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Status unknownNCT03425214NC-TCSP-IRMfUpdated Feb 9, 2018

Exploration of the Reward System by Functional MRI in Narco-cataplexy Patients With and Without REM Sleep Behavior Disorder

An interventional study of fMRI and Videopolysomnography in Narcolepsy and Cataplexy, sponsored by University Hospital, Clermont-Ferrand. Status unknown at 1 site in France. Open to participants aged 18 Years to 80 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2018-02-09.

Sponsored by University Hospital, Clermont-Ferrand · Not applicable, Interventional, and Diagnostic

The sponsor has not verified this record recently (last verified Feb 2018), so the status shown — last known as Recruiting — may be out of date.
Phase
Not applicable
Study type
Interventional
Enrollment
66
Allocation
Non-randomized
Ages
18 Years to 80 Years
Sex
All
01

Study summary

Up to 50% of Narcolepsy-cataplexy (NC) patients suffer from REM sleep behavior disorder (RBD), a parasomnia.

A strong link was found between RBD and impulse control disorders (ICD) in Parkinson disease (PD) patients. ICD are thought to be related to a dysfunction of meso-cortico-limbic pathways which belong to the so called ''reward system''.

A recent study in IRMf shows that RBD is associated with impaired reward system.

A strong link was found between these two disorders and therefore we believe that RBD is associated with impaired reward system in NC

The main objective of this study is to evaluate differences in brain activation between NC patients with and without RBD.

The investigators hypothesize that NC patients with RBD have a more severe dysfunction of the reward system (hypoactivation of the meso-cortico-limbic pathway) than patients without RBD.

Read the detailed description

Type of study: Prospective, case control study.

Number of centers: 3 (Clermont-Ferrand, Vichy and Montlucon)

Patients :

The study will be performed in 66 subjects (22 PD patients with RBD, 22 PD patients without RBD and 22 healthy volunteers, age-and sex-matched without any contraindications to perform an MRI)

Study Performance :

During the first visit (Baseline, inclusion visit, 2 hours), each subject will perform a clinical and neurological examination and neuropsychological assessment (depression by the Beck Depression Inventory (BDI); apathy by the Lille Apathy Rating Scale (LARS), impulsivity by the Urgency, lack of Premeditation, lack of Perseverance, Sensation Seeking scale (UPPS)) Eligible patients will be welcomed for a video Polysomnography in the sleep center, for one night (Month 1, 1 night) and in a subsequent visit at the MRI department for the functional MRI (Month 1, 1 hour). This session will be of about 45 minutes. The reward system will be explore using an experimental task during functional Magnetic Resonance Imaging (fMRI). The name of this task is the"monetary incentive delay task".

02

Conditions studied

  • Narcolepsy
  • Cataplexy

Keywords

  • functional MRI
  • Reward system
  • REM sleep behaviour disorder
  • Narco-cataplexy
03

Who can participate

Ages eligible
18 Years to 80 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Inclusion criteria

    • Men or women, right handed, 18 to 80 years
  • Patients with type 1 Narcolepsy according to the criteria of the International Classification of Sleep, 3rd version, 2014
  • Acceptance of the protocol and signature of a written consent
  • Social security affiliation

Exclusion criteria

Exclusion Criteria:

  • Previous history of psychosis or psychiatric disease
  • History of stroke or vascular lesion on MRI.
  • Perceptual disorder (vision, hearing) may hinder the realization of the protocols,
  • Dementia defined by a score across Montreal Cognitive Assessment (MoCA) \<26/30.
  • Major depressive state defined by a score scale Beck Depression Inventory (BDI)> 14
  • Apathy defined by a score ≥ 14 on the Apathy Scale of Starkstein. Patients with a score ≥ this one will be excluded.
  • Usual contraindications to MRI, knowing that no contrast agent injection is performed.
  • Pregnant woman.
04

Study design

Phase
Not applicable
Primary purpose
Diagnostic
Allocation
Non-randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
66 participants (estimated)

Study arms

  • Experimental
    NC with RBD

    fMRI and video polysmnography

    Other: fMRI · Other: Videopolysomnography

  • Experimental
    NC without RBD

    fMRI and video polysomnography

    Other: NC (narcolepsy-cataplexy)

  • Experimental
    control group (healthy subjects)

    fMRI

    Other: fMRI

Interventions

  • OtherfMRI

    Session will be of about 45 minutes. The reward system will be explore using an experimental task during functional Magnetic Resonance Imaging (fMRI). The name of this task is the"monetary incentive delay task".

  • OtherVideopolysomnography

    Video polysomnography will be perform in the sleep center during one night if patient did not have vPSG for 1 year.

  • OtherNC (narcolepsy-cataplexy)

    The investigators hypothesize that NC patients with RBD have a more severe dysfunction of the reward system (hypoactivation of the meso-cortico-limbic pathway) than patients without RBD.

05

What researchers measure

Primary outcomes

  1. Measure of BOLD signal variation in each region of interest

    BOLD signal variation in each region of interest (ventral tegmental area, accumbens nucleus, limbic cortex, prefrontal cortex) measured during fMRI

    Time frame: at Month 1

Secondary outcomes

  1. reaction time to the task

    Time frame: at Month 1

  2. performance score to the task

    Time frame: at Month 1

  3. Beck Depression Inventory score measured during fMRI

    Time frame: at baseline

  4. Lille Apathy Rating Scale score measured during fMRI

    Time frame: at baseline

  5. impulsivity score by the Urgency measured during fMRI

    Time frame: at baseline

06

Study locations

1 of 1 sites recruiting
  • CHU Clermont-Ferrand
    Clermont-Ferrand, 63003, France
    • Patrick LACARIN · Contact · placarin@chu-clermontferrand.fr · 04 73 75 11 95
    • Maria-Livia FANTINI · Principal investigator
    • Nicolas VITELLO · Sub investigator
    • Marcel MAILLET-VIOUF · Sub investigator
    Recruiting
07

Registry details

Key details

Study ID
NCT03425214
Lead sponsor
University Hospital, Clermont-Ferrand
Collaborators
CH MONTLUCON, Jacques Lacarin Hospital Center
Responsible party
Sponsor
First posted
Feb 7, 2018
Start date
Jan 19, 2018
Primary completion
Jun 30, 2019 (estimated)
Completion
Jun 30, 2019 (estimated)
Last update
Feb 9, 2018

Study contacts

Patrick LACARIN
Contact
placarin@chu-clermontferrand.fr
04 73 75 11 95
Maria-Livia FANTINI
principal investigator · University Hospital, Clermont-Ferrand

Oversight

FDA-regulated drug
No
FDA-regulated device
No
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