- ICH GCP
- Registro de ensaios clínicos dos EUA
- Ensaio Clínico NCT04198493
Effect of CPAP Treatment in Cognition in Adults With DS and OSA
Impact of Continuous Positive Airway Pressure Treatment on Cognitive Function in Adults With Down Syndrome With Obstructive Sleep Apnea
Adults with Down syndrome (DS) have a high prevalence of obstructive sleep apnea (OSA), which may worsen cognitive performance.
In general population, continuous positive airway pressure (CPAP), the gold Standard treatment for OSA, partially reverses cognitive impairment secondary to OSA. CPAP treatment, however, is not regularly proposed in adults with DS and OSA. It is usually presumed both by caregivers and physicians, that DS patients will not tolerate or adapt to the treatment, and that they would not benefit much more from CPAP treatment. Therefore, data about the feasibility and impact of CPAP treatment on cognitive function in this population is lacking.
The main objective of this study is to investigate cognitive performance in adults with DS and OSA, the corresponding functional brain changes and their reversibility with CPAP treatment.
Visão geral do estudo
Status
Condições
Intervenção / Tratamento
Descrição detalhada
Population Participants will be included from the Catalan Down Syndrome Foundation (FCSD). After obtaining a written informed consent, approved by the ethical committee, a total of 60 adult subjects of both sexes with SD and without dementia will be included. Forty subjects with a diagnosis of severe OSA (AHI> 30) without significant comorbidities or excessive daytime sleepiness (Epworth <12) and 20 subjects without OSA.
Objectives:
The general objective is to evaluate cognitive and/or behavioural dysfunction in adults with Down syndrome that can improve with CPAP treatment.
- By evaluating sleep, cognitive function and behaviour aspects in adults with Down syndrome with and without OSA.
- By assessing the changes in sleep, in cognitive, behavioural function, and brain connectivity measures after 6 month of treatment in subjects with DS and severe OSA.
Secondary objectives:
- Assess the relationship between the severity of OSA (AHI, hypoxemia, sleep fragmentation) and severity in cognitive impairment.
- Identify possible sleep and anthropometric parameters that could suggest a worsening in cognitive function in subjects with DS and OSA.
Methodology:
Open pilot study with randomized therapeutic intervention of parallel groups and blind evaluation in neuropsychological assessment.
Patients with severe OSA will be randomized to i) conservative treatment (CT) or to ii) CPAP and conservative treatment.
Patients included in the study will be monitored and followed for 6 months. Patients with severe OSA will perform follow up visits to monitor the objective compliance and side effects of the treatment in the 1st, 3rd and 6th month.
At baseline and after 6 months of treatment, in the three groups of subjects (i) Subjects without OSA, ii) Subjects with OSA and CPAP treatment, and iii) Subjects with OSA+ TC treatment , it will be performed:
Sleep evaluation:
Subjective sleep quality (Pittsburgh sleep quality index) and daytime Somnolence (Epworth Sleepiness Scale) Nocturnal sleep by polysomnography (PSG) Sleep-wake pattern by actigraphy
- Neurocognitive function with an extensive neuropsychological battery assessing mainly memory, attention and executive functions for DS population. (CAMCOG-DS, Cued Recall Test (CRT), different subtests of the Barcelona Test battery: orientation in person, time and space, language items (comprehension, reading and writing), verbal abstraction and oculomotor praxis, cats and dogs test, Attention cancellation test, verbal fluency test.
- Measures of cerebral functional connectivity: through measures of consistency, mutual information, probability of synchronization and transfer entropy.
Tipo de estudo
Inscrição (Antecipado)
Estágio
- Não aplicável
Contactos e Locais
Locais de estudo
-
-
-
Barcelona, Espanha, 08025
- Multidisciplinary Sleep Unit. Hospital de la Santa Creu i Sant Pau
-
-
Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
Aceita Voluntários Saudáveis
Gêneros Elegíveis para o Estudo
Descrição
Inclusion Criteria:
- Subjects of both sexes with ages over 18 years old with DS.
- A good general health with adequate visual and auditory acuity will be required
- Understanding and accepting the study procedures and signing an informed consent (guardian and / or patient).
- intelligence quotient(IQ) ratio> 34 (mild and moderate severe intellectual disability according to the International Statistical Classification of Diseases and Related Health Problems, ICD-10, criteria).
- Subjects without dementia: Absence of loss of cognitive functions (demonstrated by the longitudinal administration of neuropsychological tests and verified by family members)
- Absence of psychiatric comorbidity
Exclusion Criteria:
- Severe intellectual disability (due to limitations in cognitive tests)
- Presence of psychiatric pathology, unstable disease, cardiac or respiratory failure.
- Intake of psychoactive drugs in the three months prior to the study.
- Patients diagnosed with OSA, undergoing treatment with CPAP.
- Subjects with an Epworth Sleep Scale score > 12
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Tratamento
- Alocação: Randomizado
- Modelo Intervencional: Atribuição Paralela
- Mascaramento: Solteiro
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
---|---|
Experimental: Continuous Positive Airway Pressure(CPAP)
Patients with CPAP treatment. Titration will be performed by polysomnography CPAP to determine the optimal treatment pressure. This group will also be instructed in sleep hygiene and dietary counseling Intervention: Device: CPAP Other: Conservative treatment for OSA |
CPAP treatment every night plus conservative treatment for OSA: sleep hygiene and dietary counseling
Conservative treatment for OSA: sleep hygiene and dietary counseling
|
Comparador Ativo: CONSERVATIVE TREATMENT for OSA
Sleep hygiene and dietary counseling.
Sleep hygiene (regular sleep schedule, physical exercise) and dietary counseling Intervention: Other: Conservative treatment for OSA
|
Conservative treatment for OSA: sleep hygiene and dietary counseling
|
O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
---|---|---|
Assessment of the changes on cognitive attentional tasks
Prazo: Baseline and after 6 months of treatment
|
psychomotor speed (in seconds) performing an attentional task
|
Baseline and after 6 months of treatment
|
Changes in cerebral functional connectivity
Prazo: Baseline and after 6 months of treatment
|
Significant probability maps (SPM) showing statistical changes on connectivity measures between sleep stages
|
Baseline and after 6 months of treatment
|
Colaboradores e Investigadores
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Antecipado)
Conclusão Primária (Antecipado)
Conclusão do estudo (Antecipado)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
Outros números de identificação do estudo
- IIBSP-SAH-2019-62
Informações sobre medicamentos e dispositivos, documentos de estudo
Estuda um medicamento regulamentado pela FDA dos EUA
Estuda um produto de dispositivo regulamentado pela FDA dos EUA
Essas informações foram obtidas diretamente do site clinicaltrials.gov sem nenhuma alteração. Se você tiver alguma solicitação para alterar, remover ou atualizar os detalhes do seu estudo, entre em contato com register@clinicaltrials.gov. Assim que uma alteração for implementada em clinicaltrials.gov, ela também será atualizada automaticamente em nosso site .
Ensaios clínicos em CPAP
-
State Key Laboratory of Respiratory DiseaseConcluídoApnéia do Sono, Obstrutiva | Pressão positiva contínua nas vias aéreas | PolissonografiaChina
-
Chinese University of Hong KongConcluído
-
University of ZurichSwiss National Science FoundationConcluído
-
Ulysses Magalang MDRescindidoApneia obstrutiva do sonoEstados Unidos
-
Fisher and Paykel HealthcareSuburban Lung AssociatesConcluídoApnéia do Sono, ObstrutivaEstados Unidos
-
Krishna M. SundarConcluído
-
University Hospital, GrenobleConcluídoDéficit de memóriaFrança
-
Queen's UniversityRescindidoApneia Obstrutiva do Sono (AOS)Canadá
-
University Hospital, LilleConcluídoSíndromes da Apneia do Sono | Epilepsias ParciaisFrança
-
Ohio State UniversityConcluídoInsuficiência cardíaca | Apneia obstrutiva do sono | Insuficiência Cardíaca CongestivaEstados Unidos