Multimodal Markers of Neurodegenerative Disorders at Presymptomatic Stages

Overview

NeuroPrems is a prospective, monocentric, longitudinal, not relating to a medicinal product for human use, non-randomized, non-controlled research. The study mainly aims to identify longitudinal changes and events in multimodal markers of neurodegeneration and neuroinflammation during the presymptomatic phases of neurodegenerative diseases.

Interventions

• Radiation PET
  \[18F\]DPA-714 will be injected intravenously as a 1 minute intravenous bolus injection and dynamic PET acquisition will last 90 min. The aim is the quantification of the neuroimmune reaction during neuroinflammation process.
• Other MRI 3T
  Brain MRI will aim at providing imaging biomarkers which will allow evaluating brain structure, microstructure, iron load, myelin, neurodegeneration of the substantia nigra and locus coeruleus, functional connectivity, brain perfusion and the glymphatic system.
• Other Oculomotricity assessment
  Recording eye movements in a controlled environment (requiring no specific room or area) in binocular vision at a frequency \> 500Hz, while retaining infrared video footage of eye movements for high-quality clinical monitoring.
• Other Magnetoencephalography assessment
  Recording brain magnetic activity using the Elekta Neuromag® TRIUX Magnetoencephalograph ; The participant will be comfortably seated in an adjustable-height chair. The device is enclosed in a shielded room isolated from external electric and magnetic fields to measure the extremely weak magnetic activities produced by the brain.
• Other Body posture and gait assessment
  The acquisition of kinematic gait parameters will be achieved ; markers are positioned on the different segments of members, recognized by a camera system positioned on the walls. Neurophysiologic muscular activity of the lower limbs will also be recorded.
• Other Voice recording
  Participants will be recorded during a single session at every visit upon baseline with a professional quality head mounted microphone.
• Other Video-polysomnography
  Participants will complete standard sleep questionnaires before the visit and perform neurophysiological tests including cognitive tasks before and after the sleep recording.
• Biological Blood sampling, skin biopsy, excreta sampling, lumbar puncture
  Experimental analyses, genetic and multi-OMIC analyses for biomarker research.

Primary outcome measures

• Rate of change of clinical, neurophysiological, anatomical and molecular marker profiles of neurodegenerescence and neuroinflammation in presymptomatic individuals [Time frame: Baseline, Year 1, Year 2, Year 3, Year 4 and Year 5]

Secondary outcome measures (7)

• Intra-individual change in trajectory profiles determined by multimodal analysis [Time frame: Baseline, Year 1, Year 2, Year 3, Year 4 and Year 5]
• Rate and mean time to symptomatic conversion/progression [Time frame: Baseline, Year 1, Year 2, Year 3, Year 4 and Year 5]
• Mean time of onset in genetically presymptomatic individuals [Time frame: Baseline, Year 1, Year 2, Year 3, Year 4 and Year 5]
• Rate of change for each study marker [Time frame: Baseline, Year 1, Year 2, Year 3, Year 4 and Year 5]
• Rate of change in the self-administered questionnaires [Time frame: Baseline, Year 1, Year 2, Year 3, Year 4 and Year 5]
• Rate of change in consumption of information issued from Consultations, hospitalizations and medication prescriptions [Time frame: From Year -10 to Year 10 (annual update)]
• Time to loss of autonomy [Time frame: Baseline, Year 1, Year 2, Year 3, Year 4 and Year 5]

Eligibility criteria

• Inclusion Criteria :

• For all participants :

• Male or female
• Age ≥ 18 years
• Signed Informed consent by the subject
• Affiliated with a social security system or beneficiary of such a regime
• Ability to undergo an MRI exam with Gadobutrol
• For presymptomatic participants only :

• Absence of a diagnosis of neurodegenerative disease. And at least one of the criteria :
• Known carrier or relative of a patient carrying a mutation in a causal or at-risk responsible for a neurodegenerative disease
• Isolated REM sleep behavioral disorder
• Radiological isolated syndrome
• Abnormal brain protein aggregates
• For controls only :

• Absence of symptoms or diagnosis of neurodegenerative disease (or criteria corresponding to at risk group)
• Exclusion Criteria :

• Clinical symptoms fulfilling the criteria of a neurodegenerative disease (see table in criteria section)
• Refusal of blood draw or brain MRI
• MRI contraindication (see criteria section)
• Known allergy to gadoteric acid
• Unwillingness to be informed in case of abnormal MRI (with a significant medical anomaly)
• Pregnancy or breastfeeding. For women in fertile age a urine pregnancy test will be performed before the MRI.
• Inability to understand information about the protocol
• Person deprived of their liberty by judicial or administrative decision
• Person under legal protection (legal guardianship, tutelage or maintenance of justice)
• Person without any protection and unable to consent
• Other medical, neurological, psychiatric, or social conditions that in the investigator's opinion are likely to interfere with study conduct.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: Yes

Study design

Observational model

Cohort

Study locations

France · 1 center

• Pitié Salpêtrière Hospital — Paris

Identifiers

NCT: NCT06516016 · 2024-A00824-43

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗