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Washed Microbiota Transplantation for Tourette's Syndrome

Phase 1
Recruiting
Conditions
Tourette Syndrome
Interventions
Registration Number
NCT03764748
Lead Sponsor
The Second Hospital of Nanjing Medical University
Brief Summary

This study aimed to evaluate the efficacy of washed microbiota transplantation in the treatment of Tourette's syndrome (TS).

Detailed Description

Emerging scientific data support the significant role of microbiota in the modulation of the central nervous system. The reconstitution of gut microbiota might be a potential option to treat Tourette's syndrome (TS). FMT has been reported to be a highly effective therapy to restore the gut microbiota dysbiosis by transferring gut microbiota from healthy donors to patients. The newly improved methodology of FMT based on the automatic washing process and the related delivering consideration was named as washed microbiota transplantation (WMT) by the FMT-standardization study group. FMT has shown treatment potential in several gut-brain axis-related disorders, such as amyotrophic lateral sclerosis and Parkinson's disease, promoting us to investigate its treatment potential for Tourette's syndrome. In this study, investigators aimed to evaluate the efficacy of WMT for Tourette's syndrome and its comorbidities using specialized questionnaires for Tourette's syndrome and investigate the underlying mechanism.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
30
Inclusion Criteria
  1. Patients were aged 6 to 17 years (inclusive);
  2. Met the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria for TS;
  3. Had a Yale Global Tic Severity Scale-Total Tic Score (YGTSS-TTS) of at least 20 at screening and baseline.
  4. Underwent WMT.
Exclusion Criteria
  1. Complicated with certain brain disease, including tumor,injury,cerebrovascular disease;
  2. Complicated with other severe disease, including cancers, organ failure, heart diseases;
  3. Stereotypy associated with autism spectrum disorder;
  4. With a confirmed diagnosis of psychiatric diseases, such as bipolar disorders; schizophrenia and major depressive disorders;
  5. Clinically significant obsessive-compulsive disorder at baseline considered to be the primary cause of impairment at baseline;
  6. Medications use affecting gut microbiota such as antibiotics and probiotics three months before WMT.
  7. Other neurologic disorders other than TS that could influence the evaluation of tics.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Washed microbiota transplantationWashed Microbiota TransplantationWMT
Primary Outcome Measures
NameTimeMethod
The change of Yale Global Tic Severity Scale-Total Tic Score (YGTSS-TTS)baseline, 4 weeks, 8 weeks, 12 weeks, 6 months post transplantation

The YGTSS rating scale is a semistructured clinician- or investigator-administered rating instrument in which participants or caregivers evaluate the number, frequency, intensity, complexity, and interference of motor and phonic tics in the prior week on a 6-point scale from 0 (none) to 5 (severe) \[1\]. The total Motor Tic Severity Score (MTSS; 0-25 points) is added to the total Vocal Tic Severity Score (VTSS; 0-25 points) to determine the TTS (0-50 points).

Secondary Outcome Measures
NameTimeMethod
the change of Gilles de la Tourette Syndrome Quality-of-Life Scale scorebaseline, 4 weeks, 8 weeks, 12 weeks, 6 months post transplantation

The Gilles de la Tourette Syndrome Quality-of-Life Scale with 27 items addresses the issue of how the illness affects patients' well-being. It ranges from 0 to108, and higher values represent a worse outcome.

change of the Sleep Disturbance Scale for Children (SDSC)baseline, 4 weeks, 8 weeks, 12 weeks, 6 months post transplantation

The SDSC was 26-item test measuring sleep problems and each item received a value from 0 to 4, with higher scores indicating more severe sleep disorders.

change of the Gastrointestinal Symptom Rating Scale (GSRS) .baseline, 4 weeks, 8 weeks, 12 weeks, 6 months post transplantation

It is based on 15 questions which are scored into 5 domains: abdominal pain, reflux, indigestion, diarrhea, and constipation. Each item weights from 1 to 7, with higher scores reflecting more severe symptoms.

the Clinical Global Impressions-Improvement scale4 weeks, 8 weeks, 12 weeks, 6 months post transplantation

Positive treatment response was defined by a score of 1 (very much improved) or 2 (much improved) on the Clinical Global Impressions-Improvement scale. The Clinical Global Impression - Improvement scale is a 7 point scale that requires the clinician to assess how much the patient's illness has improved or worsened relative to a baseline state at the beginning of the intervention. and rated as:1.Very much improved; 2.Much improved; 3. Minimally improved; 4. No change; 5. Minimally worse; 6. Much worse; 7.Very much worse.

the difference of the gut microbe composition between individuals with TS and healthy children by sequencing faecal metagenome.baseline, 12 weeks, 6 months post transplantation

The composition of the gut microbiota is evaluated by sequencing faecal metagenome. We evaluate the differences in the structure of the flora and its metabolism between individuals with TS and control children at the phylum, genus and species levels of the intestinal flora, and to develop a model for predicting the structure of the flora.

the change of The Swanson, Nolan, and Pelham IV Scale (SNAP-IV)baseline, 4 weeks, 8 weeks, 12 weeks, 6 months post transplantation

It is an 26-item questionnaire that measured three of the ADHD symptoms, inattention, hyperactivity and oppositional defiant disorder. The 26-item checklist is scored on a 4-point Likert scale ranging between Not At All (0) and Very Much (3).

Trial Locations

Locations (2)

SIR RUN RUN hospital of Nanjing Medical University

🇨🇳

Nanjing, Jiangsu, China

Department of Microbiota Medicine & Medical Centre for Digestive Diseases, The Second Affiliated Hospital of Nanjing Medical University

🇨🇳

Nanjing, Jiangsu, China

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