Narcolepsy Protect Against Alzheimer's Disease?

NCT03378453 | Completed DMC

• 1 other identifier: 9636
• Study Type: interventional
• Target: 38
• Locations: 1 country
• Sites: 1

Brief Summary

Links between orexin and amyloid processes have been underlined recently. During the Alzheimer's process an upregulation of the orexin mechanism has been observed. The pathophysiological mechanism of narcolepsy type 1 is linked to orexin deficiency. Thus, the investigators hypothesized that patients with narcolepsy may be protected from amyloid brain lesions, hallmarks of the Alzheimer's process. To test this hypothesis, the investigators analyzed the brain amyloid load measured by PET-scan amyloid brain imaging in patients with narcolepsy type 1 compared to controls without cognitive deficits.

Conditions

Narcolepsy; Amyloid Pathology

Keywords

Narcolepsy; Alzheimer; Orexin; Amyloid; PET-amyloid imaging

Outcome Measures

Primary Outcomes (1)

• Mean of cortical SuVr based of the PET-scan18F-AV-45 imaging

  Mean of cortical SuVr based of the PET-scan18F-AV-45 imaging

  Upon study completion, an average of one year

Secondary Outcomes (11)

• Mean regional SuVr with PET-scan AV45

  Upon study completion, an average of one year

• CSF Amyloid Aβ42

  Upon study completion, an average of one year

• CSF Amyloid Aβ40

  Upon study completion, an average of one year

• CSF Tau protein

  Upon study completion, an average of one year

• CSF Orexin concentration

  Upon study completion, an average of one year

Study Arms (2)

NarCo

OTHER

Narcolepsy type 1 over 65 years old

Device: PET-scan18F-AV-45

CoS

OTHER

Cognitevement healthy controls

Device: PET-scan18F-AV-45

Interventions

PET-scan18F-AV-45 DEVICE

The PET-scan18F-AV-45 is a PET-scan dedicated to analyze the amyloid load in the brain with the AV45 tracer by the measurement of the mean cortical SuVr

NarCo

Eligibility Criteria

• Age: 65 Years - 85 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)

You may qualify if:

• Narcolepsy group:
• Patients with narcolepsy type 1 older than 65 y.o. with orexin deficiency as required by international diagnosis criteria (ICSD3) with a follow-up in the national reference center for narcolepsy;
• Treated or not with psychostimulant drugs in relation to disease symptoms;
• Patients with CSF samples available or with scheduled lumbar puncture for diagnosis purpose;
• No contra-indications of the PET-scan18F-AV-45
• With a free and informed consent to participate to the study.
• Control group:
• Subjects already included in the MEMENTO-AMYging and/or MAPT-AV45 ancillary studies in the memory center with normal cognitive tests after neuropsychological assessments especially in the episodic memory tests and the brain amyloid PET-scan18F-AV-45 data with SuVr measurements.

You may not qualify if:

• Controls subjects or patients without free and informed consent to participate to the study
• No PET-scan18F-AV-45 data available
• No CSF samples
• Pathologies being life-threatening in a short term
• Patients deprived of freedom by court or administrative order
• Patients living in institution
• Major protected by the Law.

Sponsors & Collaborators

• University Hospital, Montpellier: lead

Study Sites (1)

Montpellier University Hospital, Gui de Chauliac

Montpellier, 34295, France

Location

Related Publications (17)

• Bateman RJ, Munsell LY, Morris JC, Swarm R, Yarasheski KE, Holtzman DM. Human amyloid-beta synthesis and clearance rates as measured in cerebrospinal fluid in vivo. Nat Med. 2006 Jul;12(7):856-61. doi: 10.1038/nm1438. Epub 2006 Jun 25.

  PMID: 16799555 BACKGROUND

• Bateman RJ, Wen G, Morris JC, Holtzman DM. Fluctuations of CSF amyloid-beta levels: implications for a diagnostic and therapeutic biomarker. Neurology. 2007 Feb 27;68(9):666-9. doi: 10.1212/01.wnl.0000256043.50901.e3.

  PMID: 17325273 BACKGROUND

• Mawuenyega KG, Sigurdson W, Ovod V, Munsell L, Kasten T, Morris JC, Yarasheski KE, Bateman RJ. Decreased clearance of CNS beta-amyloid in Alzheimer's disease. Science. 2010 Dec 24;330(6012):1774. doi: 10.1126/science.1197623. Epub 2010 Dec 9.

  PMID: 21148344 BACKGROUND

• Xie L, Kang H, Xu Q, Chen MJ, Liao Y, Thiyagarajan M, O'Donnell J, Christensen DJ, Nicholson C, Iliff JJ, Takano T, Deane R, Nedergaard M. Sleep drives metabolite clearance from the adult brain. Science. 2013 Oct 18;342(6156):373-7. doi: 10.1126/science.1241224.

  PMID: 24136970 BACKGROUND

• Mendelsohn AR, Larrick JW. Sleep facilitates clearance of metabolites from the brain: glymphatic function in aging and neurodegenerative diseases. Rejuvenation Res. 2013 Dec;16(6):518-23. doi: 10.1089/rej.2013.1530.

  PMID: 24199995 BACKGROUND

• Kang JE, Lim MM, Bateman RJ, Lee JJ, Smyth LP, Cirrito JR, Fujiki N, Nishino S, Holtzman DM. Amyloid-beta dynamics are regulated by orexin and the sleep-wake cycle. Science. 2009 Nov 13;326(5955):1005-7. doi: 10.1126/science.1180962. Epub 2009 Sep 24.

  PMID: 19779148 BACKGROUND

• Coogan AN, Schutova B, Husung S, Furczyk K, Baune BT, Kropp P, Hassler F, Thome J. The circadian system in Alzheimer's disease: disturbances, mechanisms, and opportunities. Biol Psychiatry. 2013 Sep 1;74(5):333-9. doi: 10.1016/j.biopsych.2012.11.021. Epub 2012 Dec 28.

  PMID: 23273723 BACKGROUND

• Wu YH, Zhou JN, Van Heerikhuize J, Jockers R, Swaab DF. Decreased MT1 melatonin receptor expression in the suprachiasmatic nucleus in aging and Alzheimer's disease. Neurobiol Aging. 2007 Aug;28(8):1239-47. doi: 10.1016/j.neurobiolaging.2006.06.002. Epub 2006 Jul 11.

  PMID: 16837102 BACKGROUND

• Mirmiran M, Swaab DF, Kok JH, Hofman MA, Witting W, Van Gool WA. Circadian rhythms and the suprachiasmatic nucleus in perinatal development, aging and Alzheimer's disease. Prog Brain Res. 1992;93:151-62; discussion 162-3. doi: 10.1016/s0079-6123(08)64570-7.

  PMID: 1480747 BACKGROUND

• Hoogendijk WJ, van Someren EJ, Mirmiran M, Hofman MA, Lucassen PJ, Zhou JN, Swaab DF. Circadian rhythm-related behavioral disturbances and structural hypothalamic changes in Alzheimer's disease. Int Psychogeriatr. 1996;8 Suppl 3:245-52; discussion 269-72. doi: 10.1017/s1041610297003426. No abstract available.

  PMID: 9154571 BACKGROUND

• Dauvilliers YA, Lehmann S, Jaussent I, Gabelle A. Hypocretin and brain beta-amyloid peptide interactions in cognitive disorders and narcolepsy. Front Aging Neurosci. 2014 Jun 11;6:119. doi: 10.3389/fnagi.2014.00119. eCollection 2014.

  PMID: 24966833 BACKGROUND

• Liguori C, Romigi A, Nuccetelli M, Zannino S, Sancesario G, Martorana A, Albanese M, Mercuri NB, Izzi F, Bernardini S, Nitti A, Sancesario GM, Sica F, Marciani MG, Placidi F. Orexinergic system dysregulation, sleep impairment, and cognitive decline in Alzheimer disease. JAMA Neurol. 2014 Dec;71(12):1498-505. doi: 10.1001/jamaneurol.2014.2510.

  PMID: 25322206 BACKGROUND

• Slats D, Claassen JA, Verbeek MM, Overeem S. Reciprocal interactions between sleep, circadian rhythms and Alzheimer's disease: focus on the role of hypocretin and melatonin. Ageing Res Rev. 2013 Jan;12(1):188-200. doi: 10.1016/j.arr.2012.04.003. Epub 2012 Apr 30.

  PMID: 22575905 BACKGROUND

• Yoshida Y, Fujiki N, Nakajima T, Ripley B, Matsumura H, Yoneda H, Mignot E, Nishino S. Fluctuation of extracellular hypocretin-1 (orexin A) levels in the rat in relation to the light-dark cycle and sleep-wake activities. Eur J Neurosci. 2001 Oct;14(7):1075-81. doi: 10.1046/j.0953-816x.2001.01725.x.

  PMID: 11683899 BACKGROUND

• Roh JH, Jiang H, Finn MB, Stewart FR, Mahan TE, Cirrito JR, Heda A, Snider BJ, Li M, Yanagisawa M, de Lecea L, Holtzman DM. Potential role of orexin and sleep modulation in the pathogenesis of Alzheimer's disease. J Exp Med. 2014 Dec 15;211(13):2487-96. doi: 10.1084/jem.20141788. Epub 2014 Nov 24.

  PMID: 25422493 BACKGROUND

• Wennstrom M, Londos E, Minthon L, Nielsen HM. Altered CSF orexin and alpha-synuclein levels in dementia patients. J Alzheimers Dis. 2012;29(1):125-32. doi: 10.3233/JAD-2012-111655.

  PMID: 22207004 BACKGROUND

• Gabelle A, Jaussent I, Bouallegue FB, Lehmann S, Lopez R, Barateau L, Grasselli C, Pesenti C, de Verbizier D, Beziat S, Mariano-Goulart D, Carlander B, Dauvilliers Y; Alzheimer's Disease Neuroimaging Initiative; Multi-Domain Intervention Alzheimer's Prevention Trial study groups. Reduced brain amyloid burden in elderly patients with narcolepsy type 1. Ann Neurol. 2019 Jan;85(1):74-83. doi: 10.1002/ana.25373. Epub 2018 Dec 19.

  PMID: 30387527 DERIVED

MeSH Terms

Conditions

Narcolepsy; Alzheimer Disease

Condition Hierarchy (Ancestors)

Disorders of Excessive Somnolence; Sleep Disorders, Intrinsic; Dyssomnias; Sleep Wake Disorders; Nervous System Diseases; Mental Disorders; Dementia; Brain Diseases; Central Nervous System Diseases; Tauopathies; Neurodegenerative Diseases; Neurocognitive Disorders

Study Officials

• Audrey Gabelle, MD, PhD

  Montpellier University Hospital

  STUDY CHAIR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: August 2, 2016
• First Posted: December 19, 2017
• Study Start: April 7, 2016
• Primary Completion: November 1, 2017
• Study Completion: November 1, 2017
• Last Updated: December 19, 2017

Record last verified: 2017-12

Locations

FR (1)