RISCA : Prospective Study of Individuals at Risk for SCA1, SCA2, SCA3, SCA6, SCA7

NCT01037777 | Completed

• 1 other identifier: C08-37
• Study Type: observational
• Target: 37
• Locations: 1 country
• Sites: 1

Brief Summary

The spinocerebellar ataxias (SCAs) are a clinically and genetically heterogeneous group of autosomal dominantly inherited progressive ataxia disorders. It is estimated that there are 30,000 individuals in the European Community that directly descend from individuals affected by a SCA disorder and thus carry a 50% risk of having inherited an SCA mutation. These at risk individuals provide a unique research opportunity to prospectively study the presymptomatic phase of SCA disorders and to identify the earliest and most sensitive clinical signs and biological markers that herald the onset of the illness. This information is of critical importance for the development of future therapeutic interventions aimed at postponing the clinical onset of ataxia. We therefore propose to perform a prospective observational study of individuals at risk for the most common SCA disorders, SCA1, SCA2, SCA3 and SCA6 (RISCA). It is our aim to answer the following questions: (1) What is the incidence of disease manifestation in mutation carriers? (2) Which clinical signs precede the onset of manifest ataxia in SCA1, SCA2, SCA3 and SCA6? (3) What are the prevalence and incidence of preceding signs? (4) Are the prevalence and incidence of preceding signs affected by genotype, gender, age, estimated time until disease manifestation and repeat length? (5) Does the presence of certain preceding signs predict the manifestation of ataxia ? (6) Are there MRI alterations that precede the onset of ataxia? It is planned to enroll 480 study participants and to follow them at regular intervals over six years. At each visit, study participants are asked in a structured interview for a number of predefined clinical signs that potentially precede the onset of ataxia. In addition, the following self-assessment scales will be applied: Pittsburgh Sleep Quality Index (PSQI), Diagnostic Criteria for Restless Legs Syndrome, Patient´s Health Questionnaire (PHQ-9). All study participants will undergo a physical examination including the Scale for the Assessment and Rating of Ataxia (SARA). Study participants will further perform the SCA Functional Composite (SCA-FC) which is a comprehensive measure of functional capacity based on results in quantitative tests related to gait (8m timed walk), speech (PATA rate) and hand function (9 hole pegboard). In a subset of study participants, we will record eye movements and obtain volumetric MRIs. The study will also be used to collect and store blood and urine samples for proteomic and gene expression studies. RISCA is conducted by the Ataxia Study Group (ASG). It relies on the network structure created by the EUROSCA project.

Conditions

Spinocerebellar Ataxias

Keywords

individuals at risk for SCA1, SCA2, SCA3, SCA6 and SCA7

Outcome Measures

Primary Outcomes (12)

• Determination of the incidence rate of ataxia onset among mutation carriers

  Blood sample for a genetic test. Identification of individuals carrying a mutation for SCA types 1, 2, 3, 6, and 7

  Day 0

• Confidence Rating for Ataxia Assessment

  The invetigator must specify the degree of confidence in the presence of specific signs that may be associated with SCA ataxia . 90-100 % : investigator very confident in the diagnosis of ataxia, 70-89 % : high confidence, but with some uncertainty, 50-69 % : moderate confidence, \<50 % : significant uncertainty.

  Day 0, Month 24, Month 48, Month 72

• INAS scoring in ataxia (Inventory of Non-Ataxia Signs)

  Score range 0-16. 0 : No nonataxia signsdetected. Higher score : more non-ataxia neurological signs are present

  Day 0, Month 24, Month 48, Month 72

• Assessmet of sleep quality in ataxia : PSQI (Pittsburg Sleep Quality Index)

  The global PSQI score ranges from 0 to 21. 0-5 : good sleep quality. \>5 : Poor sleep quality / clinically significant slep disturbance. Higher scores : worse sleep quality

  Day 0, Month 24, Month 48, Month 72

• Restless Legs Syndrome (RLS) assessment in Ataxia

  Total Score : 0-40 0 : No RLS symptoms, 1-10 : Mild, 11-20 : Moderate, 21-30 : Severe, 31-40 : Very severe.

  Day 0, Month 24, Month 48, Month 72

• Assessment of depression by Patient's Health Questionnaire PHQ-9

  Used to evaluatethe severity of depressive symptoms, giving a total score rangong from 0 to 27. 0-4 : minimal or no deprssive symptoms, 5-9 : mild depression, 10-14 : moderate depression, 15-19 : moderately severe depression, 20-27 : severe depression

  Day 0, Month 24, Month 48, Month 72

• Assessment of the disease's impact on quality of life based on EQ-5D index (EuroQoL-5 Dimensions)

  It generally ranges from less than 0 to 1 (perfect health). Higher scores indicate a better quality of life

  Day 0, Month 24, Month 48, Month 72

• Assessment and Rating of Ataxia

  SARA (Scale of Assessment and Rating Ataxia) is an 8-item performance based scale, yielding a total score of 0 (no ataxia) to 40 (most severe ataxia).

  Day 0, Month 24, Month 48, Month 72

• Functional assessment of the severity of ataxia

  Using CCFS (Composite Cerebellar Functional Severity Score) method for assessing cerebellar ataxia across a wide range of severity. =0,85 : average value in an individual without ataxia. 0,90-1,00 : very mild or early-stage cerebellar impairment. 1,00-1,20 : Mild to moderate cerebellar impairment. \>1,2 : More pronounced cerebellar impairment.

  Day 0, Month 24, Month 48, Month 72

• Upper Limb motor coordination assessment

  A device equipped with a pre-calibrated force sensor that measures grip strength and lifting capacity, and a Polhemus 3D position sensor that measures position along the -x, -y, and -z axes and the object's orientation to assess movement. Grip force variability coefficient is calculated : Lowe % (more stable greap force control) - Higher % (greater variability and poorer motor coordination)

  Day 0, Month 24, Month 48, Month 72

• Finger tapping assessment

  Number of taps within 10 seconds (higher = better)

  Day 0, Month 24, Month 48, Month 72

• GAITRite in an ataxia assessment

  The participant walks along a carpet equipped with sensors that record the time it takes to make a step as well as the position of the feet.

  Day 0, Month 24, Month 48, Month 72

Secondary Outcomes (6)

• Functional performance assessment by 8MW test (8 meters walking time)

  Day 0, Month 24, Month 48, Month 72

• Functional performance assessment by 9HPT : Nine Hole Peg Test

  Day 0, Month 24, Month 48, Month 72

• Functional performance assessment by by PATA

  Day 0, Month 24, Month 48, Month 72

• Assessment of retinal thickness

  Day 0, Month 24, Month 48, Month 72

• Identification of slow saccades during eye tracking

  Day 0, Month 24, Month 48, Month 72

Study Arms (2)

presymptomatic carriers

non carrier relatives

Eligibility Criteria

• Age: 18 Years - 70 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

French population

You may qualify if:

• individuals at risk for spinocerebellar ataxia type 1, type 2, type 3, type 6 and type 7 (SCA1, SCA2, SCA3, SCA6 and SCA7)
• age between 18 and 50 years old for SCA1, SCA2, SCA3 or SCA7
• age between 35 and 70 years old for SCA6
• no clinical sign of ataxia (SARA \< 3)

You may not qualify if:

• no writing consent
• no family members affected
• presence of clinical sign of ataxia (SARA \> 3)

Sponsors & Collaborators

• Institut National de la Santé Et de la Recherche Médicale, France: lead

Study Sites (1)

Pitié Salpêtrière Hospital

Paris, 75013, France

Location

Related Publications (5)

• Wilke C, Haas E, Reetz K, Faber J, Garcia-Moreno H, Santana MM, van de Warrenburg B, Hengel H, Lima M, Filla A, Durr A, Melegh B, Masciullo M, Infante J, Giunti P, Neumann M, de Vries J, Pereira de Almeida L, Rakowicz M, Jacobi H, Schule R, Kaeser SA, Kuhle J, Klockgether T, Schols L; SCA3 neurofilament study group; Barro C, Hubener-Schmid J, Synofzik M. Neurofilaments in spinocerebellar ataxia type 3: blood biomarkers at the preataxic and ataxic stage in humans and mice. EMBO Mol Med. 2020 Jul 7;12(7):e11803. doi: 10.15252/emmm.201911803. Epub 2020 Jun 8.

  PMID: 32510847 RESULT

• Jacobi H, du Montcel ST, Romanzetti S, Harmuth F, Mariotti C, Nanetti L, Rakowicz M, Makowicz G, Durr A, Monin ML, Filla A, Roca A, Schols L, Hengel H, Infante J, Kang JS, Timmann D, Casali C, Masciullo M, Baliko L, Melegh B, Nachbauer W, Burk-Gergs K, Schulz JB, Riess O, Reetz K, Klockgether T. Conversion of individuals at risk for spinocerebellar ataxia types 1, 2, 3, and 6 to manifest ataxia (RISCA): a longitudinal cohort study. Lancet Neurol. 2020 Sep;19(9):738-747. doi: 10.1016/S1474-4422(20)30235-0.

  PMID: 32822634 RESULT

• Wilke C, Mengel D, Schols L, Hengel H, Rakowicz M, Klockgether T, Durr A, Filla A, Melegh B, Schule R, Reetz K, Jacobi H, Synofzik M. Levels of Neurofilament Light at the Preataxic and Ataxic Stages of Spinocerebellar Ataxia Type 1. Neurology. 2022 May 17;98(20):e1985-e1996. doi: 10.1212/WNL.0000000000200257. Epub 2022 Mar 9.

  PMID: 35264424 RESULT

• Jacobi H, Reetz K, du Montcel ST, Bauer P, Mariotti C, Nanetti L, Rakowicz M, Sulek A, Durr A, Charles P, Filla A, Antenora A, Schols L, Schicks J, Infante J, Kang JS, Timmann D, Di Fabio R, Masciullo M, Baliko L, Melegh B, Boesch S, Burk K, Peltz A, Schulz JB, Dufaure-Gare I, Klockgether T. Biological and clinical characteristics of individuals at risk for spinocerebellar ataxia types 1, 2, 3, and 6 in the longitudinal RISCA study: analysis of baseline data. Lancet Neurol. 2013 Jul;12(7):650-8. doi: 10.1016/S1474-4422(13)70104-2. Epub 2013 May 22.

  PMID: 23707147 RESULT

• Tezenas du Montcel S, Durr A, Rakowicz M, Nanetti L, Charles P, Sulek A, Mariotti C, Rola R, Schols L, Bauer P, Dufaure-Gare I, Jacobi H, Forlani S, Schmitz-Hubsch T, Filla A, Timmann D, van de Warrenburg BP, Marelli C, Kang JS, Giunti P, Cook A, Baliko L, Melegh B, Boesch S, Szymanski S, Berciano J, Infante J, Buerk K, Masciullo M, Di Fabio R, Depondt C, Ratka S, Stevanin G, Klockgether T, Brice A, Golmard JL. Prediction of the age at onset in spinocerebellar ataxia type 1, 2, 3 and 6. J Med Genet. 2014 Jul;51(7):479-86. doi: 10.1136/jmedgenet-2013-102200. Epub 2014 Apr 29.

  PMID: 24780882 RESULT

MeSH Terms

Conditions

Spinocerebellar Ataxias

Condition Hierarchy (Ancestors)

Cerebellar Ataxia; Cerebellar Diseases; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Spinocerebellar Degenerations; Spinal Cord Diseases; Heredodegenerative Disorders, Nervous System; Neurodegenerative Diseases; Ataxia; Dyskinesias; Neurologic Manifestations; Genetic Diseases, Inborn; Congenital, Hereditary, and Neonatal Diseases and Abnormalities

Study Design

• Study Type: observational
• Observational Model: FAMILY BASED
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER GOV
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: December 21, 2009
• First Posted: December 23, 2009
• Study Start: May 7, 2009
• Primary Completion: December 1, 2017
• Study Completion: December 14, 2017
• Last Updated: August 19, 2026

Record last verified: 2021-08

Locations

FR (1)