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Fluorescence Guided Focal Cortical Dysplasia Surgery (FLUOFOCODYS)

15 de junho de 2026 atualizado por: Hospices Civils de Lyon

Epilepsy is one of the most common neurological disorders, with one of the highest morbidity rates of all diseases. Despite the development of new anticonvulsant drugs, around a third of patients suffer from drug-resistant epilepsy (RPE). The onset of RPE can be lengthy, prolonging the period during which affected patients live with seizures that have a negative impact on their quality of life. Epilepsy surgery can be a curative treatment, and can enable anticonvulsant medication to be discontinued, optimizing quality of life and cognitive development. In addition, as it has been shown that the prolonged duration of epilepsy prior to surgery has an impact on the occurrence of postoperative seizures, early surgery is increasingly being considered. Focal cortical dysplasia (FCD) is the leading cause of focal lesional epilepsy and is generally drug-resistant. Good postoperative seizure results after surgical resection are strongly linked to complete resection of the dysplastic tissue. Consequently, accurate localization and precise delineation of FCD lesions are crucial during surgery. Currently, the extent of surgical resection is based primarily on preoperative examination, as the macroscopic appearance of dysplastic tissue does not differ from normal cortex. The various intraoperative techniques available to improve the quality of excision (neuronavigation, ultrasound, intraoperative MRI and intraoperative guidance by fluorescence microscopy) all have their limitations. In this context, new intraoperative tools are needed to help the neurosurgeon delineate lesions during surgery. Intraoperative fluorescence spectroscopy is used for surgical guidance of gliomas and other brain pathologies, and has demonstrated its ability to characterize pathological tissues. DCFs exhibit metabolic differences that can also be detected by 5-amino-levulinic acid (5-ALA)-induced protoporphyrin IX (PpIX) fluorescence intraoperatively. Indeed, in some patients who underwent surgery after a diagnosis of glioma, fluorescence was observed even though histological analysis classified the excised tissue as DCF. What's more, glioma and DCF share a common feature: the mitochondria of affected cells are deficient in complex IV. Cytochrome c oxidase (CCO) is largely involved in mitochondrial complex IV, and NAD is a central metabolite involved in redox reactions within cells. Both metabolites (CCO and NAD) can be visualized intraoperatively by optical and fluorescence spectroscopy.

FLUOFOCODYS is a prospective, non-comparative, single-center, human drug pilot clinical trial. 5 patients will be included.

Visão geral do estudo

Status

Ainda não está recrutando

Condições

Intervenção / Tratamento

Descrição detalhada

Primary objective of FLUOFOCODYS study is to measure the fluorescence of biomarkers of focal epileptic lesions by intraoperative fluorescence spectroscopy.

The secondary objectives are as follows:

  1. To compare the measurement of FCD volume between multimodal high-resolution MRI (HRM) and standard MRI.
  2. To assess the concordance of FCD measurements between multimodal high-resolution MRI (HRM) and standard MRI.
  3. Evaluate the correlation between fluorescence spectroscopy and SpiderMass measurements on the collected tissue sample.
  4. Describe any adverse events that occurred after treatment up to the end of study participation.

The hypothesis of this project is that intraoperative fluorescence spectroscopy could robustly measure 5-ALA-induced protoporphyrin IX fluorescence in FCD and could ultimately aid FCD surgery. Thus, to understand intraoperative biomarker fluorescence spectroscopy in DCF, preoperative MRI and postoperative histology are crucial. This will enable MRI-informed intraoperative fluorescence spectroscopy. These comparative measurements will be completed with SpiderMass technology (metabo-lipidomic mass spectrometry). The effectiveness of intraoperative tools could therefore be assessed prior to surgery, which could have an impact on the therapeutic decision to proceed with surgery.

Tipo de estudo

Intervencional

Inscrição (Estimado)

5

Estágio

  • Fase 2

Contactos e Locais

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Contato de estudo

Estude backup de contato

Locais de estudo

  • França
      • Bron, França, 69500
        • Hôpital Neurologique Pierre Wertheimer - Groupement Hospitalier Est - Hospices Civils de Lyon
        • Contato:
        • Investigador principal:
          • Marc GUENOT
      • Bron, França
        • Hôpital Femme Mère Enfant - Groupement Hospitalier Est - Hospices Civils de Lyon
        • Contato:
        • Investigador principal:
          • Pierre-Aurélien BEURIAT, MD

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

  • Filho
  • Adulto
  • Adulto mais velho

Aceita Voluntários Saudáveis

Não

Descrição

Inclusion Criteria:

  • Patient with drug resistant epilepsy, related to a type II FCD visible on MRI
  • Patient with surgical indication validated by the epileptic multi-disciplinary staff meeting
  • First FCD surgery
  • Signed written informed consent before any study specific intervention
  • Patient affiliated to the national health system or benefiting from it

Exclusion Criteria:

  • Patients weighing over 75kg
  • Patients requiring general anaesthesia for MRI at investigator discretion
  • Contra indication to MRI : obesity, claustrophobia, metallic object
  • Hypersensitivity to the active substance or to porphyrins
  • Acute or chronic porphyria
  • For woman of childbearing potential: Pregnancy or breastfeeding or patients who is not willing to comply with the contraceptive requirements during the study period
  • Inability to follow the procedures of the study
  • Simultaneous enrolment to another study which could influence the results of the current study
  • Patient under legal protection or deprived of liberty

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

  • Finalidade Principal: Outro
  • Alocação: N / D
  • Modelo Intervencional: Atribuição de grupo único
  • Mascaramento: Nenhum (rótulo aberto)

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Experimental: 5-ALA (Gliolan)
Children and adults with drug resistant epilepsy, related to a probable FCD and with surgical indication validated by the epileptic multi-disciplinary staff meeting will receive the study treatment (5-ALA) orally at a dose of 20mg/kg
Medicamento: 5-ALA (Gliolan)
Patients will be given 5-ALA (20 mg per kilogram body weight) before the surgery, between 2 and 4 hours before anaesthesia.

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
Concentration of fluorescent compound (in mol/L) during the chirurgical intervention on the extracted tissue sample of FCD
Prazo: Day 0
Measure of biomarkers fluorescence of focal epileptic lesion by intraoperative fluorescence spectroscopy.
Day 0

Medidas de resultados secundários

Medida de resultado
Descrição da medida
Prazo
FCD volume in mm3 on standard MRI
Prazo: 60 days before Day 0 (=surgery)
Compare FCD volume between High Resolution-MultiModal-MRI and standard MRI.
60 days before Day 0 (=surgery)
FCD volume in mm3 on High Resolution MM- MRI
Prazo: Day 0 (=surgery)
Compare FCD volume between High Resolution-MultiModal-MRI and standard MRI.
Day 0 (=surgery)
Index kappa concordance of the volume in mm3 of focal cortical dysplasia measured by standard MRI
Prazo: 60 days before day 0
Evaluation of the concordance of FCD measurements between HR-MM-MRI and standard MRI
60 days before day 0
Index kappa concordance of the volume in mm3 of focal cortical dysplasia measured by HR MM-MRI
Prazo: Day 0
Evaluation of the concordance of FCD measurements between HR-MM-MRI and standard MRI
Day 0
Concentration measured by fluorescence spectroscopy on extracted tissue sample of FCD
Prazo: Day 0
Evaluation of correlation between fluorescence spectroscopy measurements and Spidermass measurements on extracted tissue sample of FCD.
Day 0
Relative concentration of molecular species measured by SpiderMass on extracted tissue sample of FCD
Prazo: Day 0
Evaluation of correlation between fluorescence spectroscopy measurements and Spidermass measurements on extracted tissue sample of FCD.
Day 0
Number of adverse events
Prazo: From the enrollment to day 1
Description of any Adverse Events that have occurred after the experimental treatment until end of study participation
From the enrollment to day 1

Colaboradores e Investigadores

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

Patrocinador

Hospices Civils de Lyon

Investigadores

  • Investigador principal: Pierre-Aurélien BEURIAT, Hospices Civils de Lyon

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 (Estimado)

1 de setembro de 2026

Conclusão Primária (Estimado)

1 de setembro de 2028

Conclusão do estudo (Estimado)

1 de setembro de 2028

Datas de inscrição no estudo

Enviado pela primeira vez

15 de junho de 2026

Enviado pela primeira vez que atendeu aos critérios de CQ

15 de junho de 2026

Primeira postagem (Real)

18 de junho de 2026

Atualizações de registro de estudo

Última Atualização Postada (Real)

18 de junho de 2026

Última atualização enviada que atendeu aos critérios de controle de qualidade

15 de junho de 2026

Última verificação

1 de junho de 2026

Mais Informações

Termos relacionados a este estudo

Palavras-chave

Termos MeSH relevantes adicionais

Outros números de identificação do estudo

  • 69HCL24_0906
  • 2025-523608-64-00 (Ctis)

Plano para dados de participantes individuais (IPD)

Planeja compartilhar dados de participantes individuais (IPD)?

INDECISO

Informações sobre medicamentos e dispositivos, documentos de estudo

Estuda um medicamento regulamentado pela FDA dos EUA

Não

Estuda um produto de dispositivo regulamentado pela FDA dos EUA

Não

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 .

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