ClinicalTrials.gg
RecruitingNCT03434548Updated Mar 5, 2025

IMarkHD: in Vivo Longitudinal Imaging of HD Pathology

An observational study in Huntington Disease, sponsored by King's College London. Recruiting at 1 site in United Kingdom. Open to participants aged 21 Years to 75 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2025-03-05.

Sponsored by King's College London · Observational

From the registry’s dates

  • Started Jul 2021; still recruiting 5 years 3 months later.

Help build ClinicalTrials.gg — short surveys, remote interviews or testing, in your language. Take part →

Study type
Observational
Model
Case-control
Time perspective
Prospective
Enrollment
113
Ages
21 Years to 75 Years
Sex
All
01

Where this study stands

Counted across the records on this site · 2026-11-13

Among 51 studies in Huntington Disease with a site in United Kingdom — 10 open to participants now, 15 under way, 3 of them phase 3. Huntington Disease · United Kingdom.

Planned enrollment
8th of 13
113 · median 154
Started
2021
with 2 others
Observational
13 of 51
4 open now
Primary completion
2027-06
later than 5 of 14 live
Registered
23rd of 51
by date

Among the 51 studies in Huntington Disease with a site in United Kingdom, this one is the 8th largest by planned enrollment of the 13 observational ones that give a count, is one of 3 that started in 2021, is one of 13 observational ones, reaches primary completion later than 5 of the 14 other live ones, and was the 23rd registered.

Huntington Disease

293 studies on the registry are indexed under Huntington Disease; 54 are open to participants now.

Browse Huntington Disease studies →

Open to participants now

10 of the 51 studies in Huntington Disease with a site in United Kingdom are open now. Recruiting first, the newest first:

4 more — sign in →

All 10 open studies →

A study can be open while its sites in United Kingdom have not opened yet or have stopped. Only those recruiting at a site in United Kingdom →

Who these studies take

Of the 43 Huntington Disease studies recruiting now, 19 (44%) set no upper age limit and 20 (47%) stop at 75 or younger; 5 take children under 18; 20 take healthy volunteers.

This study: 21 Years to 75 Years · all sexes · healthy volunteers too.

The full table on the hub →

This tab as a report to print or save as PDF → With an account.

Was this useful?
Watch this landscapeDownload CSVNarrow it in search →With an account: a weekly mail of what changed among 51 studies in Huntington Disease with a site in United Kingdom, or all of them as a file.
02

Study summary

iMarkHD is an adaptive, longitudinal positron emission tomography (PET) and magnetic resonance (MR) imaging study in Huntington's disease (HD) that aims to assess abnormal molecular, functional, and structural changes in participants' brains, ranging from several years before symptom onset to the advanced symptom stage. The study will be conducted over a three (3) year period (Baseline, Year-1, and Year-2).

Read the detailed description

It is likely that, over time, multiple pathophysiological changes influence Huntington's disease (HD) progression. Rather than focusing on one element, the combined PET and multi-modal MRI assessments in this study will allow comprehensive examination of the molecular, functional, and structural framework of HD progression in the brain. The investigators will compare PET and MRI measurements at different disease stages with age- and sex-matched healthy control (HC) participants and monitor, over follow-up visits, to evaluate how specific or combinatorial changes may influence the development of symptoms and disease progression. Furthermore, disease progression markers may be identified that can characterize and predict events preceding symptom development, which could be used as outcome measures in future clinical trials. Study results could also lead to the development of new targeted therapies.

The study has two main objectives. First, to use a series of PET scans to investigate four target receptors in specific areas of the brain that are affected by HD and are thought to be responsible for the motor, cognitive, and behavioral symptoms. Second, to investigate structural and functional changes, including alterations in brain connections, using a multi-modal MRI protocol. The investigators will combine MRI and PET findings with clinical measures to precisely characterize univariate and multivariate markers of disease progression.

There will be two (2) cohorts in this study. Cohort 1 will consist of five (5) HC participants (who do not have the HD gene mutation) recruited and enrolled to enable optimization of MRI imaging techniques. Each participant in Cohort 1 will complete a minimum of 3 visits. Cohort 2 will consist of 72 people with HD (PwHD) and 36 HC participants; each participant will complete a minimum of 10 visits over three (3) years. The 72 PwHDs will be recruited into three (3) groups depending on disease stage: 24 PwHDs who do not have symptoms and are predicted to develop clinically relevant symptoms in a few years; 24 PwHDs with symptoms in early disease stages; and 24 PwHDs with symptoms in advanced disease stages.

The investigators will conduct a preliminary analysis after all baseline visits are completed and a decision will be made whether to add an additional group of 24 PwHDs with no symptoms and who are several years away from developing symptoms, and an additional 12 HCs. After 50% of participants have completed Year 2 follow-up visits, preliminary analysis will be carried out to determine whether to extend the study to include a Year 3 follow-up visit which would be identical to the Year 1 and 2 follow-up visits.

03

Conditions studied

  • Huntington Disease

Browse trials for

Keywords

  • Huntington's disease
  • PET imaging
  • MRI imaging
04

Who can participate

Ages eligible
21 Years to 75 Years
Sexes eligible
All
Accepts healthy volunteers
Yes
Sampling method
Probability sample

Study population

People with Huntington's disease (PwHD) and healthy controls (HCs). PwHD participants will be recruited from specialty clinics known as Participant Identification Centers (Human Genetics, Neurology, Psychiatry) that advise and treat people affected by HD. Participants may receive information about the study through a website, clinical practices, advocacy newsletters, or other approved sources. Community controls will be recruited using advertisements, flyers, and newsletters with the support of the iMarkHD operational staff.

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

PwHDs and HC participants:

  • Female and male adults, aged 21-75 years old, inclusive.
  • Adequate visual (Snellen chart) and auditory (Rinne and Weber tests) acuity to complete the psychological testing as determined by the investigator.
  • Capable of giving .
  • Willing to comply with highly effective measures following informed consent (for Cohort 2 only).
  • Vital signs within certain set ranges.
  • Considered by the investigator to be in good health as judged by the absence of diseases, laboratory values, physical examination, and able to travel to imaging and clinical assessment centers in London, UK.
  • Suitable physically and psychologically to travel (with a companion if requested) and undergo the assessments as judged by the investigator.

PwHDs without symptoms: (approximately HD-ISS stage 0 or 1)

  • HDGECs with ≥ 40 CAG repeats
  • TMS ≤ 6 AND TFC ≥ 12 AND CAP > 70 PwHDs with symptoms in early disease: (approximately HD-ISS stage 2)
  • HDGECs with ≥ 40 CAG repeats
  • If one of the following criteria is met:

    1. TMS ≤ 6 AND TFC = 11
    2. TMS is between 7 and 23 inclusive AND TFC is between 11 and 13 inclusive
    3. TMS is between 24 and 33 inclusive AND SDMT > 50 AND TFC is between 11 and 13 inclusive PwHDs with symptoms in late disease (approximately HD-ISS stage 3)
  • HDGECs with ≥ 40 CAG repeats
  • If one of the following criteria is met:

    1. TMS ≤ 6 AND TFC is between 7 and 10 inclusive
    2. TMS is between 7 and 23 inclusive AND TFC is between 8 and 10 inclusive
    3. TMS is between 24 and 33 inclusive AND SDMT > 50 AND TFC is between 7 and 10 inclusive
    4. TMS is between 7 and 23 inclusive AND TFC = 7
    5. TMS > 23 AND SDMT ≤ 50 AND TFC is between 7 and 13 inclusive
    6. TMS > 33 AND SDMT > 50 AND TFC is between 7 and 13 inclusive

Healthy Controls (HC):

  • Age- and sex-matched, and balanced (±8 years) with PwHDs.
  • No known family history of HD or have known family history of HD but have been tested for the huntingtin gene glutamine codon (CAG) expansion and are not at genetic risk for HD (CAG \< 36).

Exclusion criteria

Exclusion Criteria:

PwHD and HC participants:

  • Presence or history of other neurological condition (including brain surgery, intracranial hematoma, stroke/cerebrovascular disorders, demyelinating conditions, epilepsy) likely to interfere with imaging or PET studies or abnormal neurologic examination finding suggestive of a central nervous system pathology (for PwHDs - other than HD).
  • Presence or history of primary psychiatric disorders unrelated to HD.
  • Participants using any medications with known actions on cannabinoid type 1 receptors (CB1R), phosphodiesterase 10A (PDE-10A), 5-hydroxytryptamine-2A receptor (5-HT2AR), histamine type-3 receptors (H3R), or any other PET targets used in iMarkHD.
  • Pregnancy confirmed by a positive urine pregnancy test.
  • Participants who are currently breastfeeding or intend to breastfeed during the study.
  • to MRI, such as presence of metal devices or implants (e.g. pacemaker, vascular- or heart- valves, stents, clips), metal deposited in the body (e.g. bullets or shells), or metal grains in the eyes.
  • History of alcoholism or substance abuse within 3 years prior to study entry.
  • Failure of drug screen for substances of abuse such as amphetamines, barbiturates, benzodiazepines, methadone, opiates, cocaine, cannabinoids, phencyclidine, and creatine.
  • History of cancer.
  • Claustrophobia.
  • Significant back pain that makes prolonged laying on the PET or MRI scanner intolerable.
  • Contraindication for arterial cannulation as judged by the Allen test and the laboratory blood screening for coagulopathy (Cohort 2 only).
  • Inability to communicate or cooperate with the principal investigator/iMarkHD team for any reason.
  • Participants who are currently enrolled in or participated in clinical trials testing the efficacy of novel therapeutics with action on the specific PET targets being tested within 3 months of screening.
  • Any concurrent conditions that could interfere with the safety and/or tolerability measurements.
Terms in these criteria, in plain language(4)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

05

Study design

Observational model
Case-control
Time perspective
Prospective
Enrollment
113 participants (estimated)
Patient registry
No
Biospecimen retention
Samples without dna

Groups and cohorts

  • Cohort 1

    Healthy controls. Multi-modal MRI imaging.

    Other: Multi-modal MRI imaging

  • Cohort 2

    People with Huntington's (without symptoms, early disease stage, and later disease stage), and healthy controls People with HD divided in groups according to disease stage: * Without symptoms (approximately HD-ISS stage 0 or 1) * Early disease (approximately HD-ISS stage 2) * Later disease stage (approximately HD-ISS stage 3)

    Radiation: PET imaging · Other: Multi-modal MRI imaging

Interventions

  • RadiationPET imaging

    PET imaging Radiation: Radioligand \[¹¹C\]MePPEP Intravenous injection of radioligand in the arm with PET imaging of the brain. Radiation: Radioligand \[¹¹C\]IMA107 Intravenous injection of radioligand in the arm with PET imaging of the brain. Radiation: Radioligand \[¹¹C\]MDL100907 Intravenous injection of radioligand in the arm with PET imaging of the brain. Radiation: Radioligand \[¹¹C\]MDL100907 Intravenous injection of radioligand in the arm with PET imaging of the brain. PET imaging Radiation: Radioligand \[¹¹C\]MePPEP Intravenous injection of radioligand in the arm with PET imaging of the brain. Radiation: Radioligand \[¹¹C\]IMA107 Intravenous injection of radioligand in the arm with PET imaging of the brain. Radiation: Radioligand \[¹¹C\]MDL100907 Intravenous injection of radioligand in the arm with PET imaging of the brain. Radiation: Radioligand \[¹¹C\]MDL100907 Intravenous injection of radioligand in the arm with PET imaging of the brain.

  • OtherMulti-modal MRI imaging

    Multi-modal MRI imaging

06

What researchers measure

Primary outcomes

  1. Primary outcome measure 1

    Quantitative change in binding profile of four discrete molecular PET markers over the period of 2 years. These markers include: 1. Cannabinoid 1 Receptor binding. 2. Phosphodiesterase 10A enzyme binding. 3. 5-hydroxytryptamine-2A receptor binding. 4. Histamine type-3 receptor binding. The study will assess basal ganglia and cortical pathology with four highly specific PET radioligands (\[11C\]MePPEP, \[11C\]IMA107, \[11C\]MDL100907 and \[11C\]MK-8278), tagging 4 targets of interest: cannabinoid type 1 receptors (CB1R), phosphodiesterase 10A (PDE-10A), 5-hydroxytryptamine-2A receptor (5-HT2AR) and histamine type-3 receptors (H3R), respectively, at baseline, 1 and 2years. The main focus will be on the basal ganglia.

    Time frame: 2 years

  2. Primary outcome measure 2

    Determine whether selected PET markers could be used as markers of HD disease progression and treatment response in therapeutic trials. These markers include: 1. Cannabinoid 1 Receptor binding. 2. Phosphodiesterase 10A enzyme binding. 3. 5-hydroxytryptamine-2A receptor binding. 4. Histamine type-3 receptor binding. The study will assess basal ganglia and cortical pathology with four highly specific PET radioligands (\[11C\]MePPEP, \[11C\]IMA107, \[11C\]MDL100907 and \[11C\]MK-8278), tagging 4 targets of interest: cannabinoid type 1 receptors (CB1R), phosphodiesterase 10A (PDE-10A), 5-hydroxytryptamine-2A receptor (5-HT2AR) and histamine type-3 receptors (H3R), respectively, at baseline, 1 and 2years. These outcomes will be linked to scale-based and other clinical outcomes performed over the same timelines to determine the link between clinically defined disease progression and the PET markers.

    Time frame: 2 years

07

Study locations

1 of 1 sites recruiting
08

References and documents

Individual participant data

Plan to share: Undecided

No publications or documents are linked to this record.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Jul 2021 (actual). Primary completion is estimated for Jun 2027, 71 months after the start.

Of 34 observational studies under Huntington Disease, half reached primary completion within 47 months of starting (the median), counting those still running; a quarter within 34. This study's planned 71 months is above that.

How these figures are worked out, and which studies are left out of them.

Registered
Feb 7, 2018
First posted
Feb 15, 2018
StartActual
Jul 20, 2021
Primary completionEst.
Jun 30, 2027
CompletionEst.
Jun 30, 2027
Last update
Mar 5, 2025
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Mar 5, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03434548
Collaborators
CHDI Foundation, Inc.
Responsible party
Sponsor
First posted
Feb 15, 2018
Start date
Jul 20, 2021
Primary completion
Jun 30, 2027 (estimated)
Completion
Jun 30, 2027 (estimated)
Last update
Mar 5, 2025

Study contacts

Steve Williams, PhD
Contact
steve.williams@kcl.ac.uk
0044-(0)-203-228-3063
Daniel J van Wamelen, PhD
Contact
daniel.van_wamelen@kcl.ac.uk
0044-(0)-203-228-3084
Steve Williams, PhD
study chair · King's College London
Daniel J van Wamelen, PhD
principal investigator · King's College London

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Interested in this study?

Eligibility is decided by the study team. Share this record with your doctor or contact the team directly.

Contact study team

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion