Interest of Functional Neuroimaging in Assessing Decision-making Capacity of Older People With Neurocognitive Disorders

NCT ID: NCT03931148

Last Updated: 2021-08-23

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

Clinical Phase

NA

Total Enrollment

74 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-01-05

Study Completion Date

2023-04-30

Brief Summary

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IMAGISION aims to explore, in a cohort of patients referred for geriatric consultation for neurocognitive evaluation, the contribution of functional neuroimaging (functional MRI and, if possible, high resolution EEG) to geriatric expertise, associated with the performance of a battery of neuropsychological tests in the evaluation of decision-making capacity.

Detailed Description

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It is during aging of patients, especially those with polypathological disorders and in whom cognitive disorders appear, that the most complex and ethical questions arise. In this context, these patients are frequently referred to geriatric consultations or memory centres for a global assessment of their cognitive functions and life skills in order to optimize their care and anticipate their medical and medico-social future. The assessment of decision-making capacity is essential in this regard.

Nevertheless, there is no test that specifically explores this issue and, therefore, people's decision-making abilities may not be properly estimated and may prevent some patients from making decisions when they would be able to do so.

Thus, although the issue of decision-making has generally been explored from a neuropsychological perspective in many studies, there is no specific test or score for decision-making capacity, as it is a complex process. The question of decision-making capacity in complex situations is therefore addressed by a multiple analysis of many parameters, including different neuropsychological data, which are then synthesized by the clinician in a standardized geriatric assessment to get an idea, among other things, of the overall ability to make decisions.

Given the difficulty of this and the ethical and societal issue, the research question focuses on the contribution of neuroimaging technologies to the assessment of decision-making capacity.

In fact, several studies have explored the issue as part of the functional neuroimaging study. The investigators note, in particular:

* Decision-making studies were conducted using the EEG-High Resolution (EEG-HR) technique. It is a technique for electromagnetic analysis of brain functions with excellent temporal resolution and quite good spatial resolution. This allows, during functional decision tests, a detailed analysis of the temporality of the activation of the frontal and prefrontal areas.
* Functional MRI (fMRI) is a neurological imaging technique whose main strength lies in its spatial acuity. Thus, the performance of functional decisional tests under functional MRI allows a detailed analysis of the recruitment of the different zones between the dorsolateral prefrontal cortex and the median ventromedian cortex.

These 2 neuroimaging techniques allowed a neuro-functional analysis of decision making, based on the realization of more specific tests, modelling decision making. Among these models, the Iowa Game Task and the Balloon Assessement Risk Task are frequently used.

Nevertheless, all these tests and explorations were conducted independently, and no studies have investigated the contribution of a neurofunctional approach to patient decision-making through complementary explorations in functional MRI and /or in EEG-HR as diagnostic tools as part of an overall gerontological evaluation of decision making ability.

The question that arises is therefore that of the development of diagnostic tools.

Conditions

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Decision Making Dementia Aging

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Analyses of functional imaging results (MRI and/or EEG) will be carried out blindly from the results of the geriatric assessment of decision-making ability. The results between the geriatrician's assessment of decision-making ability and the results of functional imaging tests will then be compared.

Study Groups

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Intervention

After first consultation for diagnosis of neurodegenerative disorder :

* Geriatric Assessment with specific neuropsychologic tests of decision making
* fRMI
* EEG High Resolution
* Qualitative interview

Group Type EXPERIMENTAL

Geriatric Assesment with neuropsychological test more specific on decision making

Intervention Type DIAGNOSTIC_TEST

The following tests will be made : MoCA, FAB, TMT, Stroop-Victoria, JAT

Functional RMI

Intervention Type DIAGNOSTIC_TEST

With specific test of decision making (IGT) specially adapted to the population

High Resolution EEG

Intervention Type DIAGNOSTIC_TEST

With specific test of decision making (BART) specially adapted to the population

Qualitative interview

Intervention Type OTHER

Qualitative semi-directed interviews with participants, their caregivers and their geriatrician to analyse everyday life decision making ability.

Interventions

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Geriatric Assesment with neuropsychological test more specific on decision making

The following tests will be made : MoCA, FAB, TMT, Stroop-Victoria, JAT

Intervention Type DIAGNOSTIC_TEST

Functional RMI

With specific test of decision making (IGT) specially adapted to the population

Intervention Type DIAGNOSTIC_TEST

High Resolution EEG

With specific test of decision making (BART) specially adapted to the population

Intervention Type DIAGNOSTIC_TEST

Qualitative interview

Qualitative semi-directed interviews with participants, their caregivers and their geriatrician to analyse everyday life decision making ability.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* French speaker
* Recent diagnosis of neurocognitive disorder
* Agreed with the study

Exclusion Criteria

* Delirium
* Major depressive symptoms
* MRI contraindication
Minimum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Université de Montréal

OTHER

Sponsor Role collaborator

Centre Hospitalier Universitaire de Besancon

OTHER

Sponsor Role lead

Responsible Party

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Thomas TANNOU

University Hospital Practitioner

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Regis AUBRY, PhD

Role: STUDY_CHAIR

Centre Hospitalier Universitaire de Besancon

Locations

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CRIUGM

Montreal, Quebec, Canada

Site Status RECRUITING

Centre Hospitalier Universitaire de Besancon

Besançon, Bourgogne-Franche-Comté, France

Site Status RECRUITING

Countries

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Canada France

Central Contacts

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Thomas TANNOU, MD

Role: CONTACT

+33381669003

Aurelie MARCEAU, PhD

Role: CONTACT

++33677132916

Facility Contacts

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Thomas TANNOU, MD

Role: primary

+15143403540

Sven JOUBERT, PhD

Role: backup

+15143403540

Thomas TANNOU, MD

Role: primary

+33381669003

References

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Tannou T, Godard-Marceau A, Joubert S, Daneault S, Kergoat MJ, Magnin E, Comte A, Gabriel D, Vidal C, Pazart L, Aubry R. Added value of functional neuroimaging to assess decision-making capacity of older adults with neurocognitive disorders: protocol for a prospective, monocentric, single-arm study (IMAGISION). BMJ Open. 2021 Sep 29;11(9):e053549. doi: 10.1136/bmjopen-2021-053549.

Reference Type DERIVED
PMID: 34588264 (View on PubMed)

Other Identifiers

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API3A2018

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

Don Du Souffle 2018

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

Prix H Mutuelle Alzheimer 2019

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

API/2018/100

Identifier Type: -

Identifier Source: org_study_id

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