Assessment of ADCY5-related Movement Disorders With Motion SENSors (SENSeo-ADCY5)

Assessment of ADCY5-related Movement Disorders With Motion SENSors: a Feasibility Study

ADCY5-related movement disorders are caused by dominant mutations in the ADCY5 gene. This rare neurogenetic disease is characterized by childhood-onset generalized hyperkinetic movements. Currently, the only tools available to rate the severity of movement disorders observed in ADCY5-patients are clinical rating scales of abnormal movements. These scales use the investigators' judgement to rate globally the severity of movements observed in various body parts of the patient. This protocol proposes to investigate a multimodal approach, combining a clinical scale assessment with ViconTM's objective movement measurement. A secondary objective of the study is to assess the effect of coffee on ADCY5-patients.

Study Overview

• Status: Recruiting
• Conditions: ADCY5-related Dyskinesia
• Intervention / Treatment: Other: caffeinated coffee - decaffeinated coffee

Detailed Description

ADCY5-related movement disorders are caused by dominant mutations in the ADCY5 gene. This rare neurogenetic disease is characterized by childhood-onset generalized hyperkinetic movements. The abnormal movements typically comprise a combination of dystonia, myoclonus and chorea occurring on a background of axial hypotonia, with superimposed disabling episodes of paroxysmal dyskinesia. The causing mutations are located in the ADCY5 gene coding for the Adenylate Cyclase 5 (AC5). AC5 is highly expressed in the striatal projection neurons of the striatum, a region involved in the control of movements. No effective treatment has been found. Currently, the only tools available to rate the severity of movement disorders observed in ADCY5-patients are clinical rating scales of abnormal movements. These scales use the investigators' judgement to globally rate movements severity in various body parts. This leads to inter-raters' scoring variability. An objective assessment through refined and comprehensive quantification of movements is needed. A motion capture system, such as ViconTM, could better reflect the global and focal variations of abnormal movements. This would be critical for the evaluation of responses to potential treatments. This protocol proposes to investigate a multimodal approach, combining a clinical scale assessment with ViconTM's objective movement measurement. A secondary objective of the study is to assess the effect of coffee on ADCY5-patients. The caffeine contained in coffee acts as a nonselective adenosine receptor antagonist, with a strong affinity for A2A receptors. By blocking A2A receptors, caffeine reduces the enzymatic activity of the altered mutated AC5 protein coded by the mutated ADCY5 gene. This effect could modulate the abnormal movements observed in patients.

• Study Type: Interventional
• Enrollment (Estimated): 10
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: louise laure MARIANI, MD, PhD; Phone Number: +33 1 42 16 27 48; Email: louise-laure.mariani@icm-institute.org

Study Locations

• France
  • Paris, France, 75013
    • Recruiting
    • CIC Neurosciences, GH Pitié-Salpêtrière
    • Contact: Louise-Laure Mariani, MD; Phone Number: +33 0142162748; Email: louise-laure.mariani@icm-institute.org

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 13 years and older (Child, Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• ADCY5 mutation carriers
• Age > 15 years old and 3 months
• Informed consent from the patient or/ and a legal representative when appropriate
• Affiliated with a social security system or beneficiary of such a regime or by waiver from CPP ( french ethic committee) for patients outside the European union ( EU)
• daily caffeine consumer

Exclusion Criteria:

• Hypersensitivity to caffeine or to xanthine derivatives
• Heart condition contraindicating coffee intake
• Liver failure
• Impaired comprehension interfering with an informed consent
• Positive pregnancy test for women of childbearing potential
• Patient treated by Enoxacin, Ciprofloxacin, Norfloxacin (Noroxin), Cimetidine, Phenytoin β-adrenergic drugs (β2 mimetics) at inclusion.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Caffeinated coffee; Drink caffeinated coffee one morning and drink decaffeinated coffee the other morning	Other: caffeinated coffee - decaffeinated coffee; Drink caffeinated coffee one morning and drink decaffeinated coffee the other morning
Experimental: Decaffeinated coffee; Drink decaffeinated coffee one morning and drink caffeinated coffee the other morning	Other: caffeinated coffee - decaffeinated coffee; Drink caffeinated coffee one morning and drink decaffeinated coffee the other morning

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Quantification movement disorders	Assessment of correlation between displacement data using the ViconTM system and standardized clinical scales' scores of movements	24 HOURS

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Coffee effects	Change in abnormal movements, measured with motion sensors (ViconTM system) after caffeinated coffee vs after decaffeinated coffee	24 Hours
Involuntary scales evaluation	Change in abnormal movements, measured with standardized clinical scale (Abnormal Involuntary Movement Scale (AIMS; Global score range 0 to 28 and severity subscore range 0 to 4; higher scores mean worse outcome), after caffeinated coffee vs after decaffeinated coffee	24 Hours
Dyskinesia impairment evaluation	Change in abnormal movements, measured with standardized clinical scale Dyskinesia Impairment Scale (DIS) (total score range 0 to 288; higher scores mean worse outcome) after caffeinated coffee vs after decaffeinated coffee	24 Hours
Dyskinesia Rating Scale evaluation	Change in abnormal movements, measured with standardized clinical scale Unified Dyskinesia Rating Scale (UDysRS) (total score range of 0 to 104; higher scores mean worse outcome), after caffeinated coffee vs after decaffeinated coffee	24 Hours

Collaborators and Investigators

• Sponsor: Assistance Publique - Hôpitaux de Paris

Study record dates

Study Major Dates

• Study Start (Estimated): July 4, 2024
• Primary Completion (Estimated): July 4, 2024
• Study Completion (Estimated): July 4, 2024

Study Registration Dates

• First Submitted: April 29, 2021
• First Submitted That Met QC Criteria: November 26, 2021
• First Posted (Actual): November 29, 2021

Study Record Updates

• Last Update Posted (Actual): January 23, 2024
• Last Update Submitted That Met QC Criteria: January 19, 2024
• Last Verified: January 1, 2024

More Information

Terms related to this study

• Keywords: movement disorders; ADCY5; COFFEE
• Additional Relevant MeSH Terms: Central Nervous System Diseases; Nervous System Diseases; Neurologic Manifestations; Dyskinesias; Movement Disorders
• Other Study ID Numbers: APHP201439; 2021-A00994-37 (Other Identifier: IDRCB Number)

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