Exploring Cortical Remyelination in Children With Multiple Sclerosis (REMYELIKIDS)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Multiple sclerosis (MS) in children, a rare disease, follows a relapsing remitting course with a shorter interval between the first 2 clinical events and higher annualized relapse rate as compared with MS in adults. Residual deficits following clinical events are less frequent. The vast majority of children and adolescents with MS are thought to have a greater potential for myelin repair than adults. However convincing data in the literature to support this hypothesis are lacking, because until now no imaging technique has been validated to measure remyelination in vivo.
The investigator team has performed a first study to generate for the first time magnetization transfer ratio (MTR)-based maps of cortical myelin repair in 15 adult patients with MS. The team found that patients with MS showed a high variability in cortical myelin repair, with variable index of cortical remyelination. Moreover, there was a significant correlation between the index of cortical remyelination and clinical scores.
Even if childhood onset MS take longer to reach states of irreversible disability, severe disability will eventually occur at a young age. Moreover, pediatric MS could be responsible for cognitive disorders.
It is therefore of crucial relevance to develop research programs designed to generate novel imaging techniques to measure the efficacy of remyelinating therapies. Multiple sclerosis (MS) in children, a rare disease, follows a relapsing remitting course with a shorter interval between the first 2 clinical events and higher annualized relapse rate as compared with MS in adults. Residual deficits following clinical events are less frequent. The vast majority of children and adolescents with MS are thought to have a greater potential for myelin repair than adults. However convincing data in the literature to support this hypothesis are lacking, because until now no imaging technique has been validated to measure remyelination in vivo.
The team has performed a first study to generate for the first time magnetization transfer ratio (MTR) - based maps of cortical myelin repair in 15 adult patients with MS. The investigator team found that patients with MS showed a high variability in cortical myelin repair, with variable index of cortical remyelination. Moreover, there was a significant correlation between the index of cortical remyelination and clinical scores.
Even if childhood onset MS take longer to reach states of irreversible disability, severe disability will eventually occur at a young age. Moreover, pediatric MS could be responsible for cognitive disorders.
It is therefore of crucial relevance to develop research programs designed to generate novel imaging techniques to measure the efficacy of remyelinating therapies.
Finally, another extremely challenging issue in the care of children with MS is the difficulty of the transition between pediatric and adult care. Over last years, at the Pitié-Salpêtrière Hospital, the neurology team created a transition program called JUMP to improve medical, educational and psychosocial outcome for adolescent patients with MS .Taking part in the present study, young patients from 16 to 18 years old could have a direct access to the JUMP program, with the coordination of the dedicated nurses.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Elisabeth Maillart, MD, PH
- Phone Number: +33 1 42 16 19 75
- Email: elisabeth.maillart@aphp.fr
Study Locations
-
-
-
Le Kremlin-Bicêtre, France, 94270
- Recruiting
- Service de Neurologie Pédiatrique, Hôpital du Kremlin Bicêtre
-
Contact:
- Kumaran Deiva, MD
- Phone Number: +33 01 45 21 31 12
- Email: kumaran.deiva@aphp.fr
-
Paris, France, 75013
- Not yet recruiting
- Service de Neurologie, GH Pitié Salpêtrière
-
Contact:
- Elisabeth Maillart, MD
- Phone Number: +33 01 42 16 19 75
- Email: elisabeth.maillart@aphp.fr
-
Paris, France, 75013
- Recruiting
- CIC Neurosciences - Pitié Salpêtrière
-
Principal Investigator:
- Elisabeth Maillart, MD
-
Contact:
- Elisabeth Maillart, MD
- Phone Number: +33 01 42 16 19 75
- Email: elisabeth.maillart@aphp.fr
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria for patients :
- age between 12 years old and 18 years old
- RR-MS defined by 2017 McDonald criteria
- no relapse the last 4 weeks
- no methylprednisolone or prednisolone the last 4 weeks.
- affiliated to the social security system
- signature of the consent by the 2 holders of parental authority
Inclusion Criteria for Volunteers:
- age between 12 years old and 18 years old
- absence of any neurological
- signature of the consent by the 2 holders of parental authority
Exclusion Criteria for both groups:
- Parental rejection
- Contre-indication of brain MRI: pace maker, tatoo of the face, claustrophobia….
- Pregnancy, copper intrauterine device
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Patients with MS
Children with MS
|
MRI without injection of contrast product
|
|
Experimental: Volunteers
matched in age and sex with patients.
Volunteers will perform only one brain MRI, as requested by the neurologist
|
MRI without injection of contrast product
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
MTR-based individual indices
Time Frame: 1 day
|
To investigate the association between MTR-based individual indices of cortical myelin repair in children with MS and one cognitive score (Symbol Digital Modalities Test (SDMT)) at baseline
|
1 day
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
indices of cortical remyelination
Time Frame: 6 months
|
To investigate the association between individual indices of cortical remyelination and neurological disability
|
6 months
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Nervous System Diseases
- Pathologic Processes
- Autoimmune Diseases
- Immune System Diseases
- Demyelinating Autoimmune Diseases, CNS
- Autoimmune Diseases of the Nervous System
- Demyelinating Diseases
- Multiple Sclerosis
- Sclerosis
- Investigative Techniques
- Chemistry Techniques, Analytical
- Spectrum Analysis
- Magnetic Resonance Spectroscopy
Other Study ID Numbers
Other Study ID Numbers
- APHP210916
- 2021-A02792-39 (Other Identifier: IDRCB)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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