Retina Microvascular Remodeling and Cognitive Function In Hypertension
NCT ID: NCT02701855
Last Updated: 2016-03-08
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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UNKNOWN
160 participants
OBSERVATIONAL
2014-10-31
2017-12-31
Brief Summary
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The study plans to enrol 160 patients (100 patients with mild cognitive impairment -MCI- and 60 without MCI).
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Detailed Description
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Study population is the following:
* 60 patients with hypertension and no MCI,
* 50 patients with hypertension and stable MCI, without dementia
* 50 patients with hypertension and progressive MCI, without dementia
Every patients will perform a medical interview and examination, an MRI (brain + aorta), adaptative optics imaging, a cognitive tests and a blood test.
Primary outcome is to determine the relationships between retina micro-vascular remodeling and cognitive function in this population.
Conditions
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Study Design
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CASE_ONLY
PROSPECTIVE
Study Groups
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Hypertension and progressive MCI
50 subjects will perform brain and aorta RMI, blood test, cognitive tests and adaptative optics.
Cognitive tests
Cognitive tests include:
* The MMSE (Mini Mental State Examination)
* Free and Cued Selective Recall Reminding Test (FCSRT).
* Executive functions (fluencies, TMT A and B, span).
* Tests of verbal fluency (literal and category)
* Digit symbol substitution test or Wechsler adult intelligence scale (W.A.I.S)
* The Clinical Dementia Rating Scale
* The IADL scale evaluates autonomy.
* Geriatric Depression screening Scale (GDS)
Blood test
A blood test will be performed in order to collect following parameters: Urea, BUN, Creatinine, Potassium, Sodium, hematocrit, hsCRP, NFS, Pq, LDL-C, HDL-C, Triglycerides, Lp(a), Lp-PLA2 as well as fasting glucose, HbA1C and microalbuminuria
Brain and aorta RMI
A magnetic resonance imaging exam will be performed at the Neuroimaging Research Center of the Pitié-Salpêtrière Hospital. This exam will be optimized to fit in 30 minutes. Indeed brain 3D T1 and T2 FLAIR imaging lasts 15 minutes while cine and velocity encoded imaging of the aorta lasts 15 minutes.
Adaptative optics
The retina adaptative optic imaging will be performed at the "Unité de prevention des maladies cardiovasculaires" Pitié Salpetrière Hospital. This exam lasts 10 minutes including patient positioning and imaging.
Hypertension and stable MCI
50 subjects will perform brain and aorta RMI, blood test, cognitive tests and adaptative optics.
Cognitive tests
Cognitive tests include:
* The MMSE (Mini Mental State Examination)
* Free and Cued Selective Recall Reminding Test (FCSRT).
* Executive functions (fluencies, TMT A and B, span).
* Tests of verbal fluency (literal and category)
* Digit symbol substitution test or Wechsler adult intelligence scale (W.A.I.S)
* The Clinical Dementia Rating Scale
* The IADL scale evaluates autonomy.
* Geriatric Depression screening Scale (GDS)
Blood test
A blood test will be performed in order to collect following parameters: Urea, BUN, Creatinine, Potassium, Sodium, hematocrit, hsCRP, NFS, Pq, LDL-C, HDL-C, Triglycerides, Lp(a), Lp-PLA2 as well as fasting glucose, HbA1C and microalbuminuria
Brain and aorta RMI
A magnetic resonance imaging exam will be performed at the Neuroimaging Research Center of the Pitié-Salpêtrière Hospital. This exam will be optimized to fit in 30 minutes. Indeed brain 3D T1 and T2 FLAIR imaging lasts 15 minutes while cine and velocity encoded imaging of the aorta lasts 15 minutes.
Adaptative optics
The retina adaptative optic imaging will be performed at the "Unité de prevention des maladies cardiovasculaires" Pitié Salpetrière Hospital. This exam lasts 10 minutes including patient positioning and imaging.
Hypertension, without MCI
60 subjects will perform brain and aorta RMI, blood test, cognitive tests and adaptative optics.
Cognitive tests
Cognitive tests include:
* The MMSE (Mini Mental State Examination)
* Free and Cued Selective Recall Reminding Test (FCSRT).
* Executive functions (fluencies, TMT A and B, span).
* Tests of verbal fluency (literal and category)
* Digit symbol substitution test or Wechsler adult intelligence scale (W.A.I.S)
* The Clinical Dementia Rating Scale
* The IADL scale evaluates autonomy.
* Geriatric Depression screening Scale (GDS)
Blood test
A blood test will be performed in order to collect following parameters: Urea, BUN, Creatinine, Potassium, Sodium, hematocrit, hsCRP, NFS, Pq, LDL-C, HDL-C, Triglycerides, Lp(a), Lp-PLA2 as well as fasting glucose, HbA1C and microalbuminuria
Brain and aorta RMI
A magnetic resonance imaging exam will be performed at the Neuroimaging Research Center of the Pitié-Salpêtrière Hospital. This exam will be optimized to fit in 30 minutes. Indeed brain 3D T1 and T2 FLAIR imaging lasts 15 minutes while cine and velocity encoded imaging of the aorta lasts 15 minutes.
Adaptative optics
The retina adaptative optic imaging will be performed at the "Unité de prevention des maladies cardiovasculaires" Pitié Salpetrière Hospital. This exam lasts 10 minutes including patient positioning and imaging.
Interventions
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Cognitive tests
Cognitive tests include:
* The MMSE (Mini Mental State Examination)
* Free and Cued Selective Recall Reminding Test (FCSRT).
* Executive functions (fluencies, TMT A and B, span).
* Tests of verbal fluency (literal and category)
* Digit symbol substitution test or Wechsler adult intelligence scale (W.A.I.S)
* The Clinical Dementia Rating Scale
* The IADL scale evaluates autonomy.
* Geriatric Depression screening Scale (GDS)
Blood test
A blood test will be performed in order to collect following parameters: Urea, BUN, Creatinine, Potassium, Sodium, hematocrit, hsCRP, NFS, Pq, LDL-C, HDL-C, Triglycerides, Lp(a), Lp-PLA2 as well as fasting glucose, HbA1C and microalbuminuria
Brain and aorta RMI
A magnetic resonance imaging exam will be performed at the Neuroimaging Research Center of the Pitié-Salpêtrière Hospital. This exam will be optimized to fit in 30 minutes. Indeed brain 3D T1 and T2 FLAIR imaging lasts 15 minutes while cine and velocity encoded imaging of the aorta lasts 15 minutes.
Adaptative optics
The retina adaptative optic imaging will be performed at the "Unité de prevention des maladies cardiovasculaires" Pitié Salpetrière Hospital. This exam lasts 10 minutes including patient positioning and imaging.
Eligibility Criteria
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Inclusion Criteria
2. hypertension (BP ≥140/90 mmHg and/or antihypertensive treatment)
3. Signed informed consent by the patient
4. Sufficient mastery of the French language to perform neuropsychological tests
Exclusion Criteria
2. Dementia (defined by MMSE\<20)
3. Clinical stroke
4. Severe or resistant Hypertension
5. Hypertension treated with more than 3 different pharmacological classes
6. any other disease that may interfere with the assessment of cognitive disorders (epilepsy, Parkinson's disease, major depression, schizophrenia, manic-depressive)
7. Enrolment in a therapeutic trial that could interfere with the main objective
8. Less than 4 years of formal education
9. Illiterate, unable to read, write or count
10. major physical problems that may interfere with the tests (sight, hearing, ...)
11. Short term life threatening disease
12. Non-affiliation to a healthcare system
13. Consent refusal
14. Contraindication to MRI including claustrophobia, metallic devices, pacemaker, mechanical valve implanted before 1985, and nursing, as well as technical contra-indication: patient diameter \> 70 cm or/and weight \> 250 kg
65 Years
ALL
No
Sponsors
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Fondation de Recherche sur l'Hypertension Artérielle
OTHER
Institute of Cardiometabolism and Nutrition, France
OTHER
Responsible Party
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Locations
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Unité de prévention des maladies cardiovasculaires Pôle Cardiologie/Métabolisme Hôpital Pitié-Salpétriêre, APHP, 83 bd de l'hôpital,
Paris, , France
Countries
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Central Contacts
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Facility Contacts
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David Rosenbaum, Dr
Role: primary
References
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Ferri CP, Prince M, Brayne C, Brodaty H, Fratiglioni L, Ganguli M, Hall K, Hasegawa K, Hendrie H, Huang Y, Jorm A, Mathers C, Menezes PR, Rimmer E, Scazufca M; Alzheimer's Disease International. Global prevalence of dementia: a Delphi consensus study. Lancet. 2005 Dec 17;366(9503):2112-7. doi: 10.1016/S0140-6736(05)67889-0.
Luchsinger JA, Reitz C, Honig LS, Tang MX, Shea S, Mayeux R. Aggregation of vascular risk factors and risk of incident Alzheimer disease. Neurology. 2005 Aug 23;65(4):545-51. doi: 10.1212/01.wnl.0000172914.08967.dc.
Launer LJ, Ross GW, Petrovitch H, Masaki K, Foley D, White LR, Havlik RJ. Midlife blood pressure and dementia: the Honolulu-Asia aging study. Neurobiol Aging. 2000 Jan-Feb;21(1):49-55. doi: 10.1016/s0197-4580(00)00096-8.
Qiu C, Winblad B, Fratiglioni L. The age-dependent relation of blood pressure to cognitive function and dementia. Lancet Neurol. 2005 Aug;4(8):487-99. doi: 10.1016/S1474-4422(05)70141-1.
Perlmutter LS, Barron E, Saperia D, Chui HC. Association between vascular basement membrane components and the lesions of Alzheimer's disease. J Neurosci Res. 1991 Dec;30(4):673-81. doi: 10.1002/jnr.490300411.
Hardy JA, Mann DM, Wester P, Winblad B. An integrative hypothesis concerning the pathogenesis and progression of Alzheimer's disease. Neurobiol Aging. 1986 Nov-Dec;7(6):489-502. doi: 10.1016/0197-4580(86)90086-2.
Vagnucci AH Jr, Li WW. Alzheimer's disease and angiogenesis. Lancet. 2003 Feb 15;361(9357):605-8. doi: 10.1016/S0140-6736(03)12521-4.
Hanon O, Haulon S, Lenoir H, Seux ML, Rigaud AS, Safar M, Girerd X, Forette F. Relationship between arterial stiffness and cognitive function in elderly subjects with complaints of memory loss. Stroke. 2005 Oct;36(10):2193-7. doi: 10.1161/01.STR.0000181771.82518.1c. Epub 2005 Sep 8.
Redheuil A, Yu WC, Wu CO, Mousseaux E, de Cesare A, Yan R, Kachenoura N, Bluemke D, Lima JA. Reduced ascending aortic strain and distensibility: earliest manifestations of vascular aging in humans. Hypertension. 2010 Feb;55(2):319-26. doi: 10.1161/HYPERTENSIONAHA.109.141275. Epub 2010 Jan 11.
Redheuil A, Yu WC, Mousseaux E, Harouni AA, Kachenoura N, Wu CO, Bluemke D, Lima JA. Age-related changes in aortic arch geometry: relationship with proximal aortic function and left ventricular mass and remodeling. J Am Coll Cardiol. 2011 Sep 13;58(12):1262-70. doi: 10.1016/j.jacc.2011.06.012.
Rosenbaum D, Koch E, Girerd X, Rossant F, Paques M. [Imaging of retinal arteries with adaptative optics, feasibility and reproducibility]. Ann Cardiol Angeiol (Paris). 2013 Jun;62(3):184-8. doi: 10.1016/j.ancard.2013.04.017. Epub 2013 May 29. French.
Herment A, Kachenoura N, Lefort M, Bensalah M, Dogui A, Frouin F, Mousseaux E, De Cesare A. Automated segmentation of the aorta from phase contrast MR images: validation against expert tracing in healthy volunteers and in patients with a dilated aorta. J Magn Reson Imaging. 2010 Apr;31(4):881-8. doi: 10.1002/jmri.22124.
Bollache E, Kachenoura N, Redheuil A, Frouin F, Mousseaux E, Recho P, Lucor D. Descending aorta subject-specific one-dimensional model validated against in vivo data. J Biomech. 2014 Jan 22;47(2):424-31. doi: 10.1016/j.jbiomech.2013.11.009. Epub 2013 Nov 15.
Dogui A, Kachenoura N, Frouin F, Lefort M, De Cesare A, Mousseaux E, Herment A. Consistency of aortic distensibility and pulse wave velocity estimates with respect to the Bramwell-Hill theoretical model: a cardiovascular magnetic resonance study. J Cardiovasc Magn Reson. 2011 Jan 27;13(1):11. doi: 10.1186/1532-429X-13-11.
Other Identifiers
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14DRM_EYEBRAIN
Identifier Type: -
Identifier Source: org_study_id
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