- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03423017
Brainstem Dysfunction Involvement in the Pathogenesis of Pierre Robin Sequence (DYSROBIN)
Introduction Pierre Robin Sequence, PRS, incidence is about one hundred births per year in France. The main neonatal clinical manifestations are secondary to airway obstruction and food difficulties related to swallowing disorders. Despite recent progress, the pathogenesis of PRS is not fully understood.
The hypothesis is that brainstem dysfunction, BSD, plays a central role in the pathogenesis of PRS.
The purpose of the study is to achieve a complete evaluation of BSD to specify its role in the pathogenesis of PRS.
The primary objective is to compare central apnea index (CAI) of infants with PRS with those of infants with isolated airway obstruction (AWO) and those of healthy infants in order to clarify the direct role of BSD.
Material and Methods This prospective interventional study will be carried out in Lyon at the Hôpital Femme-Mère-Enfant and in Paris at the Hôpital Necker-Enfants Malades for 2 years. 3 groups of patients will be studied: PRS, 50 patients, AWO, 50 patients and healthy, 30 patients, included before 2 months of life. Infants will be followed for a maximum of 10 months. The evaluations will be carried out for 48 hours between birth and 2 months of life and then for 24 hours between 6 and 10 months of life for PRS and AWO group. Concerning the healthy group, the evaluation will be carried out during 48h during a single hospitalization before 2 months. Polysomnography, holter-ECG, 24h gas exchange, impedance-pH monitoring and mental region EEG will be performed. The central apnea index (mean number per hour), obstructive apnea index, non-nutritive swallowing index (NNS), gastroesophageal reflux and NNS-respiration coordination will be assessed for each stage of sleep and compared between the three groups of patients.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Philippe REIX, Pr
- Phone Number: +33 4 72 12 94 37
- Email: phlippe.reix@chu-lyon.fr
Study Contact Backup
- Name: Lauriane Couturier
- Phone Number: +33 4 27 85 59 69
- Email: lauriane.couturier@chu-lyon.fr
Study Locations
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Bron, France, 69500
- Hôpital Femme Mère Enfant
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Paris, France, 75015 Paris
- APHP-Necker
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria for the group 1
- infants with PRS
Inclusion Criteria for the group 2 - infant with isolated airway obstruction
Inclusion Criteria for the group 3
- healthy infant : siblings of sudden unexpected death of the infant or with any known pathology
Inclusion Criteria for the 3 groups
- During one hospitalization or program for one hospitalization
- Parental consent
- Social safety affiliation
Exclusion Criteria:
- Birth before 37 SA
- Neonatal complication
- Group 2 only: AWO with neurological disease including brainstem dysfunction
- Group 3 only : AWO, ENT disease or syndromic disease, neurological disease including brainstem dysfunction, Intra uterine growth retardation
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Other: Pierre Robin sequence
Infants with PRS : retrognathism, glossoptosis, cleft palate Group 1a : isolated PRS Group 1b : PRS with bone disease or collagen disease (Stickler) Group 1c : syndromic PRS or associated PRS without bone disease or collagen disease |
Recording during one hospitalization of 48 hours between birth and 2 months of life and one hospitalization of 24 hours between 6 and 10 months of life
Recording during one hospitalization of 48 hours between birth and 2 months of life
|
Other: Superior airway obstruction, AWO
Infants with AWO : laryngomalacia, tracheal stenosis, laryngeal stenosis, others etiology
|
Recording during one hospitalization of 48 hours between birth and 2 months of life and one hospitalization of 24 hours between 6 and 10 months of life
Recording during one hospitalization of 48 hours between birth and 2 months of life
|
Other: Healthy infants
Healthy infants : siblings of sudden unexpected death of the infant
|
Recording during one hospitalization of 48 hours between birth and 2 months of life and one hospitalization of 24 hours between 6 and 10 months of life
Recording during one hospitalization of 48 hours between birth and 2 months of life
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Central apnea index (CAI) (mean number per hour)
Time Frame: 2 months of life during one nocturne polysomnography
|
To compare central apnea index (CAI) (mean number per hour), according to the ASSM guidelines 2007, recording by one nocturne polysomnography, between 3 groups of infants by sleep step, between birth and 2 months of life, in order to clarify the direct role of BSD. According to the ASSM guidelines 2007, the central apnea index is measured : mean number of central apnea per hour. |
2 months of life during one nocturne polysomnography
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Obstructive apnea hypopnea index (OAHI)(mean number per hour)
Time Frame: 2 months
|
To compare obstructive apnea hypopnea index (OAHI)(mean number per hour) according to the guidelines ASSM 2007, recording by one nocturne polysomnography, between 3 groups of infants by sleep step, between birth and 2 months of life According to the ASSM guidelines 2007, the obstructive apnea hypopnea index is measured: mean number of obstructive apnea and hypopnea per hour.
|
2 months
|
Comparison of OAHI(mean number per hour) and CAI
Time Frame: between 6 and 10 months of life
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To compare obstructive apnea hypopnea index (OAHI)(mean number per hour) and central apnea index (CAI) (mean number per hour), between PRS group and AWO group by sleep step between 6 and 10 months of life According to the ASSM guidelines 2007, the obstructive apnea hypopnea index, mean number of obstructive apnea and hypopnea per hour, and the central apnea index are measured, mean number of central apnea per hour. |
between 6 and 10 months of life
|
Micro arousals index (mean number per hour)
Time Frame: up to 2 months of life
|
To compare micro arousals index (mean number per hour) between the 3 groups by sleep step between birth and 2 months of life and between PRS group and AWO group between 6 and 10 months of life to clarify the role of BSD in sleep microstructure According to the ASSM guidelines 2007, micro arousals index (mean number per hour) are measured. |
up to 2 months of life
|
Micro arousals index (mean number per hour)
Time Frame: up to 10 months of life
|
To compare micro arousals index (mean number per hour) between the 3 groups by sleep step between birth and 2 months of life and between PRS group and AWO group between 6 and 10 months of life to clarify the role of BSD in sleep microstructure According to the ASSM guidelines 2007, micro arousals index (mean number per hour) are measured. |
up to 10 months of life
|
Non-nutritive swallowing index (NNS) and apnea secondary to non-nutritive swallowing
Time Frame: up to 2 months of life
|
To compare non-nutritive swallowing index (NNS) and apnea secondary to non-nutritive swallowing between the 3 groups by sleep step between birth and 2 months of life and between PRS group and AWO group between 6 and 10 months of life to clarify the role of BSD in swallowing disorders and NNS-respiration coordination non-nutritive swallowing index (NNS), mean number per hour, and apnea secondary to non-nutritive swallowing, mean number per hour, monitoring by the mental region EEG and the one nocturne polysomnography |
up to 2 months of life
|
Non-nutritive swallowing index (NNS) and apnea secondary to non-nutritive swallowing
Time Frame: up to 10 months of life
|
To compare non-nutritive swallowing index (NNS) and apnea secondary to non-nutritive swallowing between the 3 groups by sleep step between birth and 2 months of life and between PRS group and AWO group between 6 and 10 months of life to clarify the role of BSD in swallowing disorders and NNS-respiration coordination non-nutritive swallowing index (NNS), mean number per hour, and apnea secondary to non-nutritive swallowing, mean number per hour, monitoring by the mental region EEG and the one nocturne polysomnography |
up to 10 months of life
|
Positive and negative pressures, their temporal organizations evaluated using succimetry procedure between the 3 groups of patients at 0 and 2 months of life
Time Frame: up to 2 months of life
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Compare the positive and negative pressures, their temporal organizations evaluated using succimetry procedure between the 3 groups of patients at 0 and 2 months of life.
|
up to 2 months of life
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Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 69HCL17_0816
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
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