- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT06206473
Cognitive Dysfunctions Associated With Delirium in Critically-ill ARDS Patients (DeSign)
March 7, 2024 updated by: University Hospital, Toulouse
Cognitive Dysfunctions Associated With Delirium in Critically-ill ARDS Patients: Diagnostic and Prognostic Electrophysiological Signatures
Early cognitive assessment of critically-ill acute respiratory distress syndrome (ARDS) patients with delirium using a multidimensional electrophysiological evaluation battery (mEEG) to identify and characterize the neural correlates of cognitive dysfunctions associated with delirium (vigilance, attention, semantic and lexical processing, self-processing), and to develop a prognostic evaluation of neurocognitive and psychological disorders using an innovative non-behavioral approach.
Study Overview
Status
Not yet recruiting
Conditions
Intervention / Treatment
Detailed Description
Delirium is an altered mental status associated with specific manifestations such as reduced ability to direct, focus, maintain and shift attention (DSM V criteria).
The vulnerability of critically-ill ARDS patients explains the high incidence of delirium (up to 80%) in this setting.
Delirium is an independent predictor of post-traumatic stress disorder, long term cognitive decline and mortality.
To reduce this medical and social burden, a more complete description of delirium is needed both in terms of cognitive impairments and long term neurological and neuropsychological impact.
Actually, it could be argued that the current exclusive behavioral assessment of these patients is insufficient in terms of diagnosis and prognostic assessment.
In recent years, the study of consciousness has made major progress thanks to the use of innovative electrophysiological exploration methods.
This work has notably allowed the development of new non-behavioral tools for the exploration of brain function in brain damaged patients in response to complex auditory stimulations (multidimensional electrophysiological battery, mEEG).
In this context, the investigator team has recently demonstrated alterations in cognitive functions related to language- and self-processing in ARDS patients with severe acute respiratory syndrome (SARS)-CoV2 infection.
These electrophysiological cognitive alterations were particularly marked in COVID-19 patients with delirium.
Further studies are needed to disentangle the cognitive impact specifically related to delirium from that related to a severe form of COVID-19.
The primary objective of this study is to identify diagnostic electrophysiological signatures of cognitive dysfunctions associated with the acute phase of delirium in critically-ill ARDS patients using a multidimensional electrophysiological assessment (mEEG) recording at rest and during auditory stimulation (first visit, V1).
Secondary objectives are to characterize the impact of intensive care unit (ICU)-related delirium on neurocognitive and psychological dysfunctions observed at 6 months (second visit, V2), in order to explore the prognostic predictive value of electrophysiological data acquired during the acute phase of delirium.
Study Type
Interventional
Enrollment (Estimated)
30
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 Contact
- Name: Fabrice FERRE, MD
- Phone Number: +33 0561779988
- Email: ferre.f@chu-toulouse.fr
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
- Adult
- Older Adult
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- Patients admitted to the intensive care unit with ARDS (according to Berlin criteria)
- Delirium (according to Confusion Assessment Method (CAM)-ICU criteria)
- Membership of a social security scheme
- Signed consent of the referring person
- Discontinuation of any sedative agent for ≥ 72 hours
Exclusion Criteria:
- Pre-existing psychotic disorders
- Pre-existing cognitive deficits (short Informant Questionnaire on Cognitive Decline in the Elderly (short IQCODE) ≥ 3,4)
- Recent ICU admission (> 5 days of ICU hospitalization within 6 months prior to current ICU admission)
- Patients whose delirium cannot be reliably assessed due to blindness, deafness or inability to speak French
- Patients whose life expectancy is unlikely to exceed 24 hours
- Pregnant ans breastfeeding women
- Patients under court protection
- Patients who have already participated in the study
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: Basic Science
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: ICU patients with ARDS and delirium
ICU patients with ARDS and delirium will be assessed twice: in the acute phase of ICU-related delirium (V1) using an mEEG battery (electrophysiological acquisition at rest and during complex cognitive stimulation), and 6 months ± 2 weeks later (V2) using a multi-domain clinical neurocognitive and psychological assessment battery.
|
mEEG assessment (V1) will be performed at the patient's bed within 72 hours of the diagnosis of delirium.
The mEEG recording, which lasts approximately 2 hours, will be performed by one of the investigators with expertise in electrophysiological acquisition.
This non-invasive assessment consists of placing an EEG net on the scalp of the participants and earphones through which the auditory stimuli will be delivered.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Presence or absence of the signal of weighted Symbolic Mutual Information (wSMI) measured by multidimensional ElectroEncephaloGram (mEEG) at the acute phase of delirium at rest
Time Frame: Baseline
|
Analysis of data from the multidimensional electrophysiological battery (mEEG) at the acute phase of delirium at rest: weighted Symbolic Mutual Information (wSMI) measured by presence or absence of the signal
|
Baseline
|
Presence or absence of the signal of weighted Symbolic Mutual Information (wSMI) measured by multidimensional ElectroEncephaloGram (mEEG) at the acute phase of delirium during auditory stimulation
Time Frame: Baseline
|
Analysis of data from the multidimensional electrophysiological battery (mEEG) at the acute phase of delirium during auditory stimulation : weighted Symbolic Mutual Information (wSMI) measured by presence or absence of the signal
|
Baseline
|
Amplitude of the signal of weighted Symbolic Mutual Information (wSMI) measured by multidimensional ElectroEncephaloGram (mEEG) at the acute phase of delirium at rest
Time Frame: Baseline
|
Analysis of data from the multidimensional electrophysiological battery (mEEG) at the acute phase of delirium at rest : weighted Symbolic Mutual Information (wSMI) measured by amplitude (microvolts)
|
Baseline
|
Amplitude of the signal of weighted Symbolic Mutual Information (wSMI) measured by multidimensional ElectroEncephaloGram (mEEG) at the acute phase of delirium during auditory stimulation
Time Frame: Baseline
|
Analysis of data from the multidimensional electrophysiological battery (mEEG) at the acute phase of delirium during auditory stimulation : weighted Symbolic Mutual Information (wSMI) measured by amplitude (microvolts)
|
Baseline
|
Latency of the signal of weighted Symbolic Mutual Information (wSMI) measured by multidimensional ElectroEncephaloGram (mEEG) at the acute phase of delirium at rest
Time Frame: Baseline
|
Analysis of data from the multidimensional electrophysiological battery (mEEG) at the acute phase of delirium at rest: weighted Symbolic Mutual Information (wSMI) measured by latency (milliseconds
|
Baseline
|
Latency of the signal of weighted Symbolic Mutual Information (wSMI) measured by multidimensional ElectroEncephaloGram (mEEG) at the acute phase of delirium during auditory stimulation
Time Frame: Baseline
|
Analysis of data from the multidimensional electrophysiological battery (mEEG) at the acute phase of delirium during auditory stimulation : weighted Symbolic Mutual Information (wSMI) measured by latency (milliseconds
|
Baseline
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Fabrice FERRE, MD, University Hospital, Toulouse
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 (Estimated)
April 1, 2024
Primary Completion (Estimated)
December 1, 2025
Study Completion (Estimated)
December 1, 2025
Study Registration Dates
First Submitted
January 4, 2024
First Submitted That Met QC Criteria
January 4, 2024
First Posted (Actual)
January 16, 2024
Study Record Updates
Last Update Posted (Actual)
March 8, 2024
Last Update Submitted That Met QC Criteria
March 7, 2024
Last Verified
March 1, 2024
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Mental Disorders
- Nervous System Diseases
- Respiratory Tract Diseases
- Respiration Disorders
- Lung Diseases
- Neurologic Manifestations
- Confusion
- Neurobehavioral Manifestations
- Neurocognitive Disorders
- Infant, Newborn, Diseases
- Cognition Disorders
- Lung Injury
- Infant, Premature, Diseases
- Delirium
- Cognitive Dysfunction
- Respiratory Distress Syndrome
- Respiratory Distress Syndrome, Newborn
- Acute Lung Injury
Other Study ID Numbers
- RC31/22/0487
- 2023-A00279-36 (Other Identifier: ID-RCB)
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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