search
Back to results

Hippocampal Sclerosis and Amnesia Not Due to Alzheimer's Disease (ShaTau7)

Primary Purpose

Patients With Cognitive Disturbances

Status
Unknown status
Phase
Not Applicable
Locations
France
Study Type
Interventional
Intervention
Neurological examinations
Neuropsychological examinations
Clinical examinations
MRI 3T
MRI 7T
Sponsored by
Centre Hospitalier St Anne
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Patients With Cognitive Disturbances focused on measuring Amnesia, Alzheimer, hippocampal sclerosis, fronto-temporal lobar degeneration

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

General inclusion criteria

  • Be older than18 years old.
  • Consulting in one of the centers (patients only)
  • Sufficient cognitive capacities for the realization of the clinical and neuropsychological evaluations, left to the judgement by the investigator.
  • Women old enough to procreate under effective contraception
  • Signed consent
  • Absence of general or systemic disorders that may interfere with cognition.
  • If available before inclusion, absence of brain lesions as determined by MRI that may account for even part of the clinical presentation.

Patients with Hippocampal sclerosis non AD (n=40)

Clinical criteria :

  • CDR (Clinical Dementia Rating Scale) = 0.5 or 1
  • Progressive amnestic syndrome of the hippocampal type, defined by a free recall score ≤ 17/48 and a total recall score ≤ 40/48 on the FCSRT.

Biological criteria : Absence of Profile suggestive of AD on the study of the biomarkers of the CSF (IATI ratio > 0.8)

Patients with Alheimer's Disase (n=40)

Clinical criteria :

  • CDR (Clinical Dementia Rating Scale) = 0.5 or 1
  • Typical amnesic AD : Progressive amnestic syndrome of the hippocampal type, defined by a free recall score ≤ 17/48 and a total recall score ≤ 40/48 on the FCSRT, associated or not with others cognitive impairment
  • Posterior Cortical Atrophy : initial presentation of progressive visual or visuospatial impairment; absence of ophthalmologic impairment with evidence of complex visual and/or visuospatial disorder on examination; a relatively preserved episodic memory
  • Logopenic progressive aphasia : word retrieval deficits in spontaneous speech and confrontation naming, impaired repetition of sentences, errors in spontaneous speech and naming (eg, phonological errors), and relative sparing of word and object knowledge and motor speech.

Biological criteria : CSF biomarkers suggestive of AD defined on CSF.

Patients with DLFT (n=20) :

Clinical criteria :

  • Modifications of the personality and the social conducts in the foreground
  • Compatible brain imaging with the diagnosis : profile of atrophy and/or hypometabolism in TEP-FDG (or hypoerfusion in Spect) compatible with the diagnosis of DFT and/or absence of atypie Biological criteria : No AD profile on CSF biomarkers

Patients with CBD/PSP (n=20) (Armstrong et al., 2013)

  1. Corticobasal syndrome :

    • at least one of the following signs : limb rigidity or akinesia, limb dystonia, limb myoclonusplus at least one of the following sign : orobuccal or limb apraxia, e) cortical sensory deficit, alien limb phenomena (more than simple levitation)
    • Nonfluent/agrammatic variant of primary progressive aphasia: Effortful, agrammatic speech plus at least one of: a) impaired grammar/sentence comprehension with relatively preserved, single word comprehension, or b) groping, distorted speech production (apraxia of speech)
  2. Progressive supranuclear palsy syndrome :

    • Three of the following items present: a) axial or symmetric limb rigidity or akinesia, b) postural instability or falls, c) urinary incontinence, d) behavioural changes, e) supranuclear vertical gaze palsy or decreased velocity of vertical saccades

Normal controls (n=20):

Absence of known psychiatric disorder Score on the Folstein Mini Mental Status (MMSE > or = 27) Normal neuropsychological assessment for the age and the educational level

Exclusion Criteria:

  • Subject with a psychiatric evolutionary and/or badly checked pathology (left to the judgement of the investigator).
  • Subject with a grave, severe or unstable pathology (left to the judgement of the investigator) the nature of which can interfere with the variables of evaluation.
  • Epileptics subjects, badly tolerant MRI (1.5T, 3T or 7T), Subject presenting contraindications to the MRI (if necessary, a blood pregnancy test will be performed before 7T MRI) (Pacemaker or stimulating neurosensory or implantable defibrillator, cochlear implants, eye or cerebral ferromagnetic foreign bodies close to nervous structures, metallic prostheses, agitation of the patient : not cooperative or agitated patients, very young children, claustrophobics subjects, pregnant women, neurosurgical ventriculoperitoneal shunt valves, brace)
  • Known or supposed histories (< or = 5 years) of severe alcoholism or misuse of drugs
  • Vascular, inflammatory or expansive, visible lesion in the MRI which can interfere on the criteria of diagnosis.
  • No health insurance
  • Pregnant, breast-feeding woman or planning a pregnancy in two years of follow-up.
  • For controls : anomaly detected on the MRI in the appreciation of the investigator

Sites / Locations

  • Neurologie de la mémoire et du langage, Service de Neurologie, Centre Hospitalier Sainte-AnneRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm Type

Other

Other

Other

Other

Other

Arm Label

Patients with Hippocampal sclerosis non AD

Patients with Alhzeimer's Disase

Patients with DLFT

Patients with CBD/PSP

Normal controls

Arm Description

Patients with Hippocampal sclerosis non AD (n=40)

Patients with Alhzeimer's Disase (n=40)

Patients with DLFT (n=20)

Patients with CBD/PSP (n=20)

Normal controls (n=20)

Outcomes

Primary Outcome Measures

7 tesla MRI.
Structural morphometric analysisze of hippocampal and Papez circuit sub-regions, and detection of microinfarcts/microbleeds by 7 tesla MRI.

Secondary Outcome Measures

3T MRI
Morphometry of hippocampus by 3T MRI
3T MRI
Morphometry of hippocampus by 3T MRI
3T MRI
Morphometry of hippocampus by 3T MRI
3T MRI
White matter intensities assessed by 3T MRI
3T MRI
White matter intensities assessed by 3T MRI
3T MRI
White matter intensities assessed by 3T MRI
7T MRI
Volumetry of the cholinergic nucleus basalis by 7T MRI
CSF
CSF biomarkers
Neuropsychological assessment
Neuropsychological assessment
Neuropsychological assessment
Neuropsychological assessment
Neuropsychological assessment
Neuropsychological assessment
Clinical assessment
Clinical assessment
Clinical assessment
Clinical assessment
Clinical assessment
Clinical assessment
Genetic markers of bvFTD
Genetic markers of bvFTD
Blood markers
Blood markers
Plasmatic progranulin levels
Plasmatic progranulin levels
Regional glucose hypometabolism
Regional glucose hypometabolism assessed by FDG-PET (if performed during clinical care).

Full Information

First Posted
October 13, 2015
Last Updated
October 18, 2017
Sponsor
Centre Hospitalier St Anne
search

1. Study Identification

Unique Protocol Identification Number
NCT02576821
Brief Title
Hippocampal Sclerosis and Amnesia Not Due to Alzheimer's Disease
Acronym
ShaTau7
Official Title
Hippocampal Sclerosis and Amnesia Not Due to Alzheimer's Disease
Study Type
Interventional

2. Study Status

Record Verification Date
October 2017
Overall Recruitment Status
Unknown status
Study Start Date
January 27, 2016 (Actual)
Primary Completion Date
January 2020 (Anticipated)
Study Completion Date
October 2020 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Centre Hospitalier St Anne

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Hippocampal Sclerosis (HS) leads to anterograde amnesia mimicking early Alzheimer's disease (AD) (so called HSA-nonAD). Recent studies showed that (a) the deficit of episodic memory as well as the level of hippocampal atrophy in bvFTD may be of similar severity to that observed in AD, even at initial presentation, leading to misdiagnosis in 22% of cases with post mortem diagnosis; (b) amnesia with HS due to microvascular lesion and microinfarcts can also cause impairment of episodic memory mimicking AD, without subcortical cognitive profile. Because these diseases involve distinct pathophysiological processes, they require different specific care and treatment. In consequence, it is very important to improve our knowledge about HS in order to identify its mechanism and improve the diagnosis.
Detailed Description
Hippocampal sclerosis (HS) refers to neuronal cell loss and astrocytosis in subiculum and cornu ammonis subfields of the hippocampal formation unrelated to Alzheimer's disease pathology. In contrast to HS that affects younger adults with epilepsy, older individuals with HS have significant ante-mortem cognitive dysfunction but no epilepsy. Neuropathological studies demonstrated three main types of HS associated with aging: (a) HS-Ageing to refer to the disease with HS pathology in ageing individuals, observed in more than 10% of subjects aged over 85 years; (b) HS observed in the behavioural variant of frontotemporal dementia (bvFTD), HS being more frequent in tau-negative pathology, especially in FTLD-TDP. bvFTD patients may manifest severe episodic memory impairment and hippocampal atrophy; (c) HS associated with cortical or subcortical cerebral microinfarcts, which are invisible on conventional MRI. Cerebral microinfarcts are observed in 33% of elderly over 85 years in post-mortem studies. HS leads to anterograde amnesia mimicking early Alzheimer's disease (AD) (so called HSA-nonAD). Recent studies showed that (a) the deficit of episodic memory as well as the level of hippocampal atrophy in bvFTD may be of similar severity to that observed in AD, even at initial presentation, leading to misdiagnosis in 22% of cases with post mortem diagnosis; (b) amnesia with HS due to microvascular lesion and microinfarcts can also cause impairment of episodic memory mimicking AD, without subcortical cognitive profile. Because these diseases involve distinct pathophysiological processes, they require different specific care and treatment. In consequence, it is very important to improve our knowledge about HS in order to identify its mechanism and improve the diagnosis.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Patients With Cognitive Disturbances
Keywords
Amnesia, Alzheimer, hippocampal sclerosis, fronto-temporal lobar degeneration

7. Study Design

Primary Purpose
Basic Science
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
140 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Patients with Hippocampal sclerosis non AD
Arm Type
Other
Arm Description
Patients with Hippocampal sclerosis non AD (n=40)
Arm Title
Patients with Alhzeimer's Disase
Arm Type
Other
Arm Description
Patients with Alhzeimer's Disase (n=40)
Arm Title
Patients with DLFT
Arm Type
Other
Arm Description
Patients with DLFT (n=20)
Arm Title
Patients with CBD/PSP
Arm Type
Other
Arm Description
Patients with CBD/PSP (n=20)
Arm Title
Normal controls
Arm Type
Other
Arm Description
Normal controls (n=20)
Intervention Type
Other
Intervention Name(s)
Neurological examinations
Intervention Type
Other
Intervention Name(s)
Neuropsychological examinations
Intervention Type
Other
Intervention Name(s)
Clinical examinations
Intervention Type
Radiation
Intervention Name(s)
MRI 3T
Intervention Type
Radiation
Intervention Name(s)
MRI 7T
Primary Outcome Measure Information:
Title
7 tesla MRI.
Description
Structural morphometric analysisze of hippocampal and Papez circuit sub-regions, and detection of microinfarcts/microbleeds by 7 tesla MRI.
Time Frame
up to Month 18
Secondary Outcome Measure Information:
Title
3T MRI
Description
Morphometry of hippocampus by 3T MRI
Time Frame
Baseline
Title
3T MRI
Description
Morphometry of hippocampus by 3T MRI
Time Frame
Month 12
Title
3T MRI
Description
Morphometry of hippocampus by 3T MRI
Time Frame
Month 24
Title
3T MRI
Description
White matter intensities assessed by 3T MRI
Time Frame
Baseline
Title
3T MRI
Description
White matter intensities assessed by 3T MRI
Time Frame
Month 12
Title
3T MRI
Description
White matter intensities assessed by 3T MRI
Time Frame
Month 24
Title
7T MRI
Description
Volumetry of the cholinergic nucleus basalis by 7T MRI
Time Frame
up to Month 18
Title
CSF
Description
CSF biomarkers
Time Frame
Baseline
Title
Neuropsychological assessment
Description
Neuropsychological assessment
Time Frame
Baseline
Title
Neuropsychological assessment
Description
Neuropsychological assessment
Time Frame
Month 12
Title
Neuropsychological assessment
Description
Neuropsychological assessment
Time Frame
Month 24
Title
Clinical assessment
Description
Clinical assessment
Time Frame
M0
Title
Clinical assessment
Description
Clinical assessment
Time Frame
Month 12
Title
Clinical assessment
Description
Clinical assessment
Time Frame
Month 24
Title
Genetic markers of bvFTD
Description
Genetic markers of bvFTD
Time Frame
Baseline
Title
Blood markers
Description
Blood markers
Time Frame
Baseline
Title
Plasmatic progranulin levels
Description
Plasmatic progranulin levels
Time Frame
Baseline
Title
Regional glucose hypometabolism
Description
Regional glucose hypometabolism assessed by FDG-PET (if performed during clinical care).
Time Frame
Baseline

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: General inclusion criteria Be older than18 years old. Consulting in one of the centers (patients only) Sufficient cognitive capacities for the realization of the clinical and neuropsychological evaluations, left to the judgement by the investigator. Women old enough to procreate under effective contraception Signed consent Absence of general or systemic disorders that may interfere with cognition. If available before inclusion, absence of brain lesions as determined by MRI that may account for even part of the clinical presentation. Patients with Hippocampal sclerosis non AD (n=40) Clinical criteria : CDR (Clinical Dementia Rating Scale) = 0.5 or 1 Progressive amnestic syndrome of the hippocampal type, defined by a free recall score ≤ 17/48 and a total recall score ≤ 40/48 on the FCSRT. Biological criteria : Absence of Profile suggestive of AD on the study of the biomarkers of the CSF (IATI ratio > 0.8) Patients with Alheimer's Disase (n=40) Clinical criteria : CDR (Clinical Dementia Rating Scale) = 0.5 or 1 Typical amnesic AD : Progressive amnestic syndrome of the hippocampal type, defined by a free recall score ≤ 17/48 and a total recall score ≤ 40/48 on the FCSRT, associated or not with others cognitive impairment Posterior Cortical Atrophy : initial presentation of progressive visual or visuospatial impairment; absence of ophthalmologic impairment with evidence of complex visual and/or visuospatial disorder on examination; a relatively preserved episodic memory Logopenic progressive aphasia : word retrieval deficits in spontaneous speech and confrontation naming, impaired repetition of sentences, errors in spontaneous speech and naming (eg, phonological errors), and relative sparing of word and object knowledge and motor speech. Biological criteria : CSF biomarkers suggestive of AD defined on CSF. Patients with DLFT (n=20) : Clinical criteria : Modifications of the personality and the social conducts in the foreground Compatible brain imaging with the diagnosis : profile of atrophy and/or hypometabolism in TEP-FDG (or hypoerfusion in Spect) compatible with the diagnosis of DFT and/or absence of atypie Biological criteria : No AD profile on CSF biomarkers Patients with CBD/PSP (n=20) (Armstrong et al., 2013) Corticobasal syndrome : at least one of the following signs : limb rigidity or akinesia, limb dystonia, limb myoclonusplus at least one of the following sign : orobuccal or limb apraxia, e) cortical sensory deficit, alien limb phenomena (more than simple levitation) Nonfluent/agrammatic variant of primary progressive aphasia: Effortful, agrammatic speech plus at least one of: a) impaired grammar/sentence comprehension with relatively preserved, single word comprehension, or b) groping, distorted speech production (apraxia of speech) Progressive supranuclear palsy syndrome : Three of the following items present: a) axial or symmetric limb rigidity or akinesia, b) postural instability or falls, c) urinary incontinence, d) behavioural changes, e) supranuclear vertical gaze palsy or decreased velocity of vertical saccades Normal controls (n=20): Absence of known psychiatric disorder Score on the Folstein Mini Mental Status (MMSE > or = 27) Normal neuropsychological assessment for the age and the educational level Exclusion Criteria: Subject with a psychiatric evolutionary and/or badly checked pathology (left to the judgement of the investigator). Subject with a grave, severe or unstable pathology (left to the judgement of the investigator) the nature of which can interfere with the variables of evaluation. Epileptics subjects, badly tolerant MRI (1.5T, 3T or 7T), Subject presenting contraindications to the MRI (if necessary, a blood pregnancy test will be performed before 7T MRI) (Pacemaker or stimulating neurosensory or implantable defibrillator, cochlear implants, eye or cerebral ferromagnetic foreign bodies close to nervous structures, metallic prostheses, agitation of the patient : not cooperative or agitated patients, very young children, claustrophobics subjects, pregnant women, neurosurgical ventriculoperitoneal shunt valves, brace) Known or supposed histories (< or = 5 years) of severe alcoholism or misuse of drugs Vascular, inflammatory or expansive, visible lesion in the MRI which can interfere on the criteria of diagnosis. No health insurance Pregnant, breast-feeding woman or planning a pregnancy in two years of follow-up. For controls : anomaly detected on the MRI in the appreciation of the investigator
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Marie SARAZIN, MD, PhD
Phone
00 33 1 45 65 61 72
Email
m.sarazin@ch-sainte-anne.fr
First Name & Middle Initial & Last Name or Official Title & Degree
Marie GODARD
Phone
00 33 1 45 65 77 28
Email
m.godard@ch-sainte-anne.fr
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Marie SARAZIN, MD, PhD
Organizational Affiliation
Centre Hospitalier Sainte-Anne
Official's Role
Principal Investigator
Facility Information:
Facility Name
Neurologie de la mémoire et du langage, Service de Neurologie, Centre Hospitalier Sainte-Anne
City
Paris
ZIP/Postal Code
75014
Country
France
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Marie SARAZIN, MD, PhD
Phone
00 33 1 45 65 61 72
Email
m.sarazin@ch-sainte-anne.fr
First Name & Middle Initial & Last Name & Degree
Marie GODARD
Phone
00 33 1 45 65 77 28
Email
m.godard@ch-sainte-anne.fr

12. IPD Sharing Statement

Learn more about this trial

Hippocampal Sclerosis and Amnesia Not Due to Alzheimer's Disease

We'll reach out to this number within 24 hrs