Natural History of Multiple Sclerosis and Its Mimickers
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|ClinicalTrials.gov Identifier: NCT02504840|
Recruitment Status : Completed
First Posted : July 22, 2015
Last Update Posted : March 4, 2021
- Magnetic resonance imaging (MRI) has been used for decades to help diagnose and monitor neurological disorders like multiple sclerosis (MS). Researchers want to improve how MRI pictures are taken. They also want to learn more about using newer MRIs with stronger magnets to get better pictures than standard MRIs provide.
- To collect data that will help researchers better understand MS and related diseases.
- Adults 18 and older with MS or MRI findings that appear similar to MS, or with other neurological diseases that may look or act like MS.
- Healthy adult volunteers.
- Participants will be screened with a review of their medical records.
- Participants will have a baseline visit. It will include a physical exam, medical history, and neurological exam. They may have blood tests.
- The study will last indefinitely.
- Participants may have MRIs. Some MRIs may include a contrast dye. For this, a needle will be used to guide a thin plastic tube into an arm vein.
- Participants may have up to 2 lumbar punctures per year. Skin will be numbed and a needle inserted between back bones will remove fluid.
- Participants may give saliva samples and have an eye exam.
- Participants may have evoked potential tests. These measure how the nervous system responds to different types of stimulation. Participants may sit in front of a TV and watch pictures on the screen. Or they may wear earphones that make a clicking noise or static. Or they may get a small electrical shock that may tingle and cause a hand or foot twitch.
- Participants may have tests of strength, spasticity, sensations, balance, and/or walking.
|Condition or disease|
|Neurologic Disorders Healthy Volunteers Multiple Sclerosis|
The goals of this protocol are to study the pathophysiology of multiple sclerosis (MS), primarily through small studies that utilize magnetic resonance imaging (MRI), and to correlate the results with clinical and biological measures. The protocol includes only techniques with minimal risk (standard and quantitative clinical evaluation, MRI, blood draws, saliva testing, urine and stool collection, visual evoked potentials, ophthalmologic evaluation) or more-than-minimal risk (injection of approved gadolinium-based contrast agents, lumbar punctures) that are appropriate and common in this study population. Under this protocol, we will conduct:
- Pilot substudies. These studies are exploratory and hypothesis generating. Once sufficient data are collected to justify a hypothesis-driven study and a formal power analysis, further work will continue under either a dedicated protocol or, if appropriate, a hypothesis-testing substudy. There are no enrollment limitations for pilot substudies.
- Hypothesis-testing substudy. These studies have a specific hypothesis that can be tested with at most 6 participants per arm. If additional participants are required, a memo will be sent to the Protocol Review Committee (PIRC) and its statistical reviewer to request review of a hypothesis-testing substudy for possible additional enrollment.The memo will also be forwarded to the IRB.
- Individual patient substudies. These studies seek to increase knowledge of a disease process or to assist in the diagnosis of an individual patient.
- Technique development substudies. These studies will lay the groundwork for new experimental paradigms, using the methods approved under this protocol, which can be further tested in the substudies listed above.
- Training of investigators. These studies will be done to train new investigators in techniques relevant to the studies under this protocol.
Three groups of study participants will be enrolled:
- MS patients. Participants with definite, probable, or possible MS.
- Patient controls. Participants with diseases that share features with MS.
- Healthy volunteers.
We will design small substudies as ideas arise in the course of our work that are pertinent to the theme of the pathophysiology of MS (or of diseases that share features with MS). If a hypothesis testing sub-study leads to results of interest and if a larger population is necessary to reach statistical significance, a separate protocol will be submitted with a priori hypotheses, specific study design and power analysis adapted from the pilot or exploratory substudies performed in the present protocol.
These will include MRI, clinical, and biological outcome measures consistent with the objectives of the study and its investigators. Imaging measures will focus on features related to the central nervous system (CNS), particularly focal lesions. Clinical measures will include standard and established MS disability scales as well as quantitative measures related to function. Biological measures will include genotype, gene expression, proteomics, virological studies, and immunological profiling.
|Study Type :||Observational|
|Actual Enrollment :||104 participants|
|Official Title:||Thematic Studies of Multiple Sclerosis and Related Diseases|
|Actual Study Start Date :||July 23, 2015|
|Actual Primary Completion Date :||March 18, 2020|
|Actual Study Completion Date :||March 18, 2020|
Participants with diseases that share features with MS.
patients with suspected or confirmed multiple sclerosis
Participants with definite, probable, or possible MS.
- Association between MRI findings and clinical status [ Time Frame: over time ]Association between clinical status and research data
- Focal brain lesions: presence, extent, imaging characteristics, distribution, and changes over time [ Time Frame: over time ]Focal brain lesions: presence, extent, imaging characteristics, distribution, and changes over time
- Brain volume, brain-substructure, and spinal-cord volumes [ Time Frame: over time ]Brain volume, brainsubstructure, and spinal-cord volumes
- Spinal cord lesions [ Time Frame: over time ]Spinal cord lesions
- Clinical rating scales [ Time Frame: over time ]Clinical rating scales
- Optical coherence tomography [ Time Frame: over time ]Optical coherence tomography
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02504840
|United States, Maryland|
|National Institutes of Health Clinical Center, 9000 Rockville Pike|
|Bethesda, Maryland, United States, 20892|
|Principal Investigator:||Daniel S Reich, M.D.||National Institutes of Health Clinical Center (CC)|