- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04801771
Effects of Hypoglossal Nerve Stimulation on Cognition and Language in Down Syndrome and Obstructive Sleep Apnea
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
This study is a prospective, single-arm study conducted under a common implant and follow-up protocol. The objective will be to follow fifty-seven (57) adolescents and young adults (10-21 years of age), with Down syndrome, moderate to severe sleep apnea, and post-adenotonsillectomy, for 12 months after undergoing implant of the Inspire Upper Airway Stimulation (UAS) System. The study is being conducted in order to evaluate objective change in cognition and expressive language after implant and therapy with the Inspire UAS System.
Prior to implant subjects will be required to meet eligibility criteria, complete quality of life questionnaires and undergo neurocognitive testing (NCT) and expressive language sampling. Eligibility criteria will be determined via review of medical records, an in-lab polysomnography (sleep study), and a drug-induced sleep endoscopy (DISE).
After implant of the Inspire UAS System, subjects will undergo five (5) study visits. Four (4) of the visits will include an in-lab sleep study (PSG). Follow-up expressive language sampling and neurocognitive testing will be performed at 6 months post-implant. Follow-up quality of life questionnaires will be completed at 12 months post-implant.
Subjects will conclude their participation in the study at the end of their 12 month study visit.
Study Type
Enrollment (Estimated)
Phase
- Phase 3
Contacts and Locations
Study Contact
- Name: Mike Swierzewski, MS
- Phone Number: 612-325-9723
- Email: michaelswierzewski@inspiresleep.com
Study Contact Backup
- Name: Gwen Gimmestad
- Phone Number: 763-392-9966
- Email: gwengimmestad@inspiresleep.com
Study Locations
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Georgia
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Atlanta, Georgia, United States, 30329
- Recruiting
- Children's Healthcare of Atlanta/ Emory University School of Medicine
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Contact:
- Hari Vedantam
- Email: Hari.Vedantam@choa.org
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Principal Investigator:
- Nikhila Raol, MD
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Massachusetts
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Boston, Massachusetts, United States, 02114
- Recruiting
- Massachusetts General Hospital (Mass Eye & Ear Infirmary)
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Contact:
- Odeta Dyrmishi, MPA
- Email: Odeta_Dyrmishi@meei.harvard.edu
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Principal Investigator:
- Chris Hartnick, MD
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Sub-Investigator:
- Brian Skotko, MD
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Ohio
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Cincinnati, Ohio, United States, 45229
- Recruiting
- Cincinnati Childrens Hospital
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Contact:
- Angie Duggins
- Email: angie.duggins@cchmc.org
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Principal Investigator:
- Christine Heubi, MD
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Pennsylvania
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Philadelphia, Pennsylvania, United States, 19104
- Recruiting
- Children's Hospital of Philadelphia
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Principal Investigator:
- Lisa M Elden, MD
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Contact:
- Ashley B Williams
- Email: WILLIAMSAB@chop.edu
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Pittsburgh, Pennsylvania, United States, 15224
- Recruiting
- Children's Hospital of Pittsburgh
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Contact:
- Allison Tobey, MD
- Email: allison.tobey@chp.edu
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Contact:
- Amber Shaffer, PhD
- Phone Number: 412-692-6874
- Email: shafferad@upmc.edu
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Texas
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Dallas, Texas, United States, 75207
- Recruiting
- University of Texas Southwestern/Children's Hospital of Dallas
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Contact:
- Ron Mitchell, MD
- Email: ron.mitchell@UTSouthwestern.edu
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Contact:
- Francesca Chambers
- Email: francesca.chambers@childrens.com
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Virginia
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Norfolk, Virginia, United States, 32507
- Recruiting
- Children's Hospital of the King's Daughters/East Virginia Medical School
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Contact:
- Cristina Baldassari, MD
- Email: cristina.baldassari@chkd.org
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Contact:
- Laura Stone, RN, BSN, CCRC
- Phone Number: 757-388-6238
- Email: stonelj@evms.edu
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Diagnosis of Down syndrome
- Age 10-21 years
- Prior adenotonsillectomy
- Severe OSA (AHI > 10, AHI < 50, no more than 25% AHI attributable to central events) based on prior in-lab PSG performed after adenotonsillectomy and within 18 months of enrollment
- Approval from at least two of the three physician reviewers based upon the results of a routine drug-induced sleep endoscopy (DISE) having occurred within 12 months of enrollment
- Subjects must have either tracheotomy or be ineffectively treated with CPAP due to non-compliance, discomfort, un-desirable side effects, persistent symptoms despite compliance use, or refusal to use the device
- Children and their parents/guardians must be willing to have stimulation hardware permanently implanted, and be willing to participate in follow-up visits, postoperative PSG, and questionnaire completion
- Children's parents/guardians must complete a questionnaire confirming that their child is capable of communicating feelings of pain or discomfort. They must also confirm they are able to assess their child for adverse effects related to device implantation
- Children and their parents/guardians must be proficient in English
Exclusion Criteria:
- Body mass index (BMI) above the 95th percentile for subject's age
- Circumferential airway collapse at the level of the velopharynx observed during DISE
- Other medical conditions resulting in medical instability (eg. congestive heart failure, recent open heart surgery, immunosuppression, or chronic lung disease or aspiration)
- Presence of another medical condition requiring future magnetic resonance imaging (MRI) of the chest
- Patients with another implantable device which could interact unintentionally with the Inspire system
- Any contraindication for general anesthesia
- History of bleeding or clotting disorders and those on blood thinning or NSAID medications for the week prior to implantation surgery. Subjects will be asked to refrain from the use of NSAIDS for two weeks after implantation or any revision surgeries
- Subject is currently taking muscle relaxant medication
- Life expectancy less than 12 months
- Subject's inability to communicate pain or discomfort to their caretaker/parent, based on parental or investigator assessment
- Nonverbal candidates will be excluded due to an inability to complete testing procedures including expressive language sampling
- Subjects with a co-occurring diagnosis of autism spectrum disorder
- Subjects that have a positive β-HCG
- Subjects deemed unfit for participation by the investigator for any other reason
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: Subjects implanted with Inspire UAS System
Subjects who meet eligibility criteria will be implanted with the Inspire Upper Airway Stimulation (UAS) System.
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The Inspire UAS System is an implantable device that provides hypoglossal nerve stimulation for the treatment of obstructive sleep apnea.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in intelligence using the Kaufman Brief Intelligence Scale (KBIT-2)
Time Frame: 6 Months post-implant
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Change in the Intelligence Quotient Standard Score of at least 0.5 standard deviation from baseline
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6 Months post-implant
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Change in attention using the Wechsler Intelligence Scale
Time Frame: 6 Months post-implant
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Change in Cancellation scaled score of at least 0.5 standard deviation from baseline
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6 Months post-implant
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Change in processing speed using the Cambridge Neuropsychological Test Automated Battery (CANTAB)
Time Frame: 6 Months post-implant
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Change in RTIFMDRT and RTIFMDMT raw scores of at least 0.5 standard deviation from baseline
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6 Months post-implant
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Change in executive functioning using the Delis-Kaplan Executive Functioning System (DKEFS)
Time Frame: 6 Months post-implant
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Change in Category Functioning scaled score of at least 0.5 standard deviation from baseline
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6 Months post-implant
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Change in learning and memory using the Cambridge Neuropsychological Test Automated Battery - Paired Associates Learning
Time Frame: 6 Months post-implant
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Change in PAL-TEA raw score of at least 0.5 standard deviation from baseline
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6 Months post-implant
|
Change in language using Expressive Language Sampling
Time Frame: 6 Months post-implant
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Change in % of unintelligible C-units, number of different word roots and mean length of C-units in morphemes of at least 0.5 standard deviation from baseline
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6 Months post-implant
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Rate of procedure and device-related adverse events
Time Frame: Implant through 12 Months post-implant
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Procedure and device-related adverse events will be collected in order to profile the safety of hypoglossal nerve stimulation in adolescents.
Number and percent of procedure and device-related adverse events will be reported
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Implant through 12 Months post-implant
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Change in Obstructive Sleep Apnea (OSA)
Time Frame: 3, 6, 12 Months post-implant
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Change in sleep apnea will be measured using standard in-lab PSG measures including oxygen level, partial and complete airway obstruction, and arousals.
Improvement will be defined as a 50% or more decrease in AHI.
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3, 6, 12 Months post-implant
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Change in quality of life as measured by OSA-18 and ESS-CHAD questionnaires
Time Frame: 12 months post-implant
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Quality of life improvements will be measured using the OSA-18 and ESS-CHAD.
Mean scores for each questionnaire will be reported at baseline and 12 months post-implant.
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12 months post-implant
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Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Christopher Hartnick, MD, The Massachusetts Eye and Ear Infirmary
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
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
Keywords
Additional Relevant MeSH Terms
- Pathologic Processes
- Nervous System Diseases
- Respiratory Tract Diseases
- Respiration Disorders
- Sleep Disorders, Intrinsic
- Dyssomnias
- Sleep Wake Disorders
- Neurologic Manifestations
- Neurobehavioral Manifestations
- Disease
- Congenital Abnormalities
- Genetic Diseases, Inborn
- Signs and Symptoms, Respiratory
- Intellectual Disability
- Abnormalities, Multiple
- Chromosome Disorders
- Sleep Apnea Syndromes
- Sleep Apnea, Obstructive
- Syndrome
- Apnea
- Down Syndrome
Other Study ID Numbers
- 2020-003
- 1U01DC019279-01 (U.S. NIH Grant/Contract)
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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