Genomic Profiling of Mitochondrial Disease - Imaging Analysis for Precise Mitochondrial Medicine
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| ClinicalTrials.gov Identifier: NCT05012358 |
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Recruitment Status :
Recruiting
First Posted : August 19, 2021
Last Update Posted : April 26, 2023
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| Condition or disease |
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| Mitochondrial Myopathies Mitochondrial DNA Mutation Mitochondrial Diseases Chronic Progressive External Ophthalmoplegia With Myopathy Kearns-Sayre Syndrome |
Mitochondrial myopathy follows a slowly progressive disease course of gradual worsening of muscle weakness and fatigability. Progressive mitochondrial dysfunction is thought to result in structural muscle deterioration (eventually muscle fiber atrophy/necrosis) and underlie these symptoms. Therefore, the study hypothesis is that longitudinal imaging of muscle will capture mitochondrial (using muscle MRS) and structural (using muscle MRI) abnormalities to inform objectively disease progression by capturing structural and biochemical changes in muscle over time.
Conventional multivariate analysis tools such as partial least squares-discriminant analysis (PLS-DA) and principal component analysis (PCA) will be used to assess variables of importance in discrimination of 3 subgroups based on underlying molecular defect (mitochondrial DNA (mtDNA) mutations and deletions, and nuclear gene mutations (nDNA)).
This will be followed by implementation of Collaborative Laboratory Integrated Reports (CLIR) software, a multivariate pattern recognition software that generates post-analytical interpretive tools. This study proposes to quantitatively measure MRS analytes (i.e. lactate, adenosine triphosphate (ATP), etc.) and structural muscle changes by MRI (edema, fat content, etc.). The capability for interactive data analysis would be necessary because of the nature of mitochondrial myopathy (MM) progression. One of the functionalities of CLIR is the creation of post-analytical tools applicable to either diagnosis of one condition - single condition tool; or differential diagnosis between two conditions with overlapping phenotypes (mtDNA deletions, mtDNA mutations, nDNA mutations) - dual scatter plots. The advantages of CLIR are (1) integration of primary markers with all informative permutations of ratios/biomarkers. Ratios calculated between markers not directly related at the biochemical level are particularly helpful to correct for pre-analytical factors and potential analytical bias (2) adjusted for multiple covariates (age, sex) (3) generating individual plots of disease progression.
This study is an observational longitudinal study involving the use of MRIs and video recordings taken at home of patients completing basic tasks. Subjects will be approached at outpatient appointments, or via phone/mail. Once consent is obtained, subjects will be asked to schedule an appointment with radiology to undergo the listed MRIs of the heart and/or muscle. Subjects will also be given instructions on how to use the video recording app on their personal devices, or study provided device. The subjects will be followed regularly over the course of two years, submitting video recordings of their movements and reporting to Mayo Clinic for MRIs as scheduled. Patients may withdraw from the study at any time without repercussion.
| Study Type : | Observational |
| Estimated Enrollment : | 90 participants |
| Observational Model: | Cohort |
| Time Perspective: | Prospective |
| Official Title: | Genomic Profiling of Mitochondrial Disease - Imaging Analysis for Precise Mitochondrial |
| Actual Study Start Date : | May 1, 2022 |
| Estimated Primary Completion Date : | May 2024 |
| Estimated Study Completion Date : | May 2024 |
| Group/Cohort |
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Observational Cohort
no intervention
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- Indicators of disease severity and progression - cardiac movement [ Time Frame: 2 years ]Establish the prevalence and severity of specific morbid indicators of disease severity through use of echocardiogram
- Indicators of disease severity and progression - cardiac function [ Time Frame: 2 years ]Establish the prevalence and severity of specific morbid indicators of disease severity through use of magnetic resonance imaging (MRI) of cardiac muscle
- Indicators of disease severity and progression - skeletal muscle function [ Time Frame: 2 years ]Establish the prevalence and severity of specific morbid indicators of disease severity through use of magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) of skeletal muscle
- Indicators of disease severity and progression - skeletal muscle movement [ Time Frame: 2 years ]Establish the prevalence and severity of specific morbid indicators of disease severity through use of video scoring scale during exercise
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.
| Ages Eligible for Study: | 15 Years to 80 Years (Child, Adult, Older Adult) |
| Sexes Eligible for Study: | All |
| Accepts Healthy Volunteers: | No |
| Sampling Method: | Non-Probability Sample |
Inclusion Criteria:
- Confirmed or suspected primary mitochondrial disorder *Suspected mitochondrial disorder would mean that the patient meets clinical criteria and has either biopsy or biochemical testing that supports the diagnosis.
Exclusion Criteria:
- Pregnant, breastfeeding
- Severe cardiac disease who are unable to undergo all the required testing
- Requiring anesthesia for MRIs
- Has severe claustrophobia
- Has implanted devices
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT05012358
| Contact: Erianna Burrel | 507-266-2019 | burrel.erianna@mayo.edu | |
| Contact: Alexandra Miller | 507-293-1139 | miller.alexandra@mayo.edu |
| United States, Minnesota | |
| Mayo Clinic | Recruiting |
| Rochester, Minnesota, United States, 55901 | |
| Contact: Kaitlin Schwartz 507-293-9114 schwartz.kaitlin@mayo.edu | |
| Contact: David Kveene 507-266-6917 kveene.david@mayo.edu | |
| Principal Investigator: Ralitza Gavrilova, MD | |
| Principal Investigator: | Ralitza Gavrilova, MD | Mayo Clinic |
| Responsible Party: | Ralitza Gavrilova, Associate Professor of Medical Genetics and Neurology, College of Medicine, Mayo Clinic |
| ClinicalTrials.gov Identifier: | NCT05012358 |
| Other Study ID Numbers: |
20-002721 |
| First Posted: | August 19, 2021 Key Record Dates |
| Last Update Posted: | April 26, 2023 |
| Last Verified: | April 2023 |
| Individual Participant Data (IPD) Sharing Statement: | |
| Plan to Share IPD: | No |
| Studies a U.S. FDA-regulated Drug Product: | No |
| Studies a U.S. FDA-regulated Device Product: | No |
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Mitochondrial DNA deletion |
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Muscular Diseases Mitochondrial Myopathies Ophthalmoplegia, Chronic Progressive External Kearns-Sayre Syndrome Ophthalmoplegia Mitochondrial Diseases Musculoskeletal Diseases Neuromuscular Diseases Nervous System Diseases Metabolic Diseases Ocular Motility Disorders Cranial Nerve Diseases Paralysis |
Neurologic Manifestations Eye Diseases Chronic Disease Disease Attributes Pathologic Processes Retinitis Pigmentosa Retinal Dystrophies Retinal Degeneration Retinal Diseases Cardiomyopathies Heart Diseases Cardiovascular Diseases |