Anterior Pituitary Function in Patients With Hydrocephalus
|First Received Date ICMJE||September 7, 2005|
|Last Updated Date||March 1, 2010|
|Start Date ICMJE||September 2005|
|Primary Completion Date||Not Provided|
|Current Primary Outcome Measures ICMJE
||anterior pituitary function|
|Original Primary Outcome Measures ICMJE||Same as current|
|Change History||Complete list of historical versions of study NCT00149721 on ClinicalTrials.gov Archive Site|
|Current Secondary Outcome Measures ICMJE
|Original Secondary Outcome Measures ICMJE||Same as current|
|Current Other Outcome Measures ICMJE||Not Provided|
|Original Other Outcome Measures ICMJE||Not Provided|
|Brief Title ICMJE||Anterior Pituitary Function in Patients With Hydrocephalus|
|Official Title ICMJE||Anterior Pituitary Function in Patients With Hydrocephalus|
Hydrocephalus (secondary or idiopathic) is a condition characterized by dilatation of the lateral and third ventricles, and often associated with increased intracranial pressure (ICP). We hypothesize that either the ventricle dilatation or the increased ICP may cause disturbances in the hypothalamic-pituitary axis, resulting in different degrees of hypopituitarism. The goal of this study is to determine the prevalence of hypopituitarism in adult patients with hydrocephalus.
The Johns Hopkins Adult Hydrocephalus Program evaluates approximately 250 new patients per year for hydrocephalus and associated disorders, resulting in the new diagnosis of hydrocephalus in about 100 patients annually. After treatment with either shunt surgery or third ventriculostomy, virtually all patients are followed on a regular basis by physicians in the program (Dr. Michael Williams, neurologist, and Dr. Daniele Rigamonti, neurosurgeon, both involved in this project).
These patients represent an ideal cohort to study the effect of hydrocephalus on anterior pituitary function. In addition, as data on intracranial pressure is available for all of them, evaluation of pituitary function would allow us to determine whether the level of intracranial pressure correlates with the likelihood of pituitary failure.
We propose to study 20 subjects of both sexes with NPH, aged 18-80 years over a period of 18 months. They will be recruited by direct advertising among the patients cared for by the Adult Hydrocephalus Program. Patients with hydrocephalus will be studied twice (6-12 months apart) whether or not they undergo shunting.
Subjects who have shunt surgery will undergo a second study of pituitary function not earlier than 6 months and no later than 1 year from the procedure. We will identify the degree of clinical improvement by documenting change in gait with the Tinetti Gait Assessment Tool, and change in dementia with the Mini-Mental-Status exam. If there is sufficient sample size in the clinically improved and unimproved patients, we will compare between-group results.
Patients who have been on systemic glucocorticoids (GC) for longer than 3 weeks during the previous 12 months will be excluded, as GC may cause suppression of hypothalamic-adrenal axis. In subjects who are on phenytoin, unbound T4 will be measured by equilibrium dialysis, as phenytoin may interfere with direct unbound T4 measurement. Subjects already on L-thyroxine replacement will be excluded.
|Study Type ICMJE||Interventional|
|Study Phase||Not Provided|
|Study Design ICMJE||Allocation: Non-Randomized
Endpoint Classification: Safety Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Diagnostic
|Condition ICMJE||Normal Pressure Hydrocephalus|
|Intervention ICMJE||Procedure: Ventriculo-peritonal shunting|
|Study Arm (s)||Not Provided|
|Publications *||Not Provided|
* Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
|Recruitment Status ICMJE||Terminated|
|Completion Date||December 2007|
|Primary Completion Date||Not Provided|
|Eligibility Criteria ICMJE||
Diagnosis of idiopathic hydrocephalus, made by clinical and CT or MRI imaging demonstrating ventricular dilation, and confirmed by an established protocol of continuous CSF drainage via spinal catheter. Patients who are found to be eligible for VP shunt insertion on the basis of improvement in cognition/psychomotor speed, gait, or urinary continence are referred for surgery
Known peripheral gland failure (primary hypogonadism, primary adrenal insufficiency, primary hypothyroidism); known history of pituitary tumor, pituitary surgery, pituitary hemorrhage, brain irradiation, or of identified causes of secondary hydrocephalus (subarachnoidal bleeding, meningitis, encephalitis, head trauma).
|Ages||18 Years to 80 Years|
|Accepts Healthy Volunteers||No|
|Contacts ICMJE||Contact information is only displayed when the study is recruiting subjects|
|Location Countries ICMJE||United States|
|NCT Number ICMJE||NCT00149721|
|Other Study ID Numbers ICMJE||B9R-US-X041 (terminated)|
|Has Data Monitoring Committee||Not Provided|
|Responsible Party||Not Provided|
|Study Sponsor ICMJE||Johns Hopkins University|
|Collaborators ICMJE||Eli Lilly and Company|
|Information Provided By||National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)|
|Verification Date||March 2010|
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