Magnetic Resonance Imaging of Cerebral Connectivity and Volume in Neurodegeneration and Glaucoma (EVOLUTION)
Study Overview
Detailed Description
Glaucoma is a neurodegenerative disease characterised by a progressive loss of retinal ganglion cells, typical optic neuropathy with a loss of visual field and visual function. High intraocular pressure is it's main risk factor, but the patophysiology hasn't been clearely understood, as there exist forms with normal ocular pressure (NTG - normal tension glaucoma) or mixed forms. Studies have shown that the degeneration is not limited to retinal ganglion cells only, but rather it affects the whole visual pathway including the occipital cortex. The ENVOL study has been able to show microstructural alterations of the optic radiations in glaucoma. Furthermore, glaucomatous patients have been found to be more at risk of developing other neurodegenerative diseases, namely Alzheimer's disease.
The EVOLUTION study is set to repeat 3T brain MRI in patients previously enrolled in ENVOL in order to compare brain microstructure between glaucomatous and matched healthy subjects, assess their ocular status and glaucoma progression over time, as well as compare them with orignal imagery from 10 years prior.
gression over time, as well as compare them with orignal imagery from 10 years prior.
Study subjects will undergo a typical non-invasive ophthalmic screening comprised of best-corrected visual acuity testing, slit-lamp biomicroscopy, gonioscopy, indirect opthalmoscopy, fundus photography, 30° visual field testing and optical coherence tomography of the optic nerve. They will also answer a questionnaire concerning their medical treatment, cardiovascular health and tobacco use. Next, they will undergo a 3T brain MRI comprised of a T1-weighted 3D morphological sequence, 3D FLAIR, resting state fMRI and diffusion tensor imaging.
fMRI and diffusion tensor imaging
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Cedrick Schweitzer, MD, PhD
- Phone Number: +335 56 79 55 30
- Email: cedric.schweitzer@chu-bordeaux.fr
Study Locations
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Bordeaux, France
- Recruiting
- CHU Bordeaux
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Contact:
- Cedrick Schweitzer, MD, PhD
- Phone Number: +335 56 79 55 30
- Email: cedric.schweitzer@chu-bordeaux.fr
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- having been previously included and completed the ENVOL study
- Ability and willingness to provide informed consent
- Having a valid health insurance in France
In glaucoma group :
- Glaucomatous optic neuropathy, being able to be graded by the vertical C/D ratio
- Open angle on gonioscopy in a dark-room testing according to Shaffer's classification (grade 3 or grade 4)
Visual field impairement (at least one of the following) :
- 3 adjacent points with at least 5dB loss
- one point with a loss of 10dB
- a difference of at least 10 dB for 2 adjacent points on either side of the horizontal meridian of the nasal visual field
- Mini Mental State Score of at least 28
In control group :
- No personal or family history of glaucoma or ocular hypertension (IOP > 21 mmHg)
- Open angle on gonioscopy in a dark-room testing according to Shaffer's classification (grade 3 or grade 4)
- Intraocular pressure of ≤ 21 mmHg
- Absence of glaucomatous neuropathy
- Normal visual field
Exclusion Criteria:
- Inability/unwillingness to provide informed consent
- Other causes of ocular hypertension (trauma, uveitis)
- Non-glaucomatous optic neuropathy (infectious, inflammatory, compressive, ischemic)
- Unreliable visual field (>15% false positives, >33% false negatives or >20% loss of fixation)
- Severe corneal pathology preventing access to fundus, visual field testing or altering ocular tonometry
- Contraindications to MRI testing (pacemakers or neurosensory stimulators, cochlear implants, ferromagnetic foreign bodies, claustrophobia)
- Patients under guardianship or other form of legal protection
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
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Experimental: Patient with glaucoma
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MRI
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Active Comparator: Patient without glaucoma
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MRI
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
structural and functional connectivity matrices
Time Frame: Baseline
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10-year whole brain comparison of structural and functional connectivity matrices (Hub Disruption Index) on 3T MRI in glaucoma patients and controls from the ENVOL study
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Baseline
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
microstructural changes
Time Frame: Baseline
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Comparison of microstructural changes on diffusion MRI within the whole brain and by specific regions (white matter, gray matter, hippocampus, amygdala, occipital cortex) between the 2 groups (voxel-by-voxel analysis)
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Baseline
|
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cerebral volumes
Time Frame: Baseline
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Comparison of cerebral volumes (total volume of cerebral parenchyma), and volumes of specific regions (white matter, gray matter, hippocampus, amygdala, occipital cortex) between the 2 groups
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Baseline
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Evolution of the above parameters
Time Frame: Baseline
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Comparison of evolution of the above parameters over a 10-year period between the ENVOL study and EVOLUTION follow-up study (microstructural changes on diffusion MRI within the whole brain and by specific regions (white matter, gray matter, hippocampus, amygdala, occipital cortex), cerebral volumes (total volume of cerebral parenchyma), and volumes of specific regions (white matter, gray matter, hippocampus, amygdala, occipital cortex)).
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Baseline
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Demographic factors
Time Frame: Baseline
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Identication of demographic that could be associated with overall degenerative impairment as measured in the primary objective and secondary objectives above
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Baseline
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Ophthalmological factors
Time Frame: Baseline
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Ophthalmological factors, notably characterization of the type of glaucoma (normal pressure, high pressure) that could be associated with overall degenerative impairment as measured in the primary objective and secondary objectives above
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Baseline
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Collaborators and Investigators
Sponsor
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
Additional Relevant MeSH Terms
Other Study ID Numbers
- CHUBX 2024/90
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
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