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Characterization of Clinical Skeletal and Cardiac Impairment in Carriers of DMD and BMD

Active, not recruiting
Conditions
Becker Muscular Dystrophy
Duchenne Muscular Dystrophy
Interventions
Genetic: Genetic characterization
Registration Number
NCT02972580
Lead Sponsor
Nationwide Children's Hospital
Brief Summary

Longitudinal prospective observational study. This is a 24-month study with the possibility of extending the data time points. Initially baseline, then 12 and 24 months follow up studies will be completed.

Detailed Description

Four cohorts are enrolled in this study. The target population is the cohort of genetically confirmed DMD/BMD female carriers (Cohort A). This cohort will consist of 150 DMD/BMD mothers who are somatic carriers of a mutation in the DMD gene. The data collected for this cohort will be compared to three control groups; Control Group B is a cohort of 50 DMD/BMD mothers who are NOT somatic carriers, Control Group C is a cohort of 50 age-matched healthy controls and Control Group D is a cohort of 25 genetically confirmed carriers who do not have an affected child. The inclusion of a Control Group B allows for a comparison to a group of mothers that share the emotional and cognitive burden of caring for an affected male without having the physical or cognitive risks of being a female carrier. The Control Group C offers robust data from an age-matched healthy cohort for purposes of comparison. Control Group D allows for comparison to a group of women that have the same physical or cognitive risks as the Cohort A female carriers, but do not have the same burden of care giving.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
Female
Target Recruitment
250
Inclusion Criteria
  • Age >18 years
  • Cohort A requires a genetically confirmed mutation in the DMD gene with an affected child
  • Cohort B includes DMD/BMD mothers with NO somatic mutation in the DMD gene
  • Cohort C age-matched healthy controls with a normal CK level
  • Cohort D requires a genetically confirmed mutation in the DMD gene without an affected child
  • Able to complete testing in English
  • Able to consent
Exclusion Criteria
  • Subjects with a contraindication to cardiac or skeletal muscle MRI
  • Subjects on heart failure medication at time of enrollment
  • Subjects on steroid treatment
  • Presence of an inherited neurologic disease or comorbidity that may affect their ability to complete this study
  • Has a medical condition or extenuating circumstance that, in the opinion of the investigator, might compromise the subject's ability to comply with the protocol required testing or procedures or compromise the subject's wellbeing, safety, or clinical interpretability

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Cohort AGenetic characterizationDMD/BMD Female Carriers who have/had an affected child (n=150)
Cohort CGenetic characterizationHealthy Age-Matched Controls (n=50)
Cohort DGenetic characterizationDMD/BMD Female Carriers with no affected children (n=25)
Cohort BGenetic characterizationDMD/BMD Female non-carriers controls who have/had an affected child (n=50)
Primary Outcome Measures
NameTimeMethod
Compromise of cardiac function based on Cardiac Magnetic Resonance Imaging2 years

Cardiac function as compromised by evidence of scarring of cardiac muscles, particularly of the base of the left ventricle via cardiac MRI studies with gadolinium contrast.

Secondary Outcome Measures
NameTimeMethod
Physical Therapy Assessments 6 Minute Walk Test2 years

A timed test to assess distance walked in 6 minutes is very quantitative and can be assessed in comparison to normal controls. Deterioration over time can be clearly measured.

Cardiac Function Assessment Treadmill SVO22 years

Stress on heart muscle measured by SVO2 (percentage of oxygen saturation in the blood of the pulmonary artery). SVO2 represents an average of all the venous oxygen saturation of major organs and tissues. This measure provides assessment of cardiopulmonary function and helps measure the degree of cardiac instability and can be an indicator of deterioration from normal.

Physical Therapy Assessments ACTIVE-seated2 Years

Exploratory outcome quantifying upper extremity reaching ability using a custom-designed game telling how far the arm reaches in comparison to overall functional ability of the individual ability.

Laboratory biomarkers - Creatine Kinase2 Years

CK levels are an indicator of muscle breakdown.

Laboratory biomarkers - Interleukin-62 Years

Pro-inflammatory marker indicating the degree of inflammation of muscle when there is muscle breakdown.

Caregiver Stress2 Years

Online self-report survey to assess stress burden on caregiver.

Pulmonary function testing (PFTs)2 Years

Stable or improved FVC

Physical Therapy Assessments Maximum Voluntary Isometric Contraction Testing2 Years

MVICT measures strength of skeletal muscles by assessing the force generated by by individual muscles. The results can be compared to norms and deterioration can be assessed over time.

Physical Therapy Assessments Time-to-Rise2 Years

A timed-test to measure ability to rise from the floor is quantifiable and measuring over time tells if there is loss of function.

Laboratory biomarkers - C-Reactive Protein2 Years

Pro-inflammatory marker indicating the degree of inflammation of muscle when there is muscle breakdown.

Laboratory biomarkers - Cortisol levels2 Years

Hair cortisol levels measure stress levels as a means of understanding coping with disease.

Cognitive Assessment2 Years

Cognitive function measured by Wechsler Abbreviated Scale of Intelligence (WASI) provides a possible tool to measure disease awareness and establish if IQ level correlates with disease-related stress.

Trial Locations

Locations (1)

Nationwide Children's Hosptial

🇺🇸

Columbus, Ohio, United States

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