BELANGRIJK

Voordat u aan een onderzoek deelneemt, moet u met uw zorgverlener over de risico's en mogelijke voordelen praten.

The aim of the study is to establish if caffeine consumption is associated with the evolution of the disease in premanifest HD.

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Enroll-HD is een wereldwijde observatiestudie voor families met de ziekte van Huntington. De studie volgt op hoe de ziekte zich bij verschillende mensen voordoet en in de loop van de tijd verandert. De studie staat open voor gendragers of zij die risico lopen. Ook personen die niet getest zijn, kunnen deelnemen aan Enroll-HD zonder hun genetische status te kennen of te weten komen. Het doel van de studie is om de ontdekking en ontwikkeling van nieuwe therapieën te versnellen en de ziekte beter te begrijpen. Als beter begrepen wordt hoe de ZvH zich doorgaans ontwikkelt, wordt het veel gemakkelijker om sneller te beoordelen of een nieuw experimenteel medicijn werkt om die typische veranderingen te vertragen of te stoppen. Enroll-HD is een observatiestudie, wat betekent dat mensen in de loop van de tijd gevolgd worden eerder in plaats van beroep te moeten doen op hun herinneringen.

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DOMINO-HD focus on aspects of life for people with Huntington’s that haven’t been studied in depth up until now. The study aims to improve quality of life for Huntington’s disease patients and families. DOMINO-HD is therefore investigating how sleep, nutrition and physical activity impact the progression of Huntington’s disease. By learning more about these aspects, we will perhaps be able to develop new ways to support people affected by Huntington’s. The study will also explore how digital technologies, such as wearable fitness trackers, can be used to help people.

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The primary objective is to collect a high quality CSF (Cerebrospinal fluid) sample for evaluation of biomarkers and pathways that will enable the development of novel treatments for HD. The secondary objective is to generate a high quality plasma sample collection matching the CSF collections, which will also be used to evaluate biomarkers and pathways of relevance to HD research and development.

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The main purpose of REVHD is to be able to confirm whether a protein called Brain Derived Neurotrophic Factor (BDNF) is a biomarker for Huntington’s disease (HD).

Why is this study important? We have good reasons to believe that BDNF has an active role in protecting damaged brain cells as well as enhancing growth of new ones. The study will provide us with more solid information about the connection between BDNF and symptom development in humans with Huntington’s. If proven to be relevant, BDNF levels will probably be a target for treatment in the future. In this study the BDNF levels in cerebrospinal fluid and blood will hopefully be identified as a biomarker for Huntington’s disease. 

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SHIELD HD is an International study that will follow a group of people over time who have or are at risk of developing Huntington´s Disease. SHIELD HD will collect health information that includes medical history, blood and cerebrospinal fluid samples. Participants will also undergo MRIs, cognitive and motor function tests. The information will be used to evaluate the natural history of HD and its biomarkers that are associated with modulation of the number of CAG (cytosine-adenine-guanine) repeats in the mutant Huntingtin(HTT) gene. The results of this study will inform assessments for a future interventional treatment trial.

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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.