Tiefe Hirnstimulation (DBS)

DES GLOBUS PALLIDUS (GP) BEI DER HUNTINGTON-KRANKHEIT (HUNTINGTON’S DISEASE , HD) (HD-DBS)

Rekrutierung

ZWECK

GESPONSERT VON

Heinrich-Heine University, Duesseldorf

TEILNEHMER

50

In dieser Studie werden die Wirksamkeit und Sicherheit von pallidaler Tiefenhirnstimulation (DBS) bei Huntington-Patienten untersucht und die Überlegenheit von DBS bei der motorischen Funktion in der Stimulationsgruppe gegenüber der Gruppe ohne Stimulation aufgezeigt. Diese Studie ist eine prospektive, randomisierte, doppelblinde, parallele Gruppen-, scheinkontrollierte, multizentrische Studie. Die Patienten in der Stimulationsgruppe werden für drei Monate stimuliert, während der Stimulator in der Scheingruppe für drei Monate ausgeschaltet wird. Nach drei Monaten wird der primäre Endpunkt bewertet. Danach wird der Stimulator bei allen Patienten eingeschaltet.

Voraussichtliches Abschlussdatum der Studie: 31. Dezember 2022

Studienberechtigte Altersgruppen:

18 Jahre und älter (Erwachsene, ältere Erwachsene)

Geschlechter, die für die Studie in Frage kommen:

Alle

Akzeptiert gesunde Freiwillige:

Nein

Einschlusskriterien

  • Klinisch symptomatische und genetisch bestätigte Huntington-Krankheit (Anzahl der CAG-Wiederholungen ≥ 36)
  •  Alter ≥18 Jahre
  •  Mittleres Stadium der Erkrankung (UHDRS Motor Score ≥ 30)
  • Chorea trotz bester medizinischer Behandlung (UHDRS Chorea subscore ≥ 10)
  • Mattis Demenz-Bewertungsskala ≥ 120 (oder > 80 % der Artikel sind unabhängig von motorischen Beeinträchtigungen prüfbar)
  • Der Patient hat seit sechs Wochen vor der Aufnahme eine stabile Medikation.
  • Unterzeichnete Einwilligungserklärung

Ausschlusskriterien

  • Juvenile Huntington-Krankheit (Westphal-Variante) oder vorherrschende Bradykinesie
  • Haltungsinstabilität mit UHDRS-Retropulsionswert > 2
  • Schwere Komorbidität, die die Funktionsfähigkeit und/oder die Lebenserwartung und/oder die Lebensqualität während der Studiendauer beeinträchtigt (z.B. Krebs mit Lebenserwartung < 6 Monate, NYHA 3 und 4 erhöhen das Narkoserisiko laut Anästhesist).
  • Akute Suizidalität
  • Akute Psychose (Symptome innerhalb der letzten 6 Monate)
  • Teilnahme an einer interventionellen klinischen Studie innerhalb von 2 Monaten vor dem Screening
  • Kortikale Atrophie Grad 3
  • Patienten mit dem Risiko von Koagulopathien und/oder erhöhtem Blutungsrisiko
  • Patienten mit einem implantierten Herzschrittmacher oder Defibrillator
  • Schwangerschaft
  • Laktation

LAND

ÖSTERREICH

Studienzentrum:
Medizinische Universität Innsbruck

Adresse: Innsbruck, Austria, 6020

KONTAKT
Klaus Seppi
Tel: + 43 (0)512 504-25810
klaus.seppi@tirol-kliniken.at

Marina Peball
Tel: +43 512 504/82718
marina.peball@tirol-kliniken.at

Rekrutierung

DEUTSCHLAND

Studienzentrum:
kbo-Isar-Amper-Klinikum Taufkirchen

Adresse: Taufkirchen, Germany, 84416

KONTAKT
Michael Bachmaier   
Tel: +49 (0)808 493 4417   
michael.bachmaier@kbo.de

Ralf Marquard
Tel: 08084 934 495
Ralf.Marquard@kbo.de   

Rekrutierung

Studienzentrum:
University Hospital Schleswig-Holstein

Adresse: Kiel, Germany, 24105

KONTAKT
Steffen Paschen
Tel: 0431-500-23842    Steffen.Paschen@uksh.de

Birte Hackelberg   
Tel: 0431-597 8519    birte.hackelberg@uksh.de

Rekrutierung

Studienzentrum:
Universität zu Lübeck

Adresse: Lubeck Hansestadt, Germany, 23562

KONTAKT
Alexander Münchau
Tel: 0451 31018215    alexander.muenchau@neuro.uni-luebeck.de

Vera Tadic   
Tel: 0451 31018214    vera.tadic@neuro.uni-luebeck.de

Rekrutierung

Studienzentrum:
University hospital Munich LMU

Adresse: Munich, Germany, 80336

KONTAKT
Jan Mehrkens
Tel: 08970952698    jan.mehrkens@med.uni-muenchen.de

Kai Bötzel
Tel: 089 7095 3673    Kai.Boetzel@med.uni-muenchen.de

Rekrutierung

Studienzentrum:
University Hospital Schleswig-Holstein

Adresse: Kiel, Germany, 24105

KONTAKT
Steffen Paschen
Tel: 0431-500-23842    Steffen.Paschen@uksh.de

Birte Hackelberg   
Tel: 0431-597 8519    birte.hackelberg@uksh.de

Rekrutierung

Studienzentrum:
University Hospital Freiburg

Adresse: Freiburg, Germany, 79106

KONTAKT
Volker Coenen
Tel: +4976127050630    volker.coenen@uniklinik-freiburg.de

Eva Maria Wissner   
Tel: +49 761 270-50670   
eva-maria.wissner@uniklinik-freiburg.de

Rekrutierung

Studienzentrum:
University hospital Heinrich Heine University Düsseldorf

Adresse: Düsseldorf, Germany, 40225

KONTAKT
Jan Vesper
Tel: +49 211 81 18408    jan.vesper@med.uni-duesseldorf.de

Alfons Schnitzler
Tel: +49 211 81 17893    Schnitza@med.uni-duesseldorf.de

Rekrutierung

Studienzentrum:
Charité Campus Virchow Klinikum

Adresse: Berlin, Germany, 13353

KONTAKT
Andrea Kühn
Tel: 030 450 660203    andrea.kuehn@charite.de

Mandy Schickor   
Tel: +49 (0)30 450 660 478    Mandy.Schickor@charite.de

Rekrutierung

SCHWEIZ

Studienzentrum:
Center for Neurology

Adresse: Bern, Gümlingen, Switzerland, 3073

KONTAKT
Jean Marc Burgunder
Tel: +41 031 352 20 70   
jean-marc.burgunder@dkf.unibe.ch

Michael Schüpbach
Tel: +41 316322168    wmms@bluewin.ch

Rekrutierung

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SNP-single nucleotide polymorphisms

a single-letter spelling difference in a gene. SNPs, pronounced ‘snips’, are common and most don’t change the function of the gene.

 
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at risk

You do not know if you carry the genetic mutation for HD gene 

 
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TFC-total functional capacity

A standardized rating scale for function in HD, used to assess capacity to work, handle finances, perform domestic chores and self-care tasks.
Scores range from 0 to 13, with higher scores indicating better functional capacity. 

 
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Double-blinded

 means that neither the participant nor the clinical trial doctor can choose or know the group the participant is in until the trial is over. This approach helps to prevent bias.

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Open label

A trial in which the patient and doctor know what drug is being used. Open label trials are susceptible to bias through placebo effects.

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Gene therapy

a technique that aims to treat or prevent diseases by modifying a person’s genes. It involves introducing, removing, or changing genetic material (DNA or RNA) within a patient’s cells.

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UHDRS- Unified Huntington Disease Rating Scale

A standardized neurological examination that aims to provide a uniform assessment of the clinical features of HD

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CAG repeat

The stretch of DNA at the beginning of the HD gene, which contains the sequence CAG repeated many times, and is abnormally long in people who will develop HD

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Wild-type

the opposite of ‘mutant’. Wild-type huntingtin, for example, is the ‘normal’, ‘healthy’ protein

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Tolerabilty

How well a person can handle a treatment without having serious or uncomfortable side effects.

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Striatum

Part of the brain that  coordinates multiple aspects of cognition, including both motor and action planning, decision-making, motivation, reinforcement, and reward system.

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Randomized allocation

A type of allocation strategy in which participants are assigned to the arms of a clinical trial by chance.

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Radioligand

a radioactive substance that binds to a specific target in the body, allowing visualization of that target’s distribution and activity

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Protein

Protein builds, maintains, and replaces the tissues in your body. The building blocks of life.

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Premanifest / Prodromal

Prior to onset or diagnosis of movement symptoms.

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Placebo

A placebo is a dummy medicine containing no active ingredients. The placebo effect is a psychological effect that causes people to feel better even if they’re taking a pill that doesn’t work.

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PK - Pharmacokinetics

The movement of drugs through the body

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PD - Pharmacodynamics

The body’s biological response to drugs

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PET scan

Positron emission tomography which produces detailed 3-dimensional images of the inside of the body.

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Neuron

Brain cells that store and transmit information

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MRI

Magentic resonance imaging: A technique using powerful magnetic fields to produce detailed images and visualizes the structure of organs, tissues, and bones 

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mHTT

Mutant huntingtin protein. The protein produced by the faulty HD gene.

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Manifest

after HD diagnosis, or when symptoms are already showing

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Longitudinal study

A study where each participant is looked at several times over a time period – unlike a cross-sectional study, where each participant is looked at only once

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HTT

one abbreviation for the gene that causes Huntington’s disease. The same gene is also called HD and IT-15

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fMRI

functional MRI:As with MRI, a technique using powerful magnetic fields  but focusing on brain function by measuring and mapping changes in blood flow, revealing which areas of the brain are active during specific tasks or cognitive processes

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CSF - cerebrospinal fluid

A clear fluid produced by the brain, which surrounds and supports the brain and spinal cord.

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Efficacy

A measure of whether a treatment works or not

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ASO(Antisense oligonucleotides)

A type of gene silencing treatment in which specially designed DNA molecules are used to switch off a gene

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Biomarker

a test of any kind – including blood tests, thinking tests and brain scans – that can measure or predict the progression of a disease like HD. Biomarkers may make clinical trials of new drugs quicker and more reliable

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BDNF

Brain-derived neurotrophic factor: a growth factor that may be able to protect neurons in HD.

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Allele

one of the two copies of a gene

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Plasma

Liquid component of the blood.

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Gene

The basic unit of heredity passed from parent to child. Genes are made up of sequences of DNA and are arranged, one after another, at specific locations on chromosomes in the nucleus of cells.

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Phase

Clinical trial phases are different stages of research that assess the safety and effectiveness of a new medical treatment or intervention in humans.

Each phase has a specific goal and involves a different number of participants. Generally, there are 4 phases (I-IV), with Phase I focusing on safety and dosage, Phase II on efficacy and side effects, Phase III on comparing the new treatment with standard treatments, and Phase IV on long-term safety monitoring.