Overview

This trial is active, not recruiting.

Condition late infantile metachromatic leukodystrophy
Treatments high-field mri (3 teslas)
Sponsor Assistance Publique - Hôpitaux de Paris
Collaborator European Leukodystrophy Association
Start date November 2010
End date March 2016
Trial size 29 participants
Trial identifier NCT01325025, P071232

Summary

High-field MRI and diffusion tensor imaging with 3D reconstruction of the myelin tracks, in combination with multivoxel proton spectroscopy, will allow to precise more accurately the evolution of the white matter lesions in patients affected with Metachromatic Leukodystrophy (particularly in the initial phase of the disease). This will increase the knowledge of the disease and provide new indicators for the selection and evaluation of patients eligible for new therapeutic approaches.

United States No locations recruiting
Other Countries No locations recruiting

Study Design

Allocation non-randomized
Intervention model parallel assignment
Masking open label
Arm
(Other)
Patients with a metachromatic leukodystrophy
high-field mri (3 teslas)
anatomical location conventional anatomical sequence T1, T2, FLAIR diffusion tensor sequence (21 directions) high angular resolution diffusion (HARDI) sequence field map reflexology T1, T2 spectroscopic imaging sequence
(Other)
Epileptic population
high-field mri (3 teslas)
anatomical location conventional anatomical sequence T1, T2, FLAIR diffusion tensor sequence (21 directions) high angular resolution diffusion (HARDI) sequence field map reflexology T1, T2 spectroscopic imaging sequence

Primary Outcomes

Measure
Assess the natural history of the white matter and cortex lesions in MLD using diffusion tensor imaging (DTI)and relaxometry/ high field MRI.
time frame: At inclusion (T0) and 12 months for control. At T0 then at 6 months for patients

Secondary Outcomes

Measure
Assess the natural history of the white matter and cortex lesions in MLD using using multi-voxel spectroscopic imaging.
time frame: At inclusion (T0) and 12 months for control. At T0 then at 6 months for patients
Assess the evolution of cortical atrophy,
time frame: At inclusion (T0) and 12 months for control. At T0 then at 6 months for patients
Correlate the neuroimaging parameters with motor function measure (Gross Motor Function Measure) and cognitive tests (BSID, WPPSI).
time frame: At inclusion (T0) and 12 months for control. At T0 then at 6 months for patients

Eligibility Criteria

Male or female participants from 1 year up to 6 years old.

Inclusion Criteria (patients): - Children with proven metachromatic leukodystrophy (MLD) with decreased activity of arylsulfatase A enzyme in leukocytes and abnormal excretion of urinary sulfatides - Age ≥ 1 year and ≤ 6 years - Recently diagnosed (within < 18 months) Inclusion Criteria (control): - Children with partial cryptogenic epilepsy or with a suspected brain lesion on conventional MRI, who should have high-field MRI to detect structural abnormalities that could benefit from surgical resection - Age ≥ 1 year and ≤ 6 years Exclusion Criteria: - Evolutive heart, pulmonary, renal or gastrointestinal disease - Contra-indication to sedation - Contra-indication to MRI (implanted magnetic material)

Additional Information

Official title Study of the Natural History of Cerebral White Matter Involvement in Metachromatic Leukodystrophy, Using High-field MRI and Diffusion Tensor Imaging
Principal investigator Caroline Sevin, MD, PhD
Description Metachromatic Leukodystrophy (MLD) is a rare autosomal recessive disorder caused by the deficiency of the Arylsulfatase A enzyme (ARSA), resulting in accumulation of galactosyl sulfatide (cerebroside sulfate), a major constituent of the myelin sheath. Accumulation of sulfatides leads to a progressive degeneration of the white matter in the central and peripheral nervous systems (CNS, PNS) and to a neuronal degeneration. The late-infantile form of MLD, which is usually diagnosed in the second year of life, is the most frequent and severe form of the disease. The prognosis is severe, leading to vegetative stage or death within few years after the diagnosis. There is no treatment for patients affected with this early-onset form of the disease. Conventional MRI (1.5 Tesla) shows extensive involvement of the cerebral white matter (hypo-T1, hyper- T2 and FLAIR signals) indicative of rapidly progressing leukodystrophy. Early cortical atrophy reflects associated neuronal involvement. Proton MR spectroscopy demonstrates abnormalities of choline and N-acetyl-aspartate (demyelination, neuronal loss), which are non-specific but can serve as indicators to monitor the effects of any therapeutic intervention. In early-onset forms of MLD, conventional MRI becomes abnormal at a relatively advanced stage of the disease and the neuroradiological diagnosis may be difficult before the age of 2 - 2 1/2 years of age. Moreover, topography and extent of detectable lesions are poorly correlated with the disease severity. In order to improve information provided by neuroimaging, this study aims to investigate prospectively and longitudinally (over a period of 6 months) white and grey matter lesions in 10 MLD children aged 1 to 6 years, using high-field MRI (3 Teslas) and diffusion tensor imaging (DTI) with 3D reconstruction of the myelin tracks. The time interval between diagnosis and inclusion will not exceed 18 months, thus patients will be included at an early stage of their disease. Each time-point (T0 and 6 months) will also include neurological evaluation to correlate the imaging, cognitive and motor functions. Children will be included over a period of 5 years. The total duration of the study will be 5.5 years. Controls will include 25 age-matched children with cryptogenic partial epilepsy who should have a high-field MRI to detect structural abnormalities. Controls will have a MRI and cognitive evaluation at T0 and 12 months if necessary. This study will increase our knowledge of the natural history of MLD and provide new indicators for the selection and evaluation of patients eligible for new therapeutic approaches.
Trial information was received from ClinicalTrials.gov and was last updated in December 2015.
Information provided to ClinicalTrials.gov by Assistance Publique - Hôpitaux de Paris.