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Investigating the Neuropathology of Obstructive Sleep Apnoea (INcOSA)

2019년 10월 8일 업데이트: King's College London

Our multi-disciplinary research group works closely with people who have obstructive sleep apnoea. This is a life-long illness that causes breathing to stop during sleep, which leads to low-oxygen in the blood. Breathing restarts when the airway at the back of the throat reopens, usually during arousal from sleep. In some people the repeated arousals from sleep cause daytime sleepiness. Our research has shown that the low blood oxygen levels affect thinking and feeling, and in some cases we think it damages the brain cells involved with memory, attention, emotions and decision-making.

This study will investigate the relationship between the amount of oxygen in the blood and the loss (if any) of brain cells. Also how the ability to perform complex tasks is affected in patients that suffer from sleep apnoea. The results will show whether the brain damage in patients with sleep apnoea can be reversed with treatment. These findings will guide doctors in the treatment for sleep apnoea and they will cast light onto the process of memory decline with the aim to preserve brain function.

연구 개요

상태

완전한

상세 설명

This is a cross-sectional physiological study, which is anticipated to last for 4 years. In order to study the mechanism of cognitive dysfunction in Obstructive Sleep Apnoea (OSA), patients will start Continuous Positive Airway Pressure (CPAP) treatment following the confirmed diagnosis of sleep apnoea. CPAP is the treatment of choice for patients with moderate to severe OSA who are sleepy during the day. It is also used in patients with mild OSA if they are excessively sleepy or suffer from cardiovascular risk factors. It is recommended by the National Institute for Clinical Excellence (NICE) as a treatment for adults with moderate or severe OSA (Sleep apnoea - continuous positive airway pressure, NICE 2008). In the proposed study the initiation of CPAP will be within the 18 week period set out in the National Health Service (NHS) Improvement Plan and Standards for Better Health (Standards for Better Health, Department of Health 2004). No patient with a diagnosis of OSA will commence treatment with CPAP later than advised by the NICE guidelines of clinical judgement for the best interest of the patient.

In order to investigate the neuroinflammation process and discrete changes in the brain of patients with OSA, a minimum of 9 patients with mild OSA and 9 patients with severe OSA will be compared to 9 healthy controls following initial sleep (assessment) study. All participants will undergo a dynamic Positron Emission Tomography with Magnetic Resonance Imaging (PET-MR) scan with the Translocator protein (TSPO) tracer [Fluorine-18] N,N-diethyl-2-[4-(2-fluoroethoxy)phenyl]-5,7-dimethylpyrazolo[1,5-a]pyrimidine-3-acetamide (DPA-714) at the time of enrolment to the study. Each participant will also have an MRI scan and cognitive testing.

연구 유형

관찰

등록 (실제)

27

연락처 및 위치

이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.

연구 장소

      • London, 영국
        • Guy's Hospital Sleep Centre

참여기준

연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.

자격 기준

공부할 수 있는 나이

18년 (성인, 고령자)

건강한 자원 봉사자를 받아들입니다

연구 대상 성별

남성

샘플링 방법

비확률 샘플

연구 인구

Patient group:

  • Untreated patients with mild Sleep Apnoea - Apnoea-Hypopnoea Index (AHI) >5 events/hour and <10 events/hour with excessive sleepiness (Epworth sleepiness score >9).
  • Untreated patients with severe Sleep Apnoea - AHI >30 events/hour with excessive sleepiness (Epworth sleepiness score >9).

Healthy control group:

  • Male participants
  • No history of sleep disorders
  • AHI≤5/hour
  • No current or previous major neurological or psychiatric disease
  • Not currently undertaking neuropharmacological treatment
  • Non-smoker
  • No history of alcohol or recreational drug abuse, major organ failure
  • Not professional drivers or shift workers.

설명

INCLUSION CRITERIA:

Participants with OSA:

  • Male patients
  • With untreated OSA either mild (AHI≥5/hour and ≤10/hour)
  • or severe (AHI≥30/hour)
  • With excessive sleepiness (ESS≥9)
  • Aged 18-69 years

Healthy control group:

  • Male participants
  • No history of sleep disorders
  • AHI≤5/hour
  • No current or previous major neurological or psychiatric disease
  • Not currently undertaking neuropharmacological treatment
  • Non-smoker
  • No history of alcohol or recreational drug abuse
  • No major organ failure
  • Not professional drivers or shift workers

EXCLUSION CRITERIA:

  • Having other sleep disorders, neurological or psychiatric disease
  • Undertaking neuropharmacological treatment
  • Has a history of alcohol or recreational drug abuse, major organ failure
  • Professional drivers or shift workers
  • Unable to have MR scan (e.g. too heavy (>200Kg) or have ferromagnetic implants)
  • [18F]DPA-714 affinity too low
  • Inability to comprehend what is proposed
  • Inability to travel to the research sites

공부 계획

이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.

연구는 어떻게 설계됩니까?

디자인 세부사항

코호트 및 개입

그룹/코호트
Mild OSA
Untreated OSA patients. Apnoea-Hypopnoea Index (AHI) >5 events/hour and <10 events/hour with Epworth Sleepiness Score (ESS)>9.
Severe OSA
Untreated OSA patients. AHI >30 events/hour, with excessive sleepiness (ESS >9).
Healthy control
Healthy control. AHI <5 events/hour.

연구는 무엇을 측정합니까?

주요 결과 측정

결과 측정
측정값 설명
기간
Levels of neuroinflammation, brain morphology and neurophysiology will be measured via MRI, PET-MRI imaging & EEG.
기간: MRI, PET-MRI & EEG data analyses will begin right after the completion of data collection, and the summary of results will be reported as soon as available, expected before the completion date of the study as per IRAS 01/06/2020.
27 participants, 9 healthy controls, 9 mild patients & 9 severe patients.
MRI, PET-MRI & EEG data analyses will begin right after the completion of data collection, and the summary of results will be reported as soon as available, expected before the completion date of the study as per IRAS 01/06/2020.
Cognitive performance using the CANTAB battery.
기간: Cognitive performance data analyses will be conducted after the completion of data collection, and the summary of results will be reported along the rest of results in the summary that will be published before 01/06/2020.
27 participants, 9 healthy controls, 9 mild patients & 9 severe patients.
Cognitive performance data analyses will be conducted after the completion of data collection, and the summary of results will be reported along the rest of results in the summary that will be published before 01/06/2020.

2차 결과 측정

결과 측정
측정값 설명
기간
Genetic analysis and linkage to clinical and neuroimaging data will be measured using biological samples (blood or saliva) analysed and stored in the BioResource for Mental and Neurological Health.
기간: Genetic analysis and linkage to clinical and neuroimaging data analyses are expected to continue after the end of the primary study and they will be independently reported by the BioResource for Mental and Neurological Health KCL, within 5 years of study
18 patients, 9 mild & 9 severe.
Genetic analysis and linkage to clinical and neuroimaging data analyses are expected to continue after the end of the primary study and they will be independently reported by the BioResource for Mental and Neurological Health KCL, within 5 years of study

공동 작업자 및 조사자

여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.

수사관

  • 수석 연구원: Ivana Rosenzweig, MD, PhD, King's College London

연구 기록 날짜

이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.

연구 주요 날짜

연구 시작 (실제)

2017년 11월 1일

기본 완료 (실제)

2019년 9월 9일

연구 완료 (실제)

2019년 9월 9일

연구 등록 날짜

최초 제출

2016년 8월 17일

QC 기준을 충족하는 최초 제출

2016년 11월 15일

처음 게시됨 (추정)

2016년 11월 18일

연구 기록 업데이트

마지막 업데이트 게시됨 (실제)

2019년 10월 10일

QC 기준을 충족하는 마지막 업데이트 제출

2019년 10월 8일

마지막으로 확인됨

2019년 10월 1일

추가 정보

이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .

염증에 대한 임상 시험

3
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