Use of Resveratrol to Decrease Acute Secondary Brain Injury Following Sports-Related Concussions in Boxers
Condition: Sports Concussion
MeSH terms: Brain Injuries
Study type: Interventional
Phase: Phase 1/Phase 2

Summary: 
      Sports-related concussions are a serious problem in football, boxing, and other full contact
      sports. After experiencing consecutive concussions, there is an increase in neurological
      deficits that can lead to long-term cognitive problems (Dementia pugilistica). To combat this
      increase in brain damage, novel strategies need to be developed to protect athletes that are
      participating in these full contact sports. The purpose of this study is to elucidate whether
      resveratrol decreases brain injury and improves brain function after experiencing a
      concussion in boxers.
    

Detailed description: 
      Each year, approximately 3 million sports-related concussions occur in athletes. Only about
      5% of these concussions are treated in the hospital setting. To date, there are no effective
      interventions used at decreasing the levels of oxidant injury and inflammation within these
      athletes. The standard form of care in these athletes is usually rest and light exercise for
      1 -2 weeks, before returning to the sport. Within this brain injury population,
      administration of a neuro-protectant agent immediately following the concussion may alleviate
      or prevent secondary injury and subsequent development of long-term cognitive deficits such
      as Chronic Traumatic Encephalopathy (CTE) and Dementia pugilistica (DP). Since sports-related
      concussions are a serious problem in our youth, by using safe interventions, we believe that
      the levels of oxidant injury and brain inflammation will be decreased. In addition, these
      neuro-protective agents may improve cognition in these boxers, and decrease the incidence of
      DP.

      Following brain injury, the secondary injury that immediately follows consists of heightened
      damage by oxygen radicals, which in turn damages vital lipids, proteins, and nucleic acids.
      This damage is exacerbated by highly acidic conditions with lead to the release of iron and
      the production of more harmful oxygen radicals. An increase in these oxygen radicals has been
      observed from minutes to hours within the primary injury. In addition, there is an increase
      in inflammation as well as excitotoxicity in the brain after traumatic injury. To combat this
      secondary injury, the use of anti-oxidants in individuals is warranted to decrease the amount
      of brain damage and cognitive decline after experiencing a severe brain injury. For example,
      resveratrol (3,5,4'-trihydroxystilbene) which is a polyphenol compound that is commonly found
      in grapes, is a nutritional supplement with anti-oxidant and anti-inflammatory properties
      with great promise for treating TBI secondary injury. A number of researchers have
      demonstrated that resveratrol protect multiple organs (heart, kidney, brain) from ischemia
      after injury. With respect to the brain, resveratrol has been shown to protect from oxidative
      stress, Huntington's disease, and stroke. Additionally, following TBI in various animal
      models, resveratrol protected from severe brain injuries. Results from these brain studies
      suggest that resveratrol protects from a plethora of injuries and may afford protection from
      secondary injury in individuals suffering from a severe brain injury.

      In this pilot clinical trial, boxers (n=30) will be consented to participate in this study
      prior to engaging in a boxing match. The concussion history will be collected before
      enrolling. Baseline cognitive testing and magnetic resonance imaging (MRI) scan will be
      performed to obtain both structural and functional data. Only 12 boxers that have a
      concussion will be enrolled in this study. After participating in the boxing match, if the
      boxer has been diagnosed with having a concussion by the ringside physician, the boxers will
      be treated with an oral dose of the active trans-resveratrol (500 mg) or placebo within 2
      hours of completion of the boxing match. The boxer will be treated with either resveratrol or
      placebo (depending on the randomization schedule) once a day for 30 days. Cognitive testing
      and MRI scans will be conducted on day 7 after the concussion.
    

Intervention name(s): Resveratrol; Placebo
Intervention type(s): Drug; Drug
Intervention description(s): The dose of resveratrol is 500 mg. The route of administration is oral, once-a-day for 30 days after injury.; The placebo is a sugar pill. The route of administration is oral, once-a-day for 30 days after injury.
Intervention MeSH terms: Resveratrol
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Mild Brain Injury; Concussions; Resveratrol; Boxers; ImPACT; MRI