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CompletedNCT03460951PIDCUpdated Mar 9, 2018

Diffusion Tensor Imaging in Chronic Inflammatory Demyelinating Polyneuropathy (PIDC)

An observational study in CIDP (Chronic Inflammatory Demyelinating Polyradiculoneuropathy) and CMT (Charcot Marie Tooth Disease), sponsored by University Hospital, Clermont-Ferrand. Completed at 1 site in France. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2018-03-09.

Sponsored by University Hospital, Clermont-Ferrand · Observational

Study type
Observational
Model
Case-control
Time perspective
Prospective
Enrollment
45
Ages
18 Years and older
Sex
All
01

Study summary

The main purpose of this study is to assess the clinical feasibility of diffusion tensor imaging (DTI) for the diagnosis of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). For thar purpose, investigator will compare, fractional anisotropy (FA) obtained by diffusion tensor imaging (DTI) MRI 3T on brachial plexus and cervical spinal nerve roots between patients with defined Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP), according to the EFNS 2010 criteria, and healthy controls.

The secondary outcomes will be to compare DTI parameters (FA, ADC or Apparent Diffusion Coefficient) between CIDP patients, healthy volunteers, and patients with Charcot Marie Tooth disease type 1a (CMT1a) and MRI morphological parameters (T1, STIR) between these groups. Moreover, investigator will investigate the possible relationship between MRI parameters, clinical indices, and electrophysiological measure.

Read the detailed description

Investigator will prospectively enroll 15 patients with CIDP followed in the Neurology Department of Clermont Ferrand University Hospital, who satisfy the Joint Task Force of the EFNS and PNS definite CIDP criteria. Two control groups will be studied in parallel, including 15 healthy volunteers on one side, and 15 patients with CMT-1A on the other side (proven by genetic testing). Using a 3-T magnetic resonance imaging scanner, we will obtain DTI scans of brachial plexus of these 3 groups, prepare fractional anisotropy (FA) maps, and compare these values between groups. Investigator will evaluate MRI imaging findings too (coronal STIR, T1-weighted images,and DWIs). MRI studies will be reviewed independently by two neuroradiologists, blinded to clinical informations. In all patients with CIDP, investigator will also performs clinical evaluation and electroneuromyography. Correlation between FA values clinical indices will be examined.

02

Conditions studied

  • CIDP (Chronic Inflammatory Demyelinating Polyradiculoneuropathy)
  • CMT (Charcot Marie Tooth Disease)

Keywords

  • Feasibility and reproductibility
  • DTI parameters (Fractional Anisotropy, Apparent Diffusion Coefficient)
  • MRI morphological parameters (T1, STIR)
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
Yes
Sampling method
Non-probability sample

Study population

men or women

Inclusion criteria

    • For All patients: at least 18 years-old.
  • For CMT1a group : CMT1 a should be proven by genetic testing
  • For CIDP group: CIDP should satisfied the definite CIDP criteria of the Joint Task Force of the EFNS and PNS 1 (situations A and B according to the French CIDP work group2). They might have received steroids, immunoglobulin or immunosuppressive treatments

Exclusion criteria

Exclusion Criteria:

  • For all groups: any neurological comorbidity, other causes of neuropathy or history of exposure to neurotoxic agents (the inclusion and exclusion criteria are detailed in supplemental data) allergies, renal failure, Pregnancy
04

Study design

Observational model
Case-control
Time perspective
Prospective
Enrollment
45 participants (actual)
Patient registry
No

Groups and cohorts

  • CIDP patients

    15 patients with CIDP (Chronic Inflammatory Demyelinating Polyradiculoneuropathy ) who satisfy the definite CIDP criteria of the Joint Task Force of the EFNS and PNS 1 (situations A and B according to the French CIDP work group2), and who agree to undergo cervical MRI.

    Diagnostic Test: cervical MRI

  • Normal volunteers

    15 healthy subjects matched for age and gender to CIDP patients

    Diagnostic Test: cervical MRI

  • Charcot-Marie-Tooth disease type 1A patients (CMT-1A)

    15 CMT-1A patients (proven by genetic testing), will be included as Charcot-Marie-Tooth disease type 1A patients (CMT-1A) is one of the main differential diagnoses of CIDP characterized by the diffuse demyelination of peripheral nerves.

    Diagnostic Test: cervical MRI

Interventions

  • Diagnostic testcervical MRI

    Cervical MRI will be performed in all of the patients and controls on a 3.0-T scanner (Discovery MR750, General Electric (GE) Medical Systems, Milwaukee, WI, USA)

05

What researchers measure

Primary outcomes

  1. Mean Fractional Anisotropy in C5 to C8 nerve roots in CIDP patients compared to CMT-1A patients and healthy controls.

    Diffusion Tensor Imaging (DTI) is a modality of Diffusion-Weighted Imaging (DWI). Fractional Anisotropy (FA) and Apparent Diffusion Coefficient (ADC) values, determines the magnitude of directionality of diffusion.

    Time frame: At day 1

Secondary outcomes

  1. Apparent Diffusion Coefficient (ADC) values in C5 to C8 nerve roots in CIDP patients compared to CMT-1A patients and healthy controls

    Diffusion Tensor Imaging (DTI) is a modality of Diffusion-Weighted Imaging (DWI). Fractional Anisotropy (FA) and Apparent Diffusion Coefficient (ADC) values, determines the magnitude of directionality of diffusion.

    Time frame: At day 1

  2. Cervical nerve roots diameter

    The diameters of cervical nerve roots (C6-C8) will be measured at the outlet of the intervertebral canal, on coronal STIR sequences, using an ADW 4.5 workstation.

    Time frame: at day 1

  3. Clinical data analysis

    Disease severity at inclusion (Medical Research Council score (MRC), INCAT sensory sum score (INCAT), Overall Neuropathy Limitation Scale (ONLS)) will be prospectively assessed by the same study investigator. We will also perform nerve conduction studies on all the CIDP patients

    Time frame: at day 1

  4. Electrophysiological data analysis : motor conduction

    Amplitude of compound muscle action potential (ACMAP),

    Time frame: at day 1

  5. Electrophysiological data analysis motor conduction

    Motor conduction velocity (MCV)

    Time frame: at day 1

  6. Electrophysiological data analysis motor conduction

    Motor distal latency (MDL)

    Time frame: at day 1

  7. Electrophysiological data analysis motor conduction

    F-wave latency (FL)

    Time frame: at day 1

  8. Electrophysiological data analysis :motor conduction

    terminal latency index (TLI))

    Time frame: at day 1

  9. Electrophysiological data analysis : sensitive conduction

    Amplitude of sensitive potential (ASP)

    Time frame: at day 1

  10. Electrophysiological data analysis : sensitive conduction

    Sensitive conduction velocity (SCV)

    Time frame: at day 1

  11. Electrophysiological data analysis : sensitive conduction

    Sensitive distal latency (SDL)

    Time frame: at day 1

06

Study locations

1 site
  • CHU Clermont-Ferrand
    Clermont-Ferrand, 63003, France
07

Registry details

Key details

Study ID
NCT03460951
Lead sponsor
University Hospital, Clermont-Ferrand
Responsible party
Sponsor
First posted
Mar 9, 2018
Start date
Nov 18, 2013
Primary completion
Dec 31, 2015
Completion
Dec 31, 2015
Last update
Mar 9, 2018

Study contacts

Frédéric TAITHE
principal investigator · University Hospital, Clermont-Ferrand

Oversight

FDA-regulated drug
No
FDA-regulated device
No
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