- ICH GCP
- Yhdysvaltain kliinisten tutkimusten rekisteri
- Kliininen tutkimus NCT07569887
Exploratory Study of Cerebral Perfusion and Metabolic Alterations and Neurocognitive Disorders in Patients With Unruptured Arteriovenous Malformations Before and After Surgical Treatment (APEMMAV-NR)
Tutkimuksen yleiskatsaus
Tila
Interventio / Hoito
Yksityiskohtainen kuvaus
Unruptured cerebral arteriovenous malformations are a potentially life-threatening condition and the third leading cause of intracerebral hemorrhage in young adults. Approximately two-thirds of patients with arteriovenous malformations experience a rupture leading to intracranial haemorrhage or develop progressive neurological symptoms or deficits. To date, decisions regarding interventional treatment of unruptured arteriovenous malformations are based on the characteristics of the arteriovenous malformation (size, location, etc.).However, the treatment of these arteriovenous malformations remains controversial in the literature, as the morbidity and mortality associated with intervention may exceed those the malformation's natural history. Furthermore, characteristics of arteriovenous malformations observed during examinations (size, hemodynamic patterns, vascular components) are often insufficient to predict spontaneous evolution, haemorrhagic risk, and associated symptoms.
Studies suggest that neurological symptoms may be linked to impaired cerebral perfusion and metabolism, particularly through hypoperfusion in the peri-arteriovenous malformation region or peri-lesional oedema. However, the results of these previous studies remain limited and of little significance.
The proposed project aims to establish a cohort over a 16-month period in order to study in detail the metabolic and perfusion alterations associated with arteriovenous malformations, as well as their neurocognitive and psychological impacts, with the aim of improving the pathophysiology understanding and treatment of these malformations.
Opintotyyppi
Ilmoittautuminen (Arvioitu)
Vaihe
- Ei sovellettavissa
Yhteystiedot ja paikat
Opiskeluyhteys
- Nimi: Lucas RIBEIRO, Dr
- Puhelinnumero: +33 0467337432
- Sähköposti: l-ribeiro@chu-montpellier.fr
Opiskelupaikat
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France
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Montpellier, France, Ranska, 34295
- CHU de Montpellier
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Ottaa yhteyttä:
- Lucas RIBEIRO, Dr
- Puhelinnumero: +33 0467337432
- Sähköposti: l-ribeiro@chu-montpellier.fr
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Päätutkija:
- Lucas RIBEIRO, Dr
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Osallistumiskriteerit
Kelpoisuusvaatimukset
Opintokelpoiset iät
- Aikuinen
- Vanhempi Aikuinen
Hyväksyy terveitä vapaaehtoisia
Kuvaus
Inclusion Criteria:
- Adults aged 18 and older
- Admitted for an unruptured arteriovenous malformation with a decision to proceed with surgery
Exclusion Criteria:
- Patients who refuse surgical treatment for arteriovenous malformation
- Contraindications to 18F-FDG PET (uncontrolled diabete)
- Patients' inability to lie still for 40 minutes
- Patients with a confirmed diagnosis of neurodegenerative or psychiatric disorders
- Pregnant or breastfeeding women (Article L.1121-5 of the French Public Health Code)
- Persons deprived of their liberty by judicial or administrative decision (Article L.1121-6 of the French Public Health Code)
- Persons who are subject to legal protection measures or who are unable to express their consent (guardianship, curatorship, judicial protection; Article L.1121-8 of the French Public Health Code)
- Not affiliated with a social security scheme or beneficiary of such a scheme (Article L.1121-8-1 of the French Public Health Code)
- Persons participating in another study that includes an ongoing exclusion period (Article L.1121-12 of the French Public Health Code)
- Failure to obtain written informed consent
Opintosuunnitelma
Miten tutkimus on suunniteltu?
Suunnittelun yksityiskohdat
- Ensisijainen käyttötarkoitus: Muut
- Jako: Ei käytössä
- Inventiomalli: Yksittäinen ryhmätehtävä
- Naamiointi: Ei mitään (avoin tarra)
Aseet ja interventiot
Osallistujaryhmä / Arm |
Interventio / Hoito |
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Kokeellinen: Kokeellinen käsivarsi
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For the 18F-FDG (fluorodeoxyglucose labelled with fluorine-18) PET scan, a dynamic protocol with the radiopharmaceutical injected directly under the scanner. The dose injected will be the same as that used in routine clinical practice, i.e. calculated based on the patient's weight. The patient must fast for 6 hours prior to the examination. The total duration of the dynamic PET scan is estimated at approximately 1 hour 30 minutes.
For the neuropsychological assessment, a series of standardised tests, validated for the assessment of cognitive functions, will be administered.
This assessment will be carried out by neuropsychologists trained in the use of these tests and who administer them as part of their routine practice, or by a trained physiatrist specialising in disorders of the central nervous system.
The neuropsychological assessment is expected to take 2 to 3 hours per visit for the patient.
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Mitä tutkimuksessa mitataan?
Ensisijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
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Change in Standardized Uptake Value (SUV)
Aikaikkuna: Before and at 6 months after surgical treatment of unruptured arteriovenous malformation
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Changes in Standardized Uptake Value (SUV) measured by 18F-FDG positron emission tomography (PET) in different brain regions (arteriovenous malformation region, arteriovenous malformation hemisphere including the arteriovenous malformation region, arteriovenous malformation hemisphere excluding the arteriovenous malformation region, contralateral hemisphere)
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Before and at 6 months after surgical treatment of unruptured arteriovenous malformation
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Change in K1 Transfer Constant
Aikaikkuna: Before and at 6 months after surgical treatment of unruptured arteriovenous malformation
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Change in the K1 transfer constant, representing the transfer of the tracer from the plasma compartment to the tissue compartment, measured by 18F-FDG positron emission tomography (PET) measured in different brain regions (arteriovenous malformation region, arteriovenous malformation hemisphere including the arteriovenous malformation region, arteriovenous malformation hemisphere excluding the arteriovenous malformation region, contralateral hemisphere).
Unit : mL.g-1.min-1
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Before and at 6 months after surgical treatment of unruptured arteriovenous malformation
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Change in Ki Net Influx Rate Constant
Aikaikkuna: Before and at 6 months after surgical treatment of unruptured arteriovenous malformation
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Change in Ki net influx rate constant measured by 18F-FDG positron emission tomography (PET) in different brain regions (arteriovenous malformation region, arteriovenous malformation hemisphere including the arteriovenous malformation region, arteriovenous malformation hemisphere excluding the arteriovenous malformation region, contralateral hemisphere).
Unit : mL.g-1.min-1
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Before and at 6 months after surgical treatment of unruptured arteriovenous malformation
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Change in Cerebral Metabolic Rate of glucose (CMRglu)
Aikaikkuna: Before and at 6 months after surgical treatment of unruptured arteriovenous malformation
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Change in cerebral metabolic rate of glucose (CMRglu) measured by 18F-FDG positron emission tomography (PET) in different brain regions (arteriovenous malformation region, arteriovenous malformation hemisphere including the arteriovenous malformation region, arteriovenous malformation hemisphere excluding the arteriovenous malformation region, contralateral hemisphere).
Unit : µmol.100g-¹.min-¹
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Before and at 6 months after surgical treatment of unruptured arteriovenous malformation
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Toissijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
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Headache impact
Aikaikkuna: Before, at 3 months and 6 months after surgical treatment of unruptured arteriovenous malformation
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Headache impact assessed by the total score on the Headache Impact Test - 6 items (HIT-6) Total score between 36 and 78.
A higher score indicates a greater functional impact.
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Before, at 3 months and 6 months after surgical treatment of unruptured arteriovenous malformation
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Visual attention and processing speed
Aikaikkuna: Before, at 3 months and 6 months after surgical treatment of unruptured arteriovenous malformation
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Visual attention and processing speed assessed by completion time on the Trail Making Test - Part A (TMT-A)
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Before, at 3 months and 6 months after surgical treatment of unruptured arteriovenous malformation
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Cognitive flexibility and executive control
Aikaikkuna: Before, at 3 months and 6 months after surgical treatment of unruptured arteriovenous malformation
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Cognitive flexibility and executive control assessed by completion time on the Trail Making Test - Part B (TMT-B)
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Before, at 3 months and 6 months after surgical treatment of unruptured arteriovenous malformation
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Inhibition and selective attention
Aikaikkuna: Before, at 3 months and 6 months after surgical treatment of unruptured arteriovenous malformation
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Inhibition and selective attention assessed by completion times and number of errors on the Stroop Test
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Before, at 3 months and 6 months after surgical treatment of unruptured arteriovenous malformation
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Working memory
Aikaikkuna: Before, at 3 months and 6 months after surgical treatment of unruptured arteriovenous malformation
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Working memory assessed by scores on the Digit Span subtest of the Wechsler Adult Intelligence Scale - Fourth Edition (WAIS-IV)
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Before, at 3 months and 6 months after surgical treatment of unruptured arteriovenous malformation
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Global verbal episodic memory
Aikaikkuna: Before, at 3 months and 6 months after surgical treatment of unruptured arteriovenous malformation
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Global verbal episodic memory assessed by scores on the 16-item Free Recall / Cued Recall test (RL/RI-16)
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Before, at 3 months and 6 months after surgical treatment of unruptured arteriovenous malformation
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Phonemic and semantic verbal fluency
Aikaikkuna: Before, at 3 months and 6 months after surgical treatment of unruptured arteriovenous malformation
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Phonemic and semantic verbal fluency assessed by the number of words produced on verbal fluency tests
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Before, at 3 months and 6 months after surgical treatment of unruptured arteriovenous malformation
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Ecological executive functioning
Aikaikkuna: Before, at 3 months and 6 months after surgical treatment of unruptured arteriovenous malformation
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Ecological executive functioning assessed by raw scores and composite indices on the Behavior Rating Inventory of Executive Function - Adult Version (BRIEF-A)
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Before, at 3 months and 6 months after surgical treatment of unruptured arteriovenous malformation
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Visual constructive abilities and visual memory
Aikaikkuna: Before, at 3 months and 6 months after surgical treatment of unruptured arteriovenous malformation
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Visual constructive abilities and visual memory assessed by scores on the Rey-Osterrieth Complex Figure Test
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Before, at 3 months and 6 months after surgical treatment of unruptured arteriovenous malformation
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Visual attention and spatial exploration
Aikaikkuna: Before, at 3 months and 6 months after surgical treatment of unruptured arteriovenous malformation
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Visual attention and spatial exploration assessed by the number of crossed-out targets, omissions, and their spatial distribution in the Bell Test.
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Before, at 3 months and 6 months after surgical treatment of unruptured arteriovenous malformation
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Yhteistyökumppanit ja tutkijat
Sponsori
Opintojen ennätyspäivät
Opi tärkeimmät päivämäärät
Opiskelun aloitus (Arvioitu)
Ensisijainen valmistuminen (Arvioitu)
Opintojen valmistuminen (Arvioitu)
Opintoihin ilmoittautumispäivät
Ensimmäinen lähetetty
Ensimmäinen toimitettu, joka täytti QC-kriteerit
Ensimmäinen Lähetetty (Todellinen)
Tutkimustietojen päivitykset
Viimeisin päivitys julkaistu (Todellinen)
Viimeisin lähetetty päivitys, joka täytti QC-kriteerit
Viimeksi vahvistettu
Lisää tietoa
Tähän tutkimukseen liittyvät termit
Avainsanat
Muita asiaankuuluvia MeSH-ehtoja
- Verisuonisairaudet
- Sydän-ja verisuonitaudit
- Synnynnäiset poikkeavuudet
- Kardiovaskulaariset poikkeavuudet
- Verisuonten epämuodostumat
- Synnynnäiset, perinnölliset ja vastasyntyneiden sairaudet ja poikkeavuudet
- Valtimolaskimon epämuodostumat
- Käyttäytymistieteet ja toiminnot
- Psykologiset testit
- Neuropsykologiset testit
Muut tutkimustunnusnumerot
- RECHMPL25_0330
Yksittäisten osallistujien tietojen suunnitelma (IPD)
Aiotko jakaa yksittäisten osallistujien tietoja (IPD)?
Lääke- ja laitetiedot, tutkimusasiakirjat
Tutkii yhdysvaltalaista FDA sääntelemää lääkevalmistetta
Tutkii yhdysvaltalaista FDA sääntelemää laitetuotetta
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