ClinicalTrials.gg
RecruitingNCT04944940Updated Aug 13, 2026

Clinical, Molecular and Imaging Biomarkers in Spinal and Bulbar Muscular Atrophy (SBMA)

An observational study in Spinal and Bulbar Muscular Atrophy, Kennedys Disease and Motor Neuron Disease, sponsored by National Institute of Neurological Disorders and Stroke (NINDS). Recruiting at 1 site in United States. Open to male participants aged 18 Years to 120 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-08-13.

Sponsored by National Institute of Neurological Disorders and Stroke (NINDS) · Observational

From the registry’s dates

  • Started Oct 2021; still recruiting 5 years later.

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Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
70
Ages
18 Years to 120 Years
Sex
Male
01

Where this study stands

Counted across the records on this site · 2026-11-14

Among 29 studies in Bulbo-Spinal Atrophy, X-Linked with a site in United States — 6 open to participants now, 10 under way, 3 of them phase 3. Bulbo-Spinal Atrophy, X-Linked · United States.

Started
2021
with 4 others
Observational
7 of 29
4 open now
Registered
18th of 29
by date
Lead sponsor
4 of 29
National Institute of Neurological Disorders and Stroke (NINDS)

Among the 29 studies in Bulbo-Spinal Atrophy, X-Linked with a site in United States, this one is one of 5 that started in 2021, is one of 7 observational ones, and was the 18th registered.

Bulbo-Spinal Atrophy, X-Linked

57 studies on the registry are indexed under Bulbo-Spinal Atrophy, X-Linked; 12 are open to participants now.

Browse Bulbo-Spinal Atrophy, X-Linked studies →

Open to participants now

6 of the 29 studies in Bulbo-Spinal Atrophy, X-Linked with a site in United States are open now. Recruiting first, the newest first:

All 6 open studies →

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

Who these studies take

Of the 12 Bulbo-Spinal Atrophy, X-Linked studies recruiting now, 5 (42%) set no upper age limit and 2 (17%) stop at 75 or younger; 3 take children under 18; 2 take healthy volunteers.

This study: 18 Years to 120 Years · male · healthy volunteers too.

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Watch this landscapeDownload CSVNarrow it in search →With an account: a weekly mail of what changed among 29 studies in Bulbo-Spinal Atrophy, X-Linked with a site in United States, or all of them as a file.
02

Study summary

Background:

SBMA is an inherited chronic disease. It affects males in mid to late adulthood. It causes slowly progressive weakness of muscles and hand tremors. Researchers want to learn more about the effects of SBMA.

Objective:

To identify measurements that change over time in SBMA, including tests of muscle strength and function, as well as measurements of muscle and fat size.

Eligibility:

Men over the age of 18 both with and without a history of SBMA.

Design:

Participants will have a medical history, physical exam, and blood and urine tests. They will have neuromuscular ultrasound. They will have a lumbar puncture to obtain spinal fluid. For this, a needle will be inserted into the spinal canal in the lower back.

Participants will have muscle strength and function tests. These tests may include pushing, pulling, rising from a chair and sitting back down, and/or walking. During these tests, they may wear an accelerometer (activity tracker) on their wrist.

Participants will get an activity tracker to wear on their wrist for 10 days at home every 3 months.

Participants with SBMA will also have lower limb magnetic resonance imaging (MRI) and optional whole-body MRI. They will have lung function tests. They will have speech and swallow tests. They will complete questionnaires. They may have optional body scans to measure bone density and lean body mass. They may have optional muscle biopsies. For biopsies, a needle will be used to take a small piece of muscle from the leg.

Participants with SBMA will have 5 study visits over 2 years (every 6 months). Participants without SBMA will have 1 study visit.

Read the detailed description

Study Description:

Spinal and bulbar muscular atrophy (SBMA) is an inherited form of motor neuron disease caused by a CAG-repeat expansion in the androgen receptor gene on the X chromosome for which there is no treatment currently. Biomarkers will be collected from participants with SBMA during this study to understand the natural history and progression of the disease.

Objectives:

The main objective of this study is to develop clinical, molecular and imaging outcome parameters that correlate with disease progression and severity and that predict clinical decline. These biomarkers and outcome measures can serve as potential tools for the evaluation of efficacy in future therapeutic studies in SBMA.

Endpoints:

The studies performed under this protocol are exploratory. However, the following measures may be used to characterize baseline status and disease progression over the course of the study:

Muscle strength by manual and quantitative myometry

Distance traveled in meters on the 6-minute walk test

Activity levels and parameters of gait as measured by accelerometers

Global disability measured by the SBMAFRS questionnaire and other tools/instruments

Fatigue as measured by the Fatigue Severity Scale

Breathing function measured by pulmonary function test

Swallow and speech function measured by questionnaires, tongue muscle strength, digital audio recordings for analysis of voice and speech, and barium swallow

Skeletal muscle MRI measurement of muscle volume and fat fraction

Whole body MRI measurement of body muscle fat fraction, muscle fat infiltration, and liver.

Skeletal muscle ultrasound measurement of muscle thickness, echogenicity and elasticity

Nerve ultrasound measurement of nerve cross sectional area and anterior posterior diameter

Laboratory studies from blood, serum, urine, stool, and CSF

Muscle biopsy assessment of androgen receptor levels and function

03

Conditions studied

  • Spinal and Bulbar Muscular Atrophy
  • Kennedys Disease
  • Motor Neuron Disease

Keywords

  • Motor Neuron Disease
  • Spinal and Bulbar Muscular Atrophy
  • Kennedys disease
  • Androgen Receptor
  • Natural History Study
  • Natural History
04

Who can participate

Ages eligible
18 Years to 120 Years
Sexes eligible
Male
Accepts healthy volunteers
Yes
Sampling method
Non-probability sample

Study population

Primary Clinical with a confirmatory genetic testing result that is consistent with a diagnosis of spinal and bulbar muscular atrophy.

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

Some restrictions are placed on participation in the study because we aim to identify disease biomarkers specific to those with early to intermediate stages of disease who would be potential candidates for future therapeutic studies.

In order to be eligible to participate in the SBMA cohort, an individual must meet all of the following criteria:

  • Stated willingness to comply with all study procedures and availability for the duration of the study
  • Male, above the age of 18 years
  • Genetically confirmed SBMA
  • Ability of subject to understand and the willingness to sign a written document
  • Ability of subject to travel to the NIH Clinical Center.

Note: an SBMA patient who meets both of the additional following criteria will be offered an optional whole body MRI at subsequent follow-up visits:

  • Spinal bulbar muscular atrophy functional rating of \< 50 (and > 35).
  • On initial whole body MRI, subject has evidence of muscle fat replacement such that the total volume of disease affected muscles (i.e., muscles with at least 10% muscle fat infiltration and no more than 50% muscle fat fraction) is at least:

    • 500ml if only 1 muscle is eligible or
    • 250ml if more than one muscle meets the criteria

In order to be eligible to participate in this study in the Healthy Control cohort, an individual must meet all of the following criteria:

  • Stated willingness to comply with all study procedures and availability to travel to the NIH for the duration of the study
  • Male, above the age of 18 years
  • No history of SBMA or other neuromuscular disorder
  • No history of facial palsy
  • Ability of subject to understand and the willingness to sign a written informed consent document
  • Ability of subject to travel to the NIH Clinical Center.

Exclusion criteria

EXCLUSION CRITERIA:

SBMA is a disease that affects males and manifests in adulthood. Thus, woman and children are not included in this study. This study will not include individuals who lack consent capacity.

An SBMA patient who meets any of the following criteria will be excluded from participation in this study:

  • to MRI such as a contraindicated non-removable metal device (i.e., pacemaker, defibrillator, insulin pump, metal clips, non-removable jewelry) or claustrophobia.
  • Non ambulatory
  • Use of androgen reducing agents within the past two years

Note: An SBMA patient who meets any of the following criteria will be excluded from the lumbar puncture procedure:

  • PT/ values that are prolonged greater than or equal to 3 seconds from the (including treatment with oral and parenteral anticoagulants)
  • INR greater than or equal to 1.5, thrombocytopenia (\<70,000), or abnormal bleeding time or dysfunction
  • History of a bleeding disorder
  • Use of anticoagulants

Note: An SBMA patient who meets any of the following criteria will be excluded from the muscle procedure:

  • Advanced wasting of tibialis anterior that precludes needle muscle biopsy (in order to ensure that a sample taken would be of muscle and not just fat and fascia)
  • Use of aspirin or non-steroidal anti-inflammatory agents 3 days prior to the procedure

Note: An SBMA patient who meets any of the following criteria will be excluded from the whole body MRI:

  • Patient has a history of prior treatment with androgen reducing agents including LHRH agonists or antagonists, androgen receptor antagonists and selective androgen receptor modifiers.
  • Patient is unable to complete the study assessments of QMT or timed walk tests.
  • Patient anticipates making major lifestyle changes during the observation period relating to diet and exercise.

A Healthy Control participant who meets any of the following criteria will be excluded from the study:

  • PT/PTT values that are prolonged greater than or equal to 3 seconds from the upper limit of normal (including treatment with oral and parenteral anticoagulants)
  • INR greater than or equal to 1.5, thrombocytopenia (\<70,000), or abnormal bleeding time or platelet dysfunction
  • History of a bleeding disorder
  • Use of anticoagulants
Terms in these criteria, in plain language(6)

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.

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.

INR, PT and aPTT (clotting tests)

Blood tests of how long blood takes to clot. The INR is the prothrombin time (PT) put on a common scale; about 1 is usual for someone not taking a blood thinner.

Criteria often make an exception for people on a blood thinner such as warfarin, whose INR is raised on purpose.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

05

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
70 participants (estimated)

Groups and cohorts

  • Healthy Volunteers

    Healthy male participants who are age and sex matched to the SBMA participants

  • Patients with Spinal and bulbar muscular atrophy (SBMA)

    Male participants with genetically confirmed SBMA

06

What researchers measure

Primary outcomes

  1. Disease progression as measured by clinical and molecular tests

    Clinical measurements include MRI, DEXA, physical function, swallow, and pulmonary testing. Molecular measurements include serum and plasma biomarkers, muscle analysis, and urine testing.

    Time frame: Baseline to visits every 6 months to 2 years

07

Study locations

1 of 1 sites recruiting
  • National Institutes of Health Clinical Center
    Bethesda, Maryland 20892, United States
    Recruiting
    • For more information at the NIH Clinical Center contact Office of Patient Recruitment (OPR) · Contactprpl@cc.nih.gov · 800-411-1222
08

References and documents

Publications

  • Rhodes LE, Freeman BK, Auh S, Kokkinis AD, La Pean A, Chen C, Lehky TJ, Shrader JA, Levy EW, Harris-Love M, Di Prospero NA, Fischbeck KH. Clinical features of spinal and bulbar muscular atrophy. Brain. 2009 Dec;132(Pt 12):3242-51. doi: 10.1093/brain/awp258. PubMed 19846582 ↗
  • Atsuta N, Watanabe H, Ito M, Banno H, Suzuki K, Katsuno M, Tanaka F, Tamakoshi A, Sobue G. Natural history of spinal and bulbar muscular atrophy (SBMA): a study of 223 Japanese patients. Brain. 2006 Jun;129(Pt 6):1446-55. doi: 10.1093/brain/awl096. Epub 2006 Apr 18. PubMed 16621916 ↗

Individual participant data

Plan to share: No

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Started Oct 2021 (actual). Primary completion is estimated for Dec 2026, 62 months after the start.

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

Registered
Jun 29, 2021
First posted
Jun 30, 2021
StartActual
Oct 25, 2021
Primary completionEst.
Dec 30, 2026
CompletionEst.
Feb 28, 2027
Last update
Aug 13, 2026
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 Aug 13, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04944940
Responsible party
Sponsor
First posted
Jun 30, 2021
Start date
Oct 25, 2021
Primary completion
Dec 30, 2026 (estimated)
Completion
Feb 28, 2027 (estimated)
Last update
Aug 13, 2026

Study contacts

Angela D Kokkinis, R.N.
Contact
akokkinis@mail.cc.nih.gov
(301) 451-8146
Christopher Grunseich, M.D.
Contact
grunseichc@mail.nih.gov
(301) 402-5423
Christopher Grunseich, M.D.
principal investigator · National Institute of Neurological Disorders and Stroke (NINDS)

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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