- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04501484
Bilateral Essential Tremor Treatment With FUS (BEST-FUS)
Bilateral Essential Tremor Treatment With Magnetic Resonance-guided Focused Ultrasound
Combined Phase II/III, multi-center, prospective, single-blinded trial.
Ten (10) patients with who previously underwent successful and uncomplicated MRgFUS thalamotomy for essential tremor will undergo a contralateral treatment. The incidence of side effects will be determined at 1 and 3 months postoperatively, graded per the CTCAE v5 and analyzed by a data safety monitoring board. Upon successful review, this Phase II trial will be converted to a Phase III trial of utility that will enrol 40 additional patients. The primary outcome will be the change in QUEST score at 12 months postoperatively, as well as a patient-reported assessment of Health Utility. Secondary outcomes will include objective tremor, gait and speech assessments (filmed and scored by blinded evaluators), as well as quality of life questionnaires and adverse events questionnaires. Outcomes will be assessed immediately after the procedure, as well as 1, 3, 12, 24 and 36 months post-operatively.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Christian Iorio-Morin, MD, PhD
- Email: christian.iorio-morin@usherbrooke.ca
Study Contact Backup
- Name: Martha Lenis, BHA
- Phone Number: 2797 +14166035800
- Email: martha.lenis@uhnresearch.ca
Study Locations
-
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Ontario
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Toronto, Ontario, Canada, M5T 2S8
- Recruiting
- Toronto Western Hospital, University Health Network
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Contact:
- Martha Lenis, BHA
- Phone Number: 2797 +14166035800
- Email: martha.lenis@uhnresearch.ca
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients must be ≥ 18 years
- The patient has a primary diagnosis of ET or ET plus confirmed by a movement disorder neurologist;
- The patient previously underwent a MRgFUS (> 6 months ago);
- The tremor on the untreated side negatively impacts the patients' quality of life;
- The patient wants treatment of the contralateral side.
Exclusion Criteria:
- Clinically relevant gait and/or balance impairment (e.g. wide-based, more than 2 falls/months, wheelchair, walker, cane use)
- Clinically relevant speech impairment (e.g. impairment of intelligibility)
- Inability to comply with the follow-up schedule;
- Refusal of the treating physician.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Treatment Group
Participants will undergo a thalamotomy contralateral to their previous treatment with MRgFUS using ExAblate Neuro 4000 device (InSightec Ltd, Tirat Carmel, Israel).
|
Ablation of contralateral VIM nucleus of thalamus with MRgFUS using ExAblate Neuro 4000 Device (InSightec Ltd, Tirat Carmel, Israel)
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in QUEST Score
Time Frame: 12 months
|
Difference in QUEST score between baseline and the 12-month follow-up, with statistical significance defined as p = 0.05 and a minimum clinically important difference (MCID) defined as 5
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12 months
|
Patient-based Assessment of Utility
Time Frame: 12 months
|
A patient-reported assessment of utility after 12 months using the question "Knowing what you know now, would you do this treatment again?".
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12 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Gait Assessment (NRS-11)
Time Frame: Immediately after surgery, post operative month 1, 3, 12, 24, 36
|
Patient-reported and blinded observer rating of the patient's ability to walk (Numerical rating scale (NRS-11) from 0 to 10, with 10 being best)
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Immediately after surgery, post operative month 1, 3, 12, 24, 36
|
Gait Assessment (missteps)
Time Frame: Immediately after surgery, post operative month 1, 3, 12, 24, 36
|
Number of missteps in a 6 m standardized tandem walk
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Immediately after surgery, post operative month 1, 3, 12, 24, 36
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Falls
Time Frame: Post operative month 1, 3, 12, 24, 36
|
Number of falls in last month
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Post operative month 1, 3, 12, 24, 36
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Speech Assessment (NRS-11)
Time Frame: Immediately after surgery, post operative month 1, 3, 12, 24, 36
|
Patient-reported and blinded observer rating of the patient's ability to speak (Numerical rating scale (NRS-11) from 0 to 10, with 10 being best)
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Immediately after surgery, post operative month 1, 3, 12, 24, 36
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Numbness
Time Frame: Immediately after surgery, post operative month 1, 3, 12, 24, 36
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Incidence of new-onset numbness
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Immediately after surgery, post operative month 1, 3, 12, 24, 36
|
Dysgeusia
Time Frame: Immediately after surgery, post operative month 1, 3, 12, 24, 36
|
Incidence of taste alterations
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Immediately after surgery, post operative month 1, 3, 12, 24, 36
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Other adverse events
Time Frame: Immediately after surgery, post operative month 1, 3, 12, 24, 36
|
Incidence of other adverse events as classified in the CTCAE
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Immediately after surgery, post operative month 1, 3, 12, 24, 36
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Tremor (CRST)
Time Frame: Immediately after surgery, post operative month 1, 3, 12, 24, 36
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Assessment of tremor using the Clinical Rating Scale for Tremor (CRST) parts A (0-88) and B (0-36), higher scores correspond to a worse tremor).
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Immediately after surgery, post operative month 1, 3, 12, 24, 36
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Quality of life (QUEST)
Time Frame: Post operative month 1, 3, 12, 24, 36
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QUality of life in ESsential Tremor (QUEST) questionnaire (0-100%, higher scores correspond to a worse quality of life)
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Post operative month 1, 3, 12, 24, 36
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Quality of life (CRST part C)
Time Frame: Post operative month 1, 3, 12, 24, 36
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Part C of the Clinical Rating Scale for Tremor (CRST) (0-32, higher scores correspond to a worse quality of life)
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Post operative month 1, 3, 12, 24, 36
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Health Utility (EQ-5D-5L)
Time Frame: Post operative month 1, 3, 12, 24, 36
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Health Utility measured using the EQ-5D-5L and computed using the Canadian preference weights.
Values range from 0 to 1, with 1 representing a perfect health.
|
Post operative month 1, 3, 12, 24, 36
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Collaborators and Investigators
Collaborators
Investigators
- Principal Investigator: Andres Lozano, MD, PhD, University of Toronto
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
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
- 20-5172
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.
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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