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Investigating the Neuropathology of Obstructive Sleep Apnoea (INcOSA)

8 de outubro de 2019 atualizado por: 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.

Visão geral do estudo

Status

Concluído

Condições

Descrição detalhada

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.

Tipo de estudo

Observacional

Inscrição (Real)

27

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Locais de estudo

      • London, Reino Unido
        • Guy's Hospital Sleep Centre

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

18 anos a 70 anos (Adulto, Adulto mais velho)

Aceita Voluntários Saudáveis

Sim

Gêneros Elegíveis para o Estudo

Macho

Método de amostragem

Amostra Não Probabilística

População do estudo

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.

Descrição

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

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

Coortes e Intervenções

Grupo / Coorte
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.

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
Levels of neuroinflammation, brain morphology and neurophysiology will be measured via MRI, PET-MRI imaging & EEG.
Prazo: 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.
Prazo: 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.

Medidas de resultados secundários

Medida de resultado
Descrição da medida
Prazo
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.
Prazo: 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

Colaboradores e Investigadores

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Patrocinador

Colaboradores

Investigadores

  • Investigador principal: Ivana Rosenzweig, MD, PhD, King's College London

Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo (Real)

1 de novembro de 2017

Conclusão Primária (Real)

9 de setembro de 2019

Conclusão do estudo (Real)

9 de setembro de 2019

Datas de inscrição no estudo

Enviado pela primeira vez

17 de agosto de 2016

Enviado pela primeira vez que atendeu aos critérios de CQ

15 de novembro de 2016

Primeira postagem (Estimativa)

18 de novembro de 2016

Atualizações de registro de estudo

Última Atualização Postada (Real)

10 de outubro de 2019

Última atualização enviada que atendeu aos critérios de controle de qualidade

8 de outubro de 2019

Última verificação

1 de outubro de 2019

Mais Informações

Termos relacionados a este estudo

Outros números de identificação do estudo

  • 170912

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