Very High Definition Cohort: Assessment of New Prognostic Biomarkers of Disability Worsening in a Multicenter Cohort of MS Patients by Imaging, Optical Coherence Tomography and Biology
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Multiple Sclerosis
- Sponsor
- EDMUS Foundation
- Enrollment
- 300
- Locations
- 5
- Primary Endpoint
- Global disability progression
- Status
- Recruiting
- Last Updated
- 2 years ago
Overview
Brief Summary
Multiple sclerosis (MS) is the most common acquired neurological disease leading to disability in young adults. MS often leads to the development of a physical and/or cognitive impairment that disables patients in their daily lives. Early use of disease modifying treatments for patients at risk of developing disability is therefore essential.
However, disability progression is very heterogeneous between patients and currently impossible to predict at the individual level. Thus, numerous studies, particularly epidemiological and imaging studies, have identified prognostic factors for the development of disability such as age, gender, number of relapses during the first years of the disease, existence of a residual disability after a first relapse, number of gadolinium-enhancing lesions on initial MRI, early brainstem and spinal cord lesions. However, these different factors only explain incompletely the progression of the physical or cognitive disability in MS patients. In particular, some components of MS pathophysiology, more related to the progressive development of disability, such as axonal degeneration or the existence of chronic inflammation of the central nervous system (CNS) are usually not measured by these biomarkers.
In this research project, the investigators will test promising biomarkers, focused on these components of the disease, on a large cohort of patients in a multicenter setting, in order to evaluate their added value to predict disability progression, in comparison with more classical biomarkers such as clinical characteristics, and brain and spinal cord lesion load.
In particular, the investigators will test:
- Imaging biomarkers extracted from brain and spinal cord MP2RAGE, brain and spinal cord QSM, brain and spinal cord relaxometry, brain diffusion and spinal cord magnetization transfer sequences
- Biomarkers extracted from optical coherence tomography (OCT)
- Biological biomarkers (serum neurofilament-light chain (NFL) and Glial Fibrillary Acidic Protein (GFAP))
Investigators
Eligibility Criteria
Inclusion Criteria
- •The patient must be already included in the OFSEP High Definition cohort (NCT03603457).
- •The patient must have given his informed and signed consent for the inclusion in the VHD cohort.
- •The patient must be insured or beneficiary of a health insurance plan.
Exclusion Criteria
- •The patient is under judicial protection.
- •The patient refuses to sign the consent.
- •It is impossible to correctly inform the patient (Inability to understand the study, language problem).
- •The patient has experienced a relapse in the previous 3 months.
- •The patient is pregnant or breast-feeding (MRI contraindicated).
- •Patient with MRI contra-indications (patient with a pacemaker, ferromagnetic vascular clip, infusion pump, neurostimulator, cochlear implants or in whom there is a suspicion of a metallic foreign body).
- •The patient has a severe psychiatric illness
- •The patient has severe chronic alcoholism
- •For healthy subjects:
- •Inclusion Criteria:
Outcomes
Primary Outcomes
Global disability progression
Time Frame: 2 years
Global disability progression will be scored by the Expanded disability score system (EDSS). Disability progression will be defined as an increase in the EDSS of at least 1 point if the baseline EDSS was 5.5 or less, or 0.5 point if the Baseline EDSS was
Secondary Outcomes
- Between-subject, between-center and between-session coefficient of variation of measurements extracted quantitative MRI(At inclusion)
- Composite disability progression score(2 years)
- Focal inflammatory activity(2 years)
- Number of detected brain and spinal cord lesions per patient and per expert with and without the automatic tool at baseline and 2 year(At baseline and 2 year)
- Change in the Symbol Digit Modalities Test score(2 years)
- Change in the American Spinal Cord Injury Association motor sub-score(2 years)
- No evidence of disease activity 3(2 years)
- Number of brain and spinal cord lesion detected using 3D MP2RAGE sequence and the classical OFSEP sequences at baseline and 2 year(At inclusion and 2 years)
- Number of new brain and spinal cord lesion detected at 2 years using 3DMP2RAGE sequence and the classical OFSEP sequences(2 years)