
United States

Collaborators and Investigators

Sponsor: University of Louisville

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

Study Start Date2021-04-01
Study Completion Date2026-12-31

Study Record Updates

Study Start Date2021-04-01
Study Completion Date2026-12-31

Terms related to this study

Keywords Provided by Researchers

  • epilepsy
  • vagal
  • autoimmune
  • autonomic
  • inflammatory bowel disease
  • immune

Additional Relevant MeSH Terms

  • Autoimmune Diseases
  • Epilepsy
  • Autonomic Dysfunction
  • Inflammatory Bowel Diseases