Retinal Neuro-vascular Coupling in Patients With Neurodegenerative Disease
Primary Purpose
Mild Cognitive Impairment, Alzheimer Disease, Healthy
Status
Recruiting
Phase
Not Applicable
Locations
Austria
Study Type
Interventional
Intervention
DVA
FDOCT
Pattern ERG
Optical Coherence Tomography
Sponsored by
About this trial
This is an interventional basic science trial for Mild Cognitive Impairment
Eligibility Criteria
Inclusion Criteria:
Inclusion criteria for healthy subjects
- Men and women aged over 50 years
- Non-smokers
- Normal findings in the medical history unless the investigator considers an abnormality to be clinically irrelevant
- Normal ophthalmic findings, ametropia < 6 Dpt
Inclusion criteria for patients with AD:
- Men and women aged over 50 years
- Normal ophthalmic findings, ametropia < 6 Dpt.
Confirmed diagnosis of probable AD of mild to moderate degree defined as:
- Diagnosis of probable Alzheimer's disease based on the NINCDS/ADRDA criteria
- Assessing the severity of Alzheimer's disease of mild to moderate degree by the Mini Mental State Examination (MMSE). AD of mild to moderate degree has been confirmed if the MMSE score is in the range of 20 to 26 inclusive
- Hachinski Ischemia Scale is used to try and distinguish AD from multi-infarct dementia. A score of ≤ 4 suggests AD Informed consent capability
- Adequate visual and auditory acuity to allow neuropsychological testing and participation in the ocular blood flow measurements
- A potential participant has to be on stable doses of all medications he/she is taking because of consisting illnesses according to medical history (except AD therapy itself which will be recorded separately) for at least 30 days prior inclusion, if considered relevant by the investigator.
Inclusion criteria for patients with mild cognitive impairment:
- Men and women aged over 50 years
- Normal ophthalmic findings, ametropia < 6 Dpt.
Diagnosis of probable mild cognitive impairment (MCI) defined as:
- memory complaint, corroborated by an informant
- abnormal memory function, documented by delayed recall of one paragraph from the Logical Memory II subtest of the Wechsler Memory Scale-Revised (cutoff scores: ≤8 for ≥16 years of education; ≤4 for 8 to 15 years of education; and ≤2 for 0 to 7 years of education [the maximum number of paragraph items possible to correctly recall is 25])
- normal general cognitive function, as determined by a clinician's judgment based on a structured interview with the patient and an informant (Clinical Dementia Rating [CDR]) and a Mini-Mental State Examination (MMSE) score greater than 26
- no or minimal impairment in activities of daily living (ADLs), as determined by a clinical interview with the patient and informant
- not sufficiently impaired, cognitively and functionally, to meet the NINCDS/ADRDA criteria, as judged by an experienced AD research clinician
- Hachinski Ischemia Scale is used to try and distinguish MCI from multi-infarct dementia. A score of ≤ 4 suggests MCI Informed consent capability
- Adequate visual and auditory acuity to allow neuropsychological testing and participation in the ocular blood flow measurements
- A potential participant has to be on stable doses of all medications he/she is taking because of consisting illnesses according to medical for at least 30 days prior inclusion, if considered relevant by the investigator.
Exclusion Criteria for patients:
- Presence or history of a severe medical condition other than cognitive impairment as judged by the clinical investigator
- Untreated Arterial hypertension
- History or family history of epilepsy
- Presence of any abnormalities preventing reliable measurements in the study eye as judged by the investigator
- Best corrected visual acuity < 0.5 Snellen
- Ametropia greater than 6 Dpt
- pregnancy or planned pregnancy
- Major psychiatric disorder (e.g. schizophrenia), if considered relevant by the investigator
- Significant neurological disease other than AD or MCI, if considered relevant by the investigator
- Alcoholism or substance abuse
Exclusion criteria for healthy volunteers:
- Presence or history of a severe medical condition as judged by the clinical investigator
- Untreated Arterial hypertension
- History or family history of epilepsy
- Presence of any abnormalities preventing reliable measurements in the study eye as judged by the investigator
- Family history of AD
- Best corrected visual acuity < 0.5 Snellen
- Ametropia 6 Dpt
- Pregnancy or planned pregnancy
Sites / Locations
- Department of Clinical Pharmacology, Medical University of ViennaRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm Type
Experimental
Experimental
Experimental
Arm Label
Mild cognitive impairment
Alzheimer Disease
Healthy
Arm Description
Patients with mild cognitive impairment
Patients with Alzheimer Disease
Healthy volunteers
Outcomes
Primary Outcome Measures
Flicker induced increase in retinal blood flow
Secondary Outcome Measures
Full Information
NCT ID
NCT02663531
First Posted
December 21, 2015
Last Updated
April 6, 2022
Sponsor
Medical University of Vienna
1. Study Identification
Unique Protocol Identification Number
NCT02663531
Brief Title
Retinal Neuro-vascular Coupling in Patients With Neurodegenerative Disease
Official Title
Retinal Neuro-vascular Coupling in Patients With Neurodegenerative Disease
Study Type
Interventional
2. Study Status
Record Verification Date
April 2022
Overall Recruitment Status
Recruiting
Study Start Date
September 27, 2016 (Actual)
Primary Completion Date
September 2023 (Anticipated)
Study Completion Date
September 30, 2023 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Medical University of Vienna
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
Alzheimer´s disease (AD) in one of the most important causes of dementia and poses a considerable challenge in health care. Today, criteria for the diagnosis and the follow up of patients with AD mainly rely either on subjective tests or invasive methods. This limits the general applicability of the latter test for population screening and underlines the need for the identification of easily accessible tools for the identification of high-risk subjects. Because of its unique optical properties, the eye offers the possibility of the non-invasive assessment of both structural and functional alterations in neuronal tissue. As the neuro-retina is part of the brain, it does not come as a surprise that neuro-degenerative changes in the brain are accompanied by structural and possibly also functional changes in the neuro-retina and the ocular vasculature. The current study seeks to test the hypothesis that beside the known anatomical changes, also functional changes can be detected in the retina of patients with AD. For this purpose, flicker light induced hyperemia will be measured in the retina as a functional test to assess the coupling between neural activity and blood flow. Further, structural parameters such as retinal nerve fiber layer thickness and function parameters such as ocular blood flow and retinal oxygenation will be assessed and compared to age and sex matched controls.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Mild Cognitive Impairment, Alzheimer Disease, Healthy
7. Study Design
Primary Purpose
Basic Science
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
150 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Mild cognitive impairment
Arm Type
Experimental
Arm Description
Patients with mild cognitive impairment
Arm Title
Alzheimer Disease
Arm Type
Experimental
Arm Description
Patients with Alzheimer Disease
Arm Title
Healthy
Arm Type
Experimental
Arm Description
Healthy volunteers
Intervention Type
Device
Intervention Name(s)
DVA
Other Intervention Name(s)
Dynamic Vessel Analyzer
Intervention Type
Device
Intervention Name(s)
FDOCT
Other Intervention Name(s)
Fourier Domain Color Doppler Optical Coherence Tomography
Intervention Type
Device
Intervention Name(s)
Pattern ERG
Intervention Type
Device
Intervention Name(s)
Optical Coherence Tomography
Primary Outcome Measure Information:
Title
Flicker induced increase in retinal blood flow
Time Frame
1 day
10. Eligibility
Sex
All
Minimum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria:
Inclusion criteria for healthy subjects
Men and women aged over 50 years
Non-smokers
Normal findings in the medical history unless the investigator considers an abnormality to be clinically irrelevant
Normal ophthalmic findings, ametropia < 6 Dpt
Inclusion criteria for patients with AD:
Men and women aged over 50 years
Normal ophthalmic findings, ametropia < 6 Dpt.
Confirmed diagnosis of probable AD of mild to moderate degree defined as:
Diagnosis of probable Alzheimer's disease based on the NINCDS/ADRDA criteria
Assessing the severity of Alzheimer's disease of mild to moderate degree by the Mini Mental State Examination (MMSE). AD of mild to moderate degree has been confirmed if the MMSE score is in the range of 20 to 26 inclusive
Hachinski Ischemia Scale is used to try and distinguish AD from multi-infarct dementia. A score of ≤ 4 suggests AD Informed consent capability
Adequate visual and auditory acuity to allow neuropsychological testing and participation in the ocular blood flow measurements
A potential participant has to be on stable doses of all medications he/she is taking because of consisting illnesses according to medical history (except AD therapy itself which will be recorded separately) for at least 30 days prior inclusion, if considered relevant by the investigator.
Inclusion criteria for patients with mild cognitive impairment:
Men and women aged over 50 years
Normal ophthalmic findings, ametropia < 6 Dpt.
Diagnosis of probable mild cognitive impairment (MCI) defined as:
memory complaint, corroborated by an informant
abnormal memory function, documented by delayed recall of one paragraph from the Logical Memory II subtest of the Wechsler Memory Scale-Revised (cutoff scores: ≤8 for ≥16 years of education; ≤4 for 8 to 15 years of education; and ≤2 for 0 to 7 years of education [the maximum number of paragraph items possible to correctly recall is 25])
normal general cognitive function, as determined by a clinician's judgment based on a structured interview with the patient and an informant (Clinical Dementia Rating [CDR]) and a Mini-Mental State Examination (MMSE) score greater than 26
no or minimal impairment in activities of daily living (ADLs), as determined by a clinical interview with the patient and informant
not sufficiently impaired, cognitively and functionally, to meet the NINCDS/ADRDA criteria, as judged by an experienced AD research clinician
Hachinski Ischemia Scale is used to try and distinguish MCI from multi-infarct dementia. A score of ≤ 4 suggests MCI Informed consent capability
Adequate visual and auditory acuity to allow neuropsychological testing and participation in the ocular blood flow measurements
A potential participant has to be on stable doses of all medications he/she is taking because of consisting illnesses according to medical for at least 30 days prior inclusion, if considered relevant by the investigator.
Exclusion Criteria for patients:
Presence or history of a severe medical condition other than cognitive impairment as judged by the clinical investigator
Untreated Arterial hypertension
History or family history of epilepsy
Presence of any abnormalities preventing reliable measurements in the study eye as judged by the investigator
Best corrected visual acuity < 0.5 Snellen
Ametropia greater than 6 Dpt
pregnancy or planned pregnancy
Major psychiatric disorder (e.g. schizophrenia), if considered relevant by the investigator
Significant neurological disease other than AD or MCI, if considered relevant by the investigator
Alcoholism or substance abuse
Exclusion criteria for healthy volunteers:
Presence or history of a severe medical condition as judged by the clinical investigator
Untreated Arterial hypertension
History or family history of epilepsy
Presence of any abnormalities preventing reliable measurements in the study eye as judged by the investigator
Family history of AD
Best corrected visual acuity < 0.5 Snellen
Ametropia 6 Dpt
Pregnancy or planned pregnancy
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Gerhard Garhöfer, MD
Phone
0043140400
Ext
29810
Email
gerhard.garhoefer@medunwien.ac.at
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gerhard Garhöfer, MD
Organizational Affiliation
Department of Clinical Pharmacology, Medical University of Vienna
Official's Role
Principal Investigator
Facility Information:
Facility Name
Department of Clinical Pharmacology, Medical University of Vienna
City
Vienna
ZIP/Postal Code
1090
Country
Austria
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Gerhard Garhöfer, MD
Phone
+43 (1) 40400
Ext
29810
Email
gerhard.garhoefer@meduniwien.ac.at
First Name & Middle Initial & Last Name & Degree
Gerhard Garhöfer, MD
12. IPD Sharing Statement
Learn more about this trial
Retinal Neuro-vascular Coupling in Patients With Neurodegenerative Disease
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