- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04734626
CrCest Study in Primary Mitochondrial Disease
Magnetic Resonance Imaging (MRI) Muscle Phenotyping in Mitochondrial Disease
The purpose of this study is to perform a "muscle phenotyping" magnetic resonance imaging (MRI) assessment in patients receiving clinical care at the Children's Hospital of Philadelphia (CHOP) for mitochondrial disease that is either suspected (based on clinical presentation) or has a definite genetic diagnosis. The MRI assessment quantifies skeletal muscle oxidative phosphorylation (OXPHOS) capacity.
Investigators hope that this study will contribute to our current knowledge of mitochondrial diseases and this study will help create a new diagnostic tool for use in both clinical care and in clinical trials.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
This research study visit will occur on the same day as the participants clinically scheduled MRI. The clinically indicated and study-specific scanning time will not exceed 120 minutes.
During the study visits:
- A study team member will review inclusion and exclusion criteria with the participant
- A study team member will review medical history review with the participant
- A safety assessment will occur prior to study procedures
- Study MRI scan
- During which the participant will use an MRI-safe machine to stimulate exercise, similar to pressing a gas pedal
If eligible participants return to CHOP for future clinical imaging, we will also request a study-specific MRI assessment.
Study Type
Enrollment (Estimated)
Contacts and Locations
Study Contact
- Name: Katelynn Stanley
- Phone Number: (267) 426-4961
- Email: stanleyk2@chop.edu
Study Locations
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Pennsylvania
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Philadelphia, Pennsylvania, United States, 19104
- Children's Hospital of Philadelphia
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria (Mitochondrial Disease Patients):
- Males and females, between the ages of 7 and 75, inclusive
- Suspected (based on clinical presentation) or definite genetic mitochondrial disease diagnosis (i.e., genetic mutations in the constituents of the mitochondrial respiratory chain and/or genetic mutations that are likely to affect mitochondrial function)
- Clinically eligible for an MRI of the lower leg. We are conducting clinical leg MRI scans of patients with definite mitochondrial disease for indications that include muscle weakness and muscle fatigue.
- Able to perform sub-maximal ankle dorsiflexion leg exercise during the MRI study
Inclusion Criteria (Healthy Controls):
- Males and females, between the ages of 7 and 75 years, inclusive
- Able to perform sub-maximal ankle dorsiflexion leg exercise during the MRI study
Inclusion Criteria (Evaluable Healthy Controls and Cases for Data Analysis):
- To note, we will merge coded datasets from Institutional Review Board (IRB) #15-012445, IRB #16-013364, and IRB #08-006177 with data from this study as part of our data analysis plan.
- Complete and evaluable healthy control and cases from IRB #15-012445, IRB #16-013364, and IRB #08-006177
Exclusion Criteria (Mitochondrial Disease Patients and Healthy Controls):
- In the investigator's opinion, inability to fully comply with research procedures
- Active alcohol and/or substance abuse, including tobacco-use
- A pacemaker; any metal-based medical or non-medical devices/implants; any non-removable metal-based object (e.g., body piercings, jewelry, etc.)
- Any history of intraocular injury or fragment in or around the orbit that cannot be cleared through radiologic evaluation
- Any history of bullet, shrapnel, or stabbing wounds that cannot be cleared through radiologic evaluation
- Past or current employment involving (or exposure to) a metal grinder (e.g., at a construction worksite)
- Claustrophobia or any known medical conditions which can be exacerbated by stress, anxiety, or panic attacks triggered by enclosed spaces
- Any potentially interfering clinical MRI contrast agents, as reviewed with the radiology team
- At the discretion of the principal investigator (PI), any medical condition that will interfere with or prevent the safe completion of the study
- Any female participant with childbearing potential who is knowingly pregnant or suspects that she is pregnant will be removed from the study. (Although there are no known risks of MRI on pregnant females or fetuses, there is a possibility of yet undiscovered pregnancy-related risks. Since there is no direct benefit from participating in this protocol for pregnant females, they will be excluded to ensure their long-term safety and that of their unborn fetus.)
- To note, for this protocol, participants are instructed to lie still in the MRI scanner; there is no contrast or sedation. Participants will be asked to perform a brief (< 2 minute) foot-pedal exercise. Investigators will ensure that total MRI scanning time (i.e., clinically indicated and study-specific scanning) does not exceed 120 minutes within a single day. Participants who do not possess the cognitive and/or physical abilities to perform these procedures will not be included.
Exclusion Criteria (Healthy Controls)
- Any history or genetic confirmation of mitochondrial disease
Study Plan
How is the study designed?
Design Details
- Observational Models: Cohort
- Time Perspectives: Prospective
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
Mitochondrial Disease
Individuals with suspected (based on clinical presentation) or definite genetic mitochondrial disease
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CrCEST be used to assess creatine distribution and concentrations in muscle (lower extremity), both at rest and after recovery from a brief foot-pedal depression exercise
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Healthy Controls/Volunteers
Individuals with no history of suspected (based on clinical presentation) or definite genetic mitochondrial disease
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CrCEST be used to assess creatine distribution and concentrations in muscle (lower extremity), both at rest and after recovery from a brief foot-pedal depression exercise
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Post-exercise CrCEST recovery time (seconds)
Time Frame: During the MRI
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The time it takes after the exercise occurs to recover CrCEST
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During the MRI
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Resting CrCEST
Time Frame: During the MRI
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Amount of CrCEST prior to exercise
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During the MRI
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Muscle Lipid Content
Time Frame: During the MRI
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Includes both Intramyocellular lipid (IMCL) and extramyocellular lipids (EMCL) content, both expressed in arbitrary units relative to water signal and relative to creatine
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During the MRI
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Fat-fraction
Time Frame: During the MRI
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n-point Dixon, expressed as a percentage of the total area
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During the MRI
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Collaborators and Investigators
Investigators
- Principal Investigator: Zarazuela Zolkipli Cunningham, MBChB MRCP, Children's Hospital of Phiadelphia
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Estimated)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 19-016520
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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