Impact of the Central Blood Pressure Level in Cerebral Metabolic Aging: a 18F-FDG PET Study.

NCT03345290 | Completed

• 1 other identifier: PSS2016/PACTEP-VERGER/VS
• Study Type: interventional
• Target: 92
• Locations: 1 country
• Sites: 1

Brief Summary

Cerebral glycolytic metabolism can be quantified by quantitative analysis of 18F-Fluorodeoxyglucose (18F-FDG) Positron Emission Tomography (PET). This allows to identify neurological diseases at an early stage of functional abnormalities, before any anatomical lesions, and to differentiate them from the "normal" brain aging. Aging mainly leads to atrophy with a decrease in cerebral metabolism in the prefrontal cortex, with consequent deterioration of cognitive processes, in particular executive functions (5). In a population of 92 "control" subjects, investigators have already quantified the importance of the aging in frontal cortex hypometabolism. These patients were referred for a 18F-FDG PET in the follow-up of lymphoma considered to be in complete remission (PET without cerebral step), without any chemoradiotherapy within 2 months and with normal neuropsychological tests (Mini Mental State Examination, MMSE, Mini International Neuropsychiatric Interview MINI and Frontal Assessment Battery FAB). However, cerebral aging can be "accelerated" by vascular risk factors, including increased central blood pressure, as investigators have recently reported in a pilot study involving elderly patients. This central pressure, which is directly linked to the cerebral micro-vascularization, can be easily measured by applanation tonometry. In this pilot study, investigators showed that a central pulse pressure equal or greater than 50 mmHg was associated with a significant frontal hypometabolism in elderly patients. This confirmed, at a stage of pre-clinical remodeling, the worse prognostic significance for this criterion, as reported in large epidemiological studies (increased risk of stroke and cardiac vascular events). However, it is not yet known whether the level of central blood pressure interfere with the brain metabolism of younger subjects, especially with regard to aging observed throughout life. If this hypothesis is confirmed, preventive therapeutic strategies for accelerated aging, could thus integrate the monitoring of central pressure and cerebral metabolism. The objective of this study is to determine, in a population of control subjects and on a larger scale, the impact of central blood pressure on brain metabolic aging , by using 18F-FDG PET.

Conditions

Aging Disorder

Keywords

Aging; Central pressure; FDG PET

Outcome Measures

Primary Outcomes (3)

• volume of brain areas detected by quantitative analysis

  At inclusion

• topography of brain areas detected by quantitative analysis

  At inclusion

• central blood pressure

  At inclusion

Study Arms (1)

Subjects

EXPERIMENTAL

Subjects referred to a FDG PET scan (standard PET without cerebral step) without any oncologic setting. Patients will be included as following critera: 25% of subjects will have under 40 years old, 25% between 40 and 60 yeard old et 50% higher than 60 years old.

Device: PET with a cerebral step; Device: Central blood pressure measurement; Other: Neurocognitive tests

Interventions

PET with a cerebral step DEVICE

Positron Emission Tomography with a cerebral step before to carry out the standard Position Emission Tomography

Subjects

Central blood pressure measurement DEVICE

Central blood pressure measurement

Subjects

Neurocognitive tests OTHER

Mini Mental State Examination, MMSE, Mini International Neuropsychiatric Interview MINI and Frontal Assessment Batery FAB

Subjects

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• \> 18 years old, with written informed consent,
• Subjects referred for 18F-FDG PET in a non-oncological setting,
• Absence of pregnancy or breastfeeding,
• Lack of chemotherapy in the previous year and no cerebral radiotherapy.
• No history of psychiatric or neurological pathology.
• Absence of treatment with psychotropic action, and absence of corticosteroids.

You may not qualify if:

• "abnormal" neuropsychological tests:
• Mini Mental State Examination (MMSE) \<27,
• Current major depressive episode on the Mini International Neuropsychologic Interview (MINI),
• Frontal Assessment Battery (FAB) \<15.
• F-FDG PET examination showing ischemic, neurodegenerative, neoplastic or other brain lesions (independent of a normal or accelerated aging process).

Sponsors & Collaborators

• Central Hospital, Nancy, France: lead

Study Sites (1)

CHRU Nancy

Vandœuvre-lès-Nancy, 54511, France

Location

Related Publications (1)

• Hurstel M, Joly L, Imbert L, Zimmermann G, Roch V, Schoepfer P, Lamiral Z, Salvi P, Benetos A, Verger A, Marie PY. Volume of the proximal half of the thoracic aorta is the most comprehensive FDG-PET/CT indicator of arterial aging throughout adulthood. Eur J Hybrid Imaging. 2023 Jun 28;7(1):11. doi: 10.1186/s41824-023-00169-2.

  PMID: 37369917 DERIVED

MeSH Terms

Interventions

Mental Status and Dementia Tests

Intervention Hierarchy (Ancestors)

Neuropsychological Tests; Psychological Tests; Behavioral Disciplines and Activities

Study Officials

• Antoine Verger, MD, PhD

  CHRU Nancy

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: MD, PhD

Study Record Dates

• First Submitted: November 10, 2017
• First Posted: November 17, 2017
• Study Start: July 31, 2018
• Primary Completion: November 6, 2020
• Study Completion: November 6, 2020
• Last Updated: August 24, 2022

Record last verified: 2022-08

Locations

FR (1)