RecruitingNCT03507257

Longitudinal Early-onset Alzheimer's Disease Study Protocol


Sponsor

Indiana University

Enrollment

850 participants

Start Date

Apr 30, 2018

Study Type

OBSERVATIONAL

Conditions

Summary

The Longitudinal Early-onset Alzheimer's Disease Study (LEADS) is a non-randomized, natural history, non-treatment study designed to look at disease progression in individuals with early onset cognitive impairment. Clinical, cognitive, imaging, biomarker, and genetic characteristics will be assessed across three cohorts: (1) early onset Alzheimer's Disease (EOAD) participants, (2) early onset non-Alzheimer's Disease (EOnonAD) participants, and (3) cognitively normal (CN) control participants.


Eligibility

Min Age: 40 YearsMax Age: 64 Years

Inclusion Criteria19

  • Meets NIA-AA criteria for MCI due to AD or probable AD dementia
  • Have a global CDR score ≤ 1.0
  • Have capacity to provide informed consent (IC) or has a legal authorized representative or guardian who provides IC
  • Age between 40-64 years (inclusive) at the time of consent
  • Must have a study partner (informant) who spends a minimum average of 10 hours per week with the participant (e.g., family member, significant other, friend, caregiver) who is generally aware of the participants' daily activities and can provide information about the participant's cognitive and functional performance. If the participant does not have a study partner who spends at least 10 face-to-face hours per week, other arrangements for identifying a viable study partner will be granted on a case-by-case basis by the Site PI
  • Willing and able to complete longitudinal study procedures aside from LP which is an optional procedure
  • Not pregnant or lactating. Women must be two years post-menopausal, be surgically sterile, or have a negative pregnancy test prior to each PET scan
  • Fluent in English or Spanish if enrolled in the U.S.
  • Fluent in English, Spanish, Dutch or Swedish for sites outside the U.S., according to site's spoken language(s).
  • Meets criteria for cognitively normal, based on an absence of significant impairment in cognitive functions or activities of daily living
  • Have a global CDR score = 0
  • Have capacity to provide informed consent
  • Have a Mini-Mental State Exam score between 26-30 (inclusive). Exceptions may be made for participant with less than 8 years of education at the discretion of the Site PI
  • Age between 40-64 years (inclusive) at the time of consent
  • Must have a study partner (informant) who spends a minimum average of 10 hours per week with the participant (e.g., family member, significant other, friend, caregiver) who is generally aware of the participants' daily activities and can provide information about the participant's cognitive and functional performance. If the participant does not have a study partner who spends 10 face-to-face hours per week, other arrangements for identifying a viable study partner will be granted on a case-by-case basis by the Site PI
  • Willing and able to complete longitudinal study procedures aside from LP which is an optional procedure
  • Not pregnant or lactating. Women must be two years post-menopausal, be surgically sterile, or have a negative pregnancy test prior to each PET scan
  • Fluent in English or Spanish if enrolled in the U.S.
  • Fluent in English, Spanish, Dutch or Swedish for sites outside the U.S., according to site's spoken language(s).

Exclusion Criteria19

  • Meets core clinical criteria for non-AD dementia
  • Two or more first degree relatives with a history of early-onset dementia suggestive of autosomal dominant transmission, unless known pathogenic mutations in APP, PSEN1, PSEN2, MAPT, GRN and C9ORF72 have been excluded
  • Known CLIA certified mutation in an ADAD gene (APP, PSEN1, PSEN2), or other autosomal dominant genes associated with other neurodegenerative disorders (MAPT, GRN, C9ORF72)
  • Contraindications to 3T MRI (e.g., claustrophobia, pacemaker, select aneurismal clip, artificial heart valve, select ear implants, select stents incompatible with 3T MRI, metal fragments or foreign objects in the eyes, skin or body, etc.)
  • Lifetime medical history of a brain disorder other than the disorder causing dementia except for headache (exceptions are allowed at the discretion of the Site PI - e.g., seizure disorder thought to be due to EOAD).
  • MRI scan with evidence of infection or focal lesions, cortical strokes, multiple lacunes (single lacune is allowable unless it meets criteria for strategic lacune affecting cognition)
  • Any significant systemic illness or unstable medical condition, which could lead to difficulty complying with the protocol (at the discretion of the Site PI)
  • Research radiation exposure will be assessed by the study physician. If the candidate participant has had more than one nuclear medicine study in the prior 12 months for research-related purposes, study inclusion will require approval from the PET Core
  • Investigational agents are prohibited 30 days prior to entry
  • Previous enrollment in a therapeutic trial targeting amyloid or tau.
  • Participation in other clinical studies with neuropsychological measures, with the exception of participants who are co-enrolled in the NACC Uniform Data Set (UDS) protocol (Note: This criterion is intended to reduce repeat measures effects during neuropsychological testing. Exceptions are allowed at the discretion of the Site PI)
  • Lifetime history of schizophrenia spectrum disorders (DSM-5 criteria)
  • Current history (in previous 12 months) of DSM-5 diagnosis of mania, bipolar disorder with or without psychotic features
  • Current history (in previous 6 months) of moderate or severe substance abuse (nicotine or caffeine is allowed)
  • Suicidal behaviors in the past 12 months or active suicidal ideations
  • Residing in a 24-hour care skilled nursing facility (at the time of screening)
  • (For optional lumbar puncture procedure only):
  • a. Clinical laboratory values must be within normal limits or, if abnormal, must be judged to be not clinically significant by the Site PI i. Platelet count \<100,000/ml ii. INR\>1.2 iii. Abnormal PT or PTT at screening b. Contraindications to the procedure, including but not limited to severe degenerative joint disease, deformity of the spine, history of a bleeding disorder c. Suspected elevated intracranial pressure, Arnold Chiari malformation or mass lesion d. Use of the anticoagulant medications such as but not limited to warfarin, rivaroxaban, dabigatran
  • Deemed ineligible by the Site PI for any other reason

Interventions

DRUGFlortaucipir

All participants will receive a single bolus intravenous injection of approximately 10 mCi (+/- 10%, 20μg mass dose) of flortaucipir (18F-AV-1451). At approximately 75-minutes post dose, scanning will begin. An approximately 30-minute image acquisition scan will be performed.

DRUGFlorbetaben

All participants will receive a single bolus intravenous injection of approximately 8 mCi +/- .8mCi of florbetaben (AV-45). At approximately 90-minutes (+/- 10 minutes) post dose, scanning will begin. An approximately 20-minute image acquisition scan will be performed.

DRUGFluorodeoxyglucose

All participants will receive a single bolus intravenous injection of approximately 5 mCi (+/- 10%, 0.5 mCi) of fluorodeoxyglucose. At approximately 30 minutes post dose, scanning will begin. An approximately 30-minute image acquisition scan will be performed.


Locations(23)

Banner Sun Health Research Institute

Sun City, Arizona, United States

University of California, Los Angeles

Los Angeles, California, United States

Stanford University

Palo Alto, California, United States

University of California, San Francisco

San Francisco, California, United States

Georgetown University

Washington D.C., District of Columbia, United States

Mayo Clinic, Jacksonville

Jacksonville, Florida, United States

Wien Center

Miami Beach, Florida, United States

Emory University

Atlanta, Georgia, United States

Northwestern University

Chicago, Illinois, United States

Indiana University

Indianapolis, Indiana, United States

Johns Hopkins University

Baltimore, Maryland, United States

Massachusetts General Hospital

Boston, Massachusetts, United States

Mayo Clinic, Rochester

Rochester, Minnesota, United States

Washington University, St. Louis

St Louis, Missouri, United States

Columbia University

New York, New York, United States

University of Pennsylvania

Philadelphia, Pennsylvania, United States

Butler Hospital

Providence, Rhode Island, United States

Houston Methodist Hospital

Houston, Texas, United States

Fleni

Buenos Aires, Argentina

Amsterdam UMC

Amsterdam, Netherlands

Hospital de la Santa Creu i Sant Pau

Barcelona, Spain

Lund University

Malmo, Sweden

University College London

London, United Kingdom

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NCT03507257


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