- ICH GCP
- US Clinical Trials Registry
- Klinisk utprøving NCT05281445
Exploring the Role of Neuroactive Steroids in Tourette Syndrome (NS in TS)
Studieoversikt
Status
Forhold
Intervensjon / Behandling
Detaljert beskrivelse
Tourette syndrome (TS) is a disabling neurodevelopmental disorder characterized by motor and phonic tics. Available treatment strategies remain unsatisfactory, due to limited knowledge of the biological foundations of this disorder. The studies proposed in this application will explore the mechanisms underlying two of the least well-understood biological characteristics of TS, namely its marked male predominance and stress susceptibility. Studies from the investigators suggest that these features of TS are contributed by neuroactive steroids, a family of mediators implicated in sex and stress regulation.
The typical age of onset of TS is 6-7 years, coinciding with adrenarche, a phase of adrenal maturation characterized by an upsurge in adrenal neuroactive steroids, such as dehydroepiandrosterone (DHEA) and its sulfate (DHEAS). In preliminary studies, the investigators found that DHEA exacerbated tic-like responses in animal models of TS. Interestingly, the dose of DHEA needed to elicit TS-like responses in females is higher than those needed in males, possibly pointing to a mechanism of sex differences in TS.
Stress reduces the ability of TS patients to suppress tics, but the underlying mechanisms remain unknown. Studies in animal models indicate that this process may be due to the elevation of the neuroactive steroid allopregnanolone (AP) in the prefrontal cortex. By inhibiting the ability of the prefrontal cortex to suppress tics, AP promotes tic execution. In a pilot study, the investigators found that tic suppression, a well-known stressful task in TS patients, increases AP salivary levels. Furthermore, in another proof-of-concept study, the investigators found that inhibiting AP synthesis led to a reduction in tic severity and facilitated voluntary control of tics in stressful situations.
These findings lead to the hypothesis that TS patients exhibit alterations of the composition of their neuroactive steroid profiles, including: 1) an increase in baseline DHEA(S) levels in male TS patients, in correlation with life-time severity; and 2) an exaggerated elevation in AP in response to acute stress.
The two Aims of this proposal will test this hypothesis by: 1) comparing the baseline urinary steroidomic profile of TS-affected boys and girls with non-affected sex- and age-matched controls; and 2) charting the dynamic alterations in steroidomic salivary profiles in response to tic suppression. These studies will advance understanding of the endocrine mechanisms in TS and lead to the identification of potential biomarkers for the severity of tics and comorbid symptoms. In the long run, the results of these studies may open the way for the development of new therapies for TS that may reduce tic severity and increase patients' responsiveness to behavioral interventions.
Studietype
Registrering (Forventet)
Fase
- Ikke aktuelt
Kontakter og plasseringer
Studiekontakt
- Navn: Marco Bortolato, MD PhD
- Telefonnummer: 8015873352
- E-post: marco.bortolato@utah.edu
Studer Kontakt Backup
- Navn: Michael Himle, PhD
- Telefonnummer: 8015817529
- E-post: michael.himle@utah.edu
Studiesteder
-
-
Utah
-
Salt Lake City, Utah, Forente stater, 84112
- University of Utah
-
Ta kontakt med:
- Michael Himle, PhD
- Telefonnummer: 801-581-7529
- E-post: michael.himle@utah.edu
-
-
Deltakelseskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
Tar imot friske frivillige
Kjønn som er kvalifisert for studier
Beskrivelse
Inclusion Criteria:
- Diagnostic criteria of TS for cases (and lack of any tic disorders for controls)
- Age between 8 and 12 years old (this age range is to ensure that TS participants can perform the tic suppression task)
- confirmation of sexual development by parent and/or self-reported Tanner stage of pubic hair development.
Exclusion Criteria:
- major psychiatric disorders such as a psychotic disorder, autism spectrum disorder, conduct disorder, and substance use disorder;
- other neurological disorders;
- clinically significant endocrinological disorders;
- use of therapies that can modify hormonal profile;
- pharmacotherapies that may change stress sensitivity, such as antidepressants and anxiolytics.
Studieplan
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Grunnvitenskap
- Tildeling: N/A
- Intervensjonsmodell: Enkeltgruppeoppdrag
- Masking: Ingen (Open Label)
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
---|---|
Eksperimentell: Tic suppression
Children with tics will undergo a tic suppression experimental paradigm.
|
Tic Suppression Task (TST, administered to Tourette syndrome participants only): At the beginning of the task, the child participant will be seated alone in front of a computer monitor with a countdown timer visible on the screen.
For the first 10 minutes (baseline condition) they will be asked to tic freely and not to try to suppress their tics.
For the second 10 minutes children will be asked to suppress their tics and will receive points for successful suppression.
Participants will then be asked to sit alone in the room and tic freely for an additional 10-minutes.
|
Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
---|---|---|
Salivary allopregnanolone concentrations
Tidsramme: Through study completion, an average of 2 years
|
Change of concentrations of salivary allopregnanolone, as measured by chromatography/ mass spectrometry.
All concentrations will be expressed in pg/ml.
|
Through study completion, an average of 2 years
|
Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
---|---|---|
Tic frequency
Tidsramme: Through study completion, an average of 2 years
|
Direct observation
|
Through study completion, an average of 2 years
|
Andre resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
---|---|---|
Measurement of salivary concentrations of other neuroactive steroids
Tidsramme: Through study completion, an average of 2 years
|
Changes in concentrations of pregnenolone, 17-hydroxypregnenolone, dehydroepiandrosterone, dehydroepiandrosterone sulfate, androstenediol, progesterone, androstenedione, testosterone, dihydroprogesterone, dihydrotestosterone, isoallopregnanolone, pregnanolone, epipregnanolone, 3-alpha androstanediol, androsterone, epiandrosterone, etiocholanolone, and cortisol as measured by chromatography/ mass spectrometry.
All concentrations will be expressed in pg/ml.
|
Through study completion, an average of 2 years
|
Samarbeidspartnere og etterforskere
Sponsor
Etterforskere
- Hovedetterforsker: Marco Bortolato, MD PhD, University of Utah
Studierekorddatoer
Studer hoveddatoer
Studiestart (Forventet)
Primær fullføring (Forventet)
Studiet fullført (Forventet)
Datoer for studieregistrering
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Faktiske)
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Ytterligere relevante MeSH-vilkår
- Psykiske lidelser
- Patologiske prosesser
- Hjernesykdommer
- Sykdommer i sentralnervesystemet
- Sykdommer i nervesystemet
- Sykdom
- Genetiske sykdommer, medfødte
- Basal ganglia sykdommer
- Bevegelsesforstyrrelser
- Nevrodegenerative sykdommer
- Heredodegenerative lidelser, nervesystemet
- Nevroutviklingsforstyrrelser
- Tic lidelser
- Syndrom
- Tourettes syndrom
Andre studie-ID-numre
- 00150143
Plan for individuelle deltakerdata (IPD)
Planlegger du å dele individuelle deltakerdata (IPD)?
Legemiddel- og utstyrsinformasjon, studiedokumenter
Studerer et amerikansk FDA-regulert medikamentprodukt
Studerer et amerikansk FDA-regulert enhetsprodukt
Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .
Kliniske studier på Tourettes syndrom hos barn
-
Zagazig UniversityRekrutteringof Lung Ultrasound in Diagnosis of Acute Respiratory Distress SyndromeEgypt
-
Women's Hospital School Of Medicine Zhejiang UniversityRekrutteringPolycystisk ovariesyndrom | in vitro fertiliseringKina
-
Institut Universitari DexeusAvsluttetPolycystisk ovariesyndrom | In vitro fertiliseringSpania
-
Second Affiliated Hospital, School of Medicine,...RekrutteringLocked-in syndrom; Pulmonal arteriovenøs misdannelseKina
-
OHSU Knight Cancer InstituteNational Cancer Institute (NCI); Oregon Health and Science UniversityRekrutteringOndartet fast neoplasma | Lynch syndrom | Neoplasma i hematopoetisk og lymfoid system | Duktalt brystkarsinom in situ | Arvelig neoplastisk syndrom | BRCA1/2-assosiert arvelig bryst- og ovariekreftsyndromForente stater
-
Damascus UniversityFullførtPolycystisk ovariesyndrom | Infertilitet | In vitro fertilisering | Intracytoplasmatisk spermieinjeksjonDen syriske arabiske republikk
-
Region SkaneRekrutteringMelanom | Mutasjon | Bilde | Dysplastisk Nevi | Melanom in situ | Føflekk (dermatologi)Sverige
-
Damascus UniversityFullførtPolycystisk ovariesyndrom | Infertilitet | In vitro fertilisering | Intracytoplasmatisk spermieinjeksjonDen syriske arabiske republikk
-
Mayo ClinicNational Cancer Institute (NCI)FullførtAnatomisk stadium I brystkreft AJCC v8 | Anatomisk stadium IA brystkreft AJCC v8 | Anatomisk stadium IB brystkreft AJCC v8 | Anatomisk stadium II brystkreft AJCC v8 | Anatomisk stadium IIA brystkreft AJCC v8 | Anatomisk stadium IIB brystkreft AJCC v8 | Anatomisk stadium III brystkreft AJCC v8 | Anatomisk... og andre forholdForente stater
-
McGill University Health Centre/Research Institute...RekrutteringDiabetes mellitus, type 1 | Wolfram syndrom | Neonatal diabetes | Monogen diabetes | Maturity-debut diabetes in the Young (MODY) | Wolcott-Rallison syndrom | Mitokondriell diabetesCanada
Kliniske studier på Tic suppression task
-
Bowdoin CollegeMassachusetts General HospitalFullført
-
KU LeuvenAktiv, ikke rekrutterende
-
Medical University of ViennaMedical University of GrazHar ikke rekruttert ennåHjerteutfall | Hemodynamisk måling | Ikke-invasivØsterrike
-
University of Texas at AustinRekrutteringTraume | Posttraumatisk stresslidelseForente stater
-
KU LeuvenFullførtParkinsons sykdom | Medikamentoverholdelse | Smarttelefon | Trykk på OppgaveBelgia
-
Instituto Nacional de Cardiologia Ignacio ChavezUkjent
-
Chang Gung Memorial HospitalRekrutteringMild kognitiv sviktTaiwan
-
Innovative Chemical and Environmental Technologies...National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)AvsluttetUrinveisinfeksjonForente stater
-
University of AmericasAktiv, ikke rekrutterendeSkjørhet | Funksjonell bevegelsesforstyrrelseChile