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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT05579236
Other study ID # RHM NEU0402
Secondary ID NIHR202146
Status Recruiting
Phase
First received
Last updated
Start date September 28, 2022
Est. completion date April 2025

Study information

Verified date May 2023
Source University Hospital Southampton NHS Foundation Trust
Contact Angus Prosser, PhD
Phone +44(0)2381206132
Email angus.prosser@soton.ac.uk
Is FDA regulated No
Health authority
Study type Observational

Clinical Trial Summary

The aim of this study is to find out whether a new image analysis technique called Cortical Disarray Measurement (CDM) could be used to help better diagnose Alzheimer's disease. This study will see whether changes on CDM can be used to identify Alzheimer's disease from a group of people living with memory and thinking problems. The study will also explore how CDM relates to changes in memory or thinking over time.


Description:

This is a multi-centre observational longitudinal cohort study to evaluate and optimise the Cortical Disarray Measurement (CDM) technique for diagnosis and prognosis in patients with mild cognitive impairment and prodromal / mild Alzheimer's Disease. CDM is a novel MRI analysis tool that quantifies cortical and regional diffusion tensor imaging signals in grey matter to observe pathological changes related to neurodegeneration. Participants in this study will be monitored for 2 years. Research Aims: - Assess the accuracy of CDM in detecting progressive change in cognitive and functional measures over 2 years in participants presenting with mild cognitive impairment or early dementia. - Determine the relationship between CDM (both cross-sectionally and longitudinally) and change on standard cognitive and functional assessment measures. - Explore patient and companion views and experiences of the diagnostic journey for dementia and their views on CDM implementation. - To explore the costs and consequences of introducing CDM-augmented MRI as a form of early diagnosis of Alzheimer's disease in people presenting with MCI or mild AD compared to current practice.


Recruitment information / eligibility

Status Recruiting
Enrollment 400
Est. completion date April 2025
Est. primary completion date April 2025
Accepts healthy volunteers No
Gender All
Age group 50 Years to 90 Years
Eligibility PATIENT PARTICIPANTS Inclusion Criteria: - Diagnosis of mild cognitive impairment (MCI) or prodromal Alzheimer's Disease (AD) as defined by National Institute on Ageing/Alzheimer's Association (NIA/AA) diagnostic criteria for MCI/prodromal AD, NOT including MCI unlikely due to AD; OR, Diagnosis of Alzheimer's disease as defined by NIA/AA criteria for probable AD - Clinical dementia rating (CDR) scale global score of very mild or mild (0.5 or 1) impairment - Ability to undergo and tolerate MRI scans, with no contraindications to MRI - Ability to tolerate blood draws - Ability to give informed consent to participate in the study Exclusion Criteria: - Do not meet the inclusion criteria - No study companion available - Individuals with a non-progressive learning disability - Pregnant or intending to become pregnant during the study COMPANION PARTICIPANTS Inclusion Criteria: - Aged over 18 years - Sufficient knowledge on study participant's condition to complete companion assessments of the patient, in the investigator's judgement - Able and willing to attend all clinical visits for completion of companion assessments or provide the relevant assessments remotely via phone or video call Exclusion Criteria: - A condition or reason, in the investigator's judgement, that would question the validity of the acquired companion reported data - Individuals who are not fluent in English

Study Design


Locations

Country Name City State
United Kingdom Dorset Healthcare University NHS Foundation Trust Bournemouth
United Kingdom Cardiff and Vale University Health Board Cardiff
United Kingdom University Hospital Southampton NHS Foundation Trust Southampton Hampshire

Sponsors (7)

Lead Sponsor Collaborator
University Hospital Southampton NHS Foundation Trust Bournemouth University, Cardiff and Vale University Health Board, Cardiff University, Oxford Brain Diagnostics Ltd, University of Oxford, University of Southampton

Country where clinical trial is conducted

United Kingdom, 

Outcome

Type Measure Description Time frame Safety issue
Primary CDR Progression CDR Progression defined as a binary variable (yes/no) indicating either an increase in global outcome on Clinical Dementia Rating (CDR) scale (which takes value 0, 0.5, 1, 2 or 3, with higher scores reflecting more severe dementia), or an increase greater than, or equal to, 2 points on CDR Sum of Boxes (which takes values from 0 to 18 with higher values indicating a worse outcome) Baseline (Study day 1) to month 24
Secondary CDR Sum of Boxes Change from baseline in the Clinical Dementia Rating (CDR) Sum of Boxes. CDR Sum of boxes is the sum over 6 domains (memory, orientation, judgment & problem solving, community affairs, home & hobbies, and personal care), each rated on a 5-point scale (0, 0.5, 1, 2, 3), giving a total score that ranges from 0 to 18, with higher values indicating a worse outcome. Baseline (Study day 1) to month 24
Secondary ADAS-cog Change from baseline in Alzheimer's Disease Assessment Scale - Cognitive subscale (ADAS-cog). Higher scores for ADAS-Cog represent a worse outcome. Baseline (Study day 1) to month 24
Secondary MMSE Change from baseline in Mini Mental State Examination (MMSE). MMSE ranges from 0 to 30, with lower scores representing a worse outcome. Baseline (Study day 1) to month 24
Secondary ADCOMS Change from baseline in Alzheimer's disease composite score (ADCOMS). The range of ADCOMS is between 0 and 1.97, with higher scores representing a worse outcome. Baseline (Study day 1) to month 24
Secondary RBANS Change from baseline in the RBANS total score. The repeatable battery for the assessment of neuropsychological status (RBANS) is a brief neuropsychological battery. The total score can classify patients as follows: Average/Mild Impairment (standard scores of 70 or above), Moderate Impairment (standard scores from 55 to 69), and Severe Impairment (standard scores <54), such that lower scores indicate a worse outcome. Baseline (Study day 1) to month 24
Secondary ADCS-ADL Change from baseline in Alzheimer's Disease Cooperative Study Activities of Daily Living Scale (ADCS-ADL). ADCS-ADL Baseline (Study day 1) to month 24
Secondary Functional Activities Questionnaire (FAQ) The Functional Activities Questionnaire (FAQ) measures instrumental activities of daily living. Scores range from 0 (independent) to 30 (dependent), with higher scores indicating a worse outcome. Baseline (Study day 1) to month 24
Secondary Institutionalisation or POC Institutionalisation in care home or nursing home or implementation of package of care (POC) for dementia. Binary outcome (yes, no), with "yes" indicating a worse outcome. Baseline (Study day 1) to month 24
Secondary Death (any cause) Death due to any cause Baseline (Study day 1) to month 24
Secondary EQ-5D-5L (Patient Participant) EuroQuol EQ-5D-5L is an instrument to describe and value health on five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems and extreme problems. Baseline (Study day 1) to month 24
Secondary EQ-5D-5L (Study Companion) EuroQuol EQ-5D-5L is an instrument to describe and value health on five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems and extreme problems. Baseline (Study day 1) to month 24
Secondary Zarit Burden Interview The Zarit Burden Interview (ZBI) assesses caregiver perceptions of burden. Higher scores indicate a worse outcome. Baseline (Study day 1) to month 24
Secondary Health and social care resource usage Health and social care resource usage questionnaire. Higher values indicate a worse outcome. Baseline (Study day 1) to month 24
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