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Serial Fasciculation Measurements in Motor Neurone Disease

Primary Purpose

Motor Neuron Disease, Benign Fasciculation-Cramp Syndrome

Status
Completed
Phase
Not Applicable
Locations
United Kingdom
Study Type
Interventional
Intervention
High-density surface electromyography
Sponsored by
King's College Hospital NHS Trust
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Motor Neuron Disease

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion criteria for MND patients:

(i) Aged between 40 and 80 years of age inclusive, at the time of signing the informed consent.

(ii) Diagnosed with MND by a neurologist with expertise in MND.(20) For subjects with bulbar onset there must be objective limb involvement of at least one limb.

(iii) Diagnosed with MND within 24 months of symptom onset. (iv) Subjects must be ambulatory (i.e. must not be confined to a wheelchair). (v) Male and female subjects (vi) Capable of giving signed informed consent (vii) Capable and willing to comply with the requirements of the protocol (either by themselves or with assistance).

Inclusion criteria for Benign Fasciculation Syndrome (BFS) patients:

(i) Aged between 18 and 80 years of age inclusive, at the time of signing the informed consent.

(ii) Diagnosed with BFS by a neurologist with expertise in motor nerve disorders.

(iii) Male and female subjects (vi) Capable of giving signed informed consent (vii) Capable and willing to comply with the requirements of the protocol (either by themselves or with assistance).

Exclusion criteria for MND patients:

(i) Neurological (other than the subject's MND) or non-neurological co-morbidities (e.g. joint disease, respiratory disease) which limit mobility.

(ii) Clinically significant cognitive impairment in the opinion of the investigator or lacking capacity in accordance with the Mental Capacity Act (2005).

(iii) Regionally restricted forms of MND, or other atypical variants:

  • Isolated corticobulbar pattern of MND with normal ambulation
  • Primary lateral sclerosis
  • Signs of chronic partial denervation restricted to a single limb
  • MND or parkinsonism dementia complex (iv) Subjects requiring mechanical ventilation (non-invasive ventilation for sleep apnoea is allowed).

    (v) Historical or current evidence of clinically significant uncontrolled disease which, in the opinion of the chief investigator, would put the safety of the subject at risk through participation or impact the study assessments or endpoints.

(vi) Presence of an active implantable cardiac medical device (e.g., pacemaker or implantable cardioverter-defibrillator) or at a high risk for needing external defibrillation.

(vii) History of skin hypersensitivity to adhesives. (viii) Current participation in a clinical trial which in the opinion of the chief investigator might impact the objectives of this study.

Exclusion criteria for Benign Fasciculation Syndrome patients:

(i) Significant diagnostic uncertainty, whereby motor neurone disease remains a possible differential diagnosis.

(ii) Historical or current evidence of clinically significant uncontrolled disease which, in the opinion of the chief investigator, would put the safety of the subject at risk through participation or impact the study assessments or endpoints.

(iii) Presence of an active implantable cardiac medical device (e.g., pacemaker or implantable cardioverter-defibrillator) or at a high risk for needing external defibrillation.

(iv) History of skin hypersensitivity to adhesives. (v) Current participation in a clinical trial which in the opinion of the chief investigator might impact the objectives of this study.

Sites / Locations

  • King's College Hospital NHS Foundation Trust

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Active Comparator

Arm Label

Motor neuron disease

Benign fasciculation syndrome

Arm Description

Outcomes

Primary Outcome Measures

Change in fasciculation frequency over time
To characterise the frequency of fasciculations in patients with motor neurone disease and to determine whether these parameters correlate with the trajectory of disease progression over a 12-month period.

Secondary Outcome Measures

Change in fasciculation morphology over time
Change in Functional Rating Scale (FRS) over time
Maximum score of 48; lower scores indicate worse disability
Change in motor unit number index measurements over time
Change in MRC power sum score over time
Change in slow vital capacity over time

Full Information

First Posted
March 13, 2018
Last Updated
August 20, 2019
Sponsor
King's College Hospital NHS Trust
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1. Study Identification

Unique Protocol Identification Number
NCT03809845
Brief Title
Serial Fasciculation Measurements in Motor Neurone Disease
Official Title
Sequential High-density Surface Electromyography (HDSEMG) Recordings in Motor Neurone Disease: Fasciculations as a Biomarker of Motor Neurone Health
Study Type
Interventional

2. Study Status

Record Verification Date
August 2019
Overall Recruitment Status
Completed
Study Start Date
July 6, 2017 (Actual)
Primary Completion Date
March 1, 2019 (Actual)
Study Completion Date
March 1, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
King's College Hospital NHS Trust

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
Patients with motor neurone disease (MND) typically experience relentless motor decline and die within three years of symptom onset from respiratory muscle weakness. There are currently no effective therapies and the discovery of novel therapies is hampered by the lack of a sensitive disease biomarker. Consequently, there is a huge drive to discover novel biomarkers, which can reliably track disease progression over time. These can then be incorporated into clinical drug trials to expedite effective drug discovery. Muscle fasciculations represent the hyperexcitability of diseased motor neurons and are almost universally present from the early stages of MND. The investigators predict that the site, frequency and shape of fasciculations might provide a sensitive measure of disease progression in an individual. In order to calibrate this technique, the investigators will conduct a 12-month longitudinal study, recruiting 24 patients from the King's College Hospital Motor Nerve Clinic, comprising a mixture of patients with MND and those with benign fasciculation syndrome. Patients in this latter group have fasciculations but do not develop weakness and have normal lifespans. They are therefore an optimal control group. At each visit, the investigators will take resting HDSEMG recordings from all four limbs and perform standard clinical measures of disease progression. The investigators will also monitor the decline in motor unit number using a newly validated neurophysiological technique, called Motor Unit Number Index (MUNIX).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Motor Neuron Disease, Benign Fasciculation-Cramp Syndrome

7. Study Design

Primary Purpose
Other
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
20 Motor Neuron Disease (MND) patients and 5 Benign Fasciculation Syndrome (BFS) patients undergoing same assessments at 2-monthly intervals for one year
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
25 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Motor neuron disease
Arm Type
Active Comparator
Arm Title
Benign fasciculation syndrome
Arm Type
Active Comparator
Intervention Type
Device
Intervention Name(s)
High-density surface electromyography
Intervention Description
High-density surface electromyography
Primary Outcome Measure Information:
Title
Change in fasciculation frequency over time
Description
To characterise the frequency of fasciculations in patients with motor neurone disease and to determine whether these parameters correlate with the trajectory of disease progression over a 12-month period.
Time Frame
12 months
Secondary Outcome Measure Information:
Title
Change in fasciculation morphology over time
Time Frame
12 months
Title
Change in Functional Rating Scale (FRS) over time
Description
Maximum score of 48; lower scores indicate worse disability
Time Frame
12 months
Title
Change in motor unit number index measurements over time
Time Frame
12 months
Title
Change in MRC power sum score over time
Time Frame
12 months
Title
Change in slow vital capacity over time
Time Frame
12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion criteria for MND patients: (i) Aged between 40 and 80 years of age inclusive, at the time of signing the informed consent. (ii) Diagnosed with MND by a neurologist with expertise in MND.(20) For subjects with bulbar onset there must be objective limb involvement of at least one limb. (iii) Diagnosed with MND within 24 months of symptom onset. (iv) Subjects must be ambulatory (i.e. must not be confined to a wheelchair). (v) Male and female subjects (vi) Capable of giving signed informed consent (vii) Capable and willing to comply with the requirements of the protocol (either by themselves or with assistance). Inclusion criteria for Benign Fasciculation Syndrome (BFS) patients: (i) Aged between 18 and 80 years of age inclusive, at the time of signing the informed consent. (ii) Diagnosed with BFS by a neurologist with expertise in motor nerve disorders. (iii) Male and female subjects (vi) Capable of giving signed informed consent (vii) Capable and willing to comply with the requirements of the protocol (either by themselves or with assistance). Exclusion criteria for MND patients: (i) Neurological (other than the subject's MND) or non-neurological co-morbidities (e.g. joint disease, respiratory disease) which limit mobility. (ii) Clinically significant cognitive impairment in the opinion of the investigator or lacking capacity in accordance with the Mental Capacity Act (2005). (iii) Regionally restricted forms of MND, or other atypical variants: Isolated corticobulbar pattern of MND with normal ambulation Primary lateral sclerosis Signs of chronic partial denervation restricted to a single limb MND or parkinsonism dementia complex (iv) Subjects requiring mechanical ventilation (non-invasive ventilation for sleep apnoea is allowed). (v) Historical or current evidence of clinically significant uncontrolled disease which, in the opinion of the chief investigator, would put the safety of the subject at risk through participation or impact the study assessments or endpoints. (vi) Presence of an active implantable cardiac medical device (e.g., pacemaker or implantable cardioverter-defibrillator) or at a high risk for needing external defibrillation. (vii) History of skin hypersensitivity to adhesives. (viii) Current participation in a clinical trial which in the opinion of the chief investigator might impact the objectives of this study. Exclusion criteria for Benign Fasciculation Syndrome patients: (i) Significant diagnostic uncertainty, whereby motor neurone disease remains a possible differential diagnosis. (ii) Historical or current evidence of clinically significant uncontrolled disease which, in the opinion of the chief investigator, would put the safety of the subject at risk through participation or impact the study assessments or endpoints. (iii) Presence of an active implantable cardiac medical device (e.g., pacemaker or implantable cardioverter-defibrillator) or at a high risk for needing external defibrillation. (iv) History of skin hypersensitivity to adhesives. (v) Current participation in a clinical trial which in the opinion of the chief investigator might impact the objectives of this study.
Facility Information:
Facility Name
King's College Hospital NHS Foundation Trust
City
London
Country
United Kingdom

12. IPD Sharing Statement

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Serial Fasciculation Measurements in Motor Neurone Disease

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