- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04279912
MR-Guided Focused Ultrasound (MRgFUS) for the Management of Tremor in Patients With Multiple Sclerosis (MSFUS001)
February 19, 2020 updated by: Dr. Nir Lipsman, Sunnybrook Health Sciences Centre
A Feasibility and Safety Clinical Trial of the Magnetic Resonance Guided Focused Ultrasound (MRgFUS) for the Management of Tremor in Patients With Multiple Sclerosis
This study will be a single-centre, prospective, single-arm, open-label pilot trial assessing the feasibility and safety of unilateral MR-guided focused ultrasound (MRgFUS) thalamotomy for refractory hand tremor in up to 12 patients with multiple sclerosis (relapsing-remitting, primary progressive or secondary progressive MS).
This study will be conducted at the Focused Ultrasound Centre of Excellence and MS Clinic located at Sunnybrook Health Sciences Centre/ University of Toronto.
Patients with stable MS and refractory hand tremor providing informed consent will receive MRgFUS thermal ablation of the Vim thalamus contralateral to the most affected side of the body (frequently this will be the dominant hand).
Study Overview
Status
Unknown
Conditions
Intervention / Treatment
Study Type
Interventional
Enrollment (Anticipated)
6
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
Ontario
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Toronto, Ontario, Canada, M4N 3M5
- Recruiting
- Sunnybrook Health Sciences Centre
-
Contact:
- Nadia Scatlebury, PhD
- Phone Number: 4390 +1 416-480-6100
- Email: nadia.scantlebury@sunnybrook.ca
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
16 years to 78 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Male or Female aged 18-80 years
- Willing and able to give consent and attend all study visits
- A confirmed diagnosis of medication-refractory, MS-related hand tremor
- No clinical evidence of relapse over 12 months or more before enrollment
- No MRI activity over 3 months or more before enrollment
- Presence of disabling postural or kinetic tremor
- Unsatisfactory tremor response to adequate trials of at least two medications
- Able to communicate sensations during the treatment
- Stable doses of all medications for 30 days prior to and during study
Exclusion Criteria:
- Severe cerebellar dysfunction measured by Scale for the Assessment and Rating of Ataxia (>35 out of 40)
- Severe weakness or sensory loss in arm contralateral to the side of the brain considered for MRgFUS
- Evidence of a superimposed or atypical movement disorder
- Unstable cardiac status such as angina pectoris, congestive heart failure, etc.
- Severe hypertension
- Patients with standard contraindications for MR imaging
- History of abnormal bleeding and/or coagulopathy
- Ischemic or hemorrhagic stroke within 6 months
- Symptoms and signs of increased intracranial pressure (e.g. headache, nausea, vomiting, lethargy, and papilledema)
- Untreated, uncontrolled sleep apnea
- Active or suspected acute or chronic uncontrolled infection
- Receiving anticoagulant or antiplatelet therapy within one week of focused ultrasound procedure or drugs known to increase risk or hemorrhage within one month of MRgFUS surgery
- Not able or willing to tolerate the required prolonged stationary supine position during treatment
- Participating or have participated in another clinical trial in the last 30 days
- Unable to communicate with the investigator and staff
- Presence of neurodegenerative disease or significant cognitive impairment
- Presence of significant cognitive impairment (≤24 on MMSE)
- Uncontrolled major psychiatric disorder or suicidal ideation
- Risk factors for intraoperative or postoperative bleeding or documented coagulopathy
- Presence of brain tumours
- Any illness that in the investigator's opinion preclude participation in this study
- Pregnancy or lactation
- Legal incapacity or limited legal capacity
- Deep Brain Stimulation or a prior stereotactic ablation of the basal ganglia
- A history of seizures within the past year
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Device Feasibility
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Patients with Multiple Sclerosis and Tremor
Participants will undergo MRgFUS thermal ablation of the ventral intermedius (Vim) thalamus contralateral to the most affected side of the body.
|
Device: Focused Ultrasound (MRgFUS) for the Management of Tremor in Patients With Multiple Sclerosis
The intervention is MRIgFUS thermal ablation of the ventral intermedius (Vim) thalamus contralateral to the most affected side of the body.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Composite safety outcome of MRgFUS thalamotomy
Time Frame: 90 days
|
Composite outcome of detectable Vim lesion on MRI scan; AND lack of new-onset or worsening of contralateral upper limb sensory loss or weakness
|
90 days
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Incidence and severity of adverse events related to MRgFUS thalamotomy
Time Frame: 1, 7, 30, 90 and 120 days
|
Incidence and severity of adverse events possibly, probably or definitely related to the MRgFUS procedure at 1, 7, 30, 90 and 120 days after treatment.
|
1, 7, 30, 90 and 120 days
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Incidence and severity of adverse events related to MS disease relapse or progression
Time Frame: 30 and 90 days
|
Incidence and severity of AEs possibly, probably or definitely-related to MS disease relapse or progression (based on clinical assessment) over 30 and 90 days.
|
30 and 90 days
|
Changes from baseline in the EDSS (Expanded Disability Status Scale) scores
Time Frame: 30 and 90 days
|
Changes from baseline in the EDSS scores at 30 and 90 days.
This is a scale to of quantify disability in multiple sclerosis.
Score: 0 to 10 with higher scores meaning worse outcome.
|
30 and 90 days
|
Changes from baseline in the SARA (Scale for Assessment and Rating of Ataxia) scores
Time Frame: 30 and 90 days
|
Changes from baseline in the SARA scores at 30 and 90 days.
This is a scale to of quantify function and disability related to ataxia.
Score: 0 to 40 with higher scores meaning worse outcome.
|
30 and 90 days
|
Changes from baseline in the speech intelligibility (percentage of intelligible words recorded during standardized passage reading)
Time Frame: 30 and 90 days
|
Changes from baseline in intelligibility percentage at 30 and 90 days.
Score: 0 to 100% with higher scores meaning better outcome.
|
30 and 90 days
|
Changes from baseline in QUEST (Quality of Life in Essential Tremor Questionnaire) scores
Time Frame: 30 and 90 days
|
Changes from baseline in QUEST scores at 30 and 90 days.
This is a 30-item scale developed specifically for patients with essential tremor to measure items impacting perceived quality of life (QOL) that generic QOL measures do not effectively capture, including activities of daily living that are affected by tremor.
Higher scores mean worse outcome.
|
30 and 90 days
|
Change from baseline in the CRST (Clinical Rating Scale for Tremors)
Time Frame: 30 and 90 days
|
Change from baseline in the treated upper limb tremor subscore of the CRST at 30 and 90 days.
Score: 0 to 32 with higher scores meaning worse outcome.
|
30 and 90 days
|
Composite safety outcome of MRgFUS thalamotomy
Time Frame: 30 days
|
Composite outcome of detectable Vim lesion on MRI scan; AND lack of new-onset or worsening of contralateral upper limb sensory loss or weakness
|
30 days
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Collaborators
Investigators
- Principal Investigator: Agessandro Abrahao, MD, MSc, Sunnybrook Health Sciences Centre
- Principal Investigator: Nir Lipsman, MD, PhD, Sunnybrook Health Sciences Centre
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
January 16, 2020
Primary Completion (Anticipated)
March 1, 2021
Study Completion (Anticipated)
July 1, 2021
Study Registration Dates
First Submitted
January 31, 2020
First Submitted That Met QC Criteria
February 19, 2020
First Posted (Actual)
February 21, 2020
Study Record Updates
Last Update Posted (Actual)
February 21, 2020
Last Update Submitted That Met QC Criteria
February 19, 2020
Last Verified
February 1, 2020
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 029-2019
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
No
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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