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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
Medical University of Vienna
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Mild Cognitive Impairment

Eligibility Criteria

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

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:

    1. Diagnosis of probable Alzheimer's disease based on the NINCDS/ADRDA criteria
    2. 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:

    1. memory complaint, corroborated by an informant
    2. 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])
    3. 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
    4. no or minimal impairment in activities of daily living (ADLs), as determined by a clinical interview with the patient and informant
    5. 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

First Posted
December 21, 2015
Last Updated
April 6, 2022
Sponsor
Medical University of Vienna
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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

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Retinal Neuro-vascular Coupling in Patients With Neurodegenerative Disease

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