Retina Microvascular Remodeling and Cognitive Function In Hypertension

NCT ID: NCT02701855

Last Updated: 2016-03-08

Study Results

Results pending

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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Recruitment Status

UNKNOWN

Total Enrollment

160 participants

Study Classification

OBSERVATIONAL

Study Start Date

2014-10-31

Study Completion Date

2017-12-31

Brief Summary

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This study aims to determine the relationships between retina micro-vascular remodeling and cognitive function in hypertensive patients.

The study plans to enrol 160 patients (100 patients with mild cognitive impairment -MCI- and 60 without MCI).

Detailed Description

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Our project stands on physiopathological and cognitive angles, and is mainly based on the major role of large and small arteries elasticity on cognitive aging. It will benefit from the recent innovative accurate and non invasive techniques such as MRI for central large arteries and adaptative optics for retina arterioles imaging.

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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Hypertension Mild Cognitive Impairment

Study Design

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Observational Model Type

CASE_ONLY

Study Time Perspective

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

Intervention Type BEHAVIORAL

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

Intervention Type BIOLOGICAL

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

Intervention Type RADIATION

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

Intervention Type OTHER

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

Intervention Type BEHAVIORAL

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

Intervention Type BIOLOGICAL

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

Intervention Type RADIATION

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

Intervention Type OTHER

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

Intervention Type BEHAVIORAL

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

Intervention Type BIOLOGICAL

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

Intervention Type RADIATION

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

Intervention Type OTHER

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)

Intervention Type BEHAVIORAL

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

Intervention Type BIOLOGICAL

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.

Intervention Type RADIATION

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.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

1. Aged 65 or more
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

1. Impossibility to visualize the retinal : severe cataract
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
Minimum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Fondation de Recherche sur l'Hypertension Artérielle

OTHER

Sponsor Role collaborator

Institute of Cardiometabolism and Nutrition, France

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

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

Site Status RECRUITING

Countries

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France

Central Contacts

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David Rosenbaum, Dr

Role: CONTACT

01 42 17 57 74 ext. +33

Facility Contacts

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David Rosenbaum, Dr

Role: primary

References

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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.

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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.

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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.

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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.

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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.

Reference Type BACKGROUND
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Other Identifiers

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14DRM_EYEBRAIN

Identifier Type: -

Identifier Source: org_study_id

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