MIND-MAPS-ALS

Molecular Imaging of Neurodegenerative Disease – Mitochondria, Associated Proteins and Synapses – Amyotrophic Lateral Sclerosis (MIND-MAPS-ALS)

MIND-MAPS-ALS needs your support. This study is actively recruiting.

What are biomarkers?

Biomarkers are the 'fingerprints' of MND, chemical signals unique to the disease. We will analyse thousands of blood, cerebrospinal fluid and skin samples from each of our participants and monitor the progress of their disease every three months.

Finding the biomarkers unique to MND will make testing the effect of drugs and treatments much more accurate. In the future, these biomarkers may be critical in our search for a cure.

Who are we?

The Neurodegeneration Imaging Group (NIG) is headed by Professor Marios Politis and is part of the University of Exeter. NIG aims to investigate the causes of neurological diseases and identify new targets for treatments.

What is amyotrophic lateral sclerosis?

Amyotrophic lateral sclerosis (ALS), also referred to as motor neuron disease (MND), is a rare disease involving loss of motor nerve cells which leads to loss of muscle strength and increasing body weakness. It is the most common type of MND.

Genetics and the environment play a role in the development of the disease, but the exact disease process is still unknown.

Why are we conducting this research?

Our aim is to look into the disease process causing the condition and to find new targets for treatments that can slow or stop the worsening muscle weakness seen in this condition.

How are we conducting our research?

Using state of the art imaging techniques called PET and MRI, we can explore the processes taking place in your brain. We will look at the energy sources of nerve cells and the connections between the nerve cells. Each brain scan will last about 60–90 minutes. There will be eight scans over 12 months. We will also perform clinical and neuropsychological evaluations on three occasions lasting approximately 2–3 hours.

Where are we conducting our research?

You will come to NIHR Imperial Clinical Research Facility (W12 0HS) for the clinical and neuropsychological evaluation and to Invicro London (W12 0NN) for PET and MRI scans. Both facilities are located on Hammersmith Hospital Campus in West London.

UK Chief Investigator

Dr Marios Politis

Research summary

ALS is the most common form of motor neurone disease. In this disease there is death of the nerve cells that control muscle movement. This leads to increasing muscle weakness, including muscles important for movement, swallowing and breathing.

The cause of this condition is still unknown, although it is thought that people's genes and their environment play a role. Our aim is to look into the cause of this disease, so that in the future treatments can be made to slow or even stop the worsening of the condition.

We plan to use a special type of brain scan, called PET, to explore how brain activity is effected in ALS. In particular, we will measure the mitochondrial activity (the source of energy of brain cells) and synapses (the links between the nerve cells that allow communication and control of the movements). Another type of brain scan, called MRI, will be used to investigate the brain's structure and function. Finally, we will complete a detailed clinical and psychological assessment.

We aim to follow up participants with a new ALS diagnosis (with symptoms starting in their limbs), aged between 25 and 85, over a one year period. Three clinical visits will take place at King's College Hospital and four visits for brain scans will take place at Invicro, an imaging centre next to Hammersmith Hospital. We will reimburse transportation to and from home to the hospital and refreshments throughout the visits. We will also offer, as a small thank you, £100 per scan (up to £800).

The findings from this study will be reported at local, national and international meetings and conferences. We will maintain a high impact publishing policy, submitting to open-access, top-tier, and peer-reviewed journals and will inform participants of relevant publications.

Inclusion / exclusion criteria

Inclusion criteria

  • 25–85 years of age, male or female.

  • Able to give informed consent.

  • Adequate visual and auditory acuity to complete the psychological testing.

  • No presence or history of other significant neurological or psychiatric disorders.

  • Diagnosis of sporadic ALS according to revised El Escorial criteria 63 from an experienced MND neurologist.

  • Limb disease onset.

  • Less than six months since ALS diagnosis.

  • Negative family history for ALS.

Exclusion criteria

  • Current or a recent history of drug or alcohol abuse/dependence.

  • Presence of other neurological disorders and known intracranial co-morbidities such as stroke, haemorrhage, space-occupying lesions.

  • Pregnancy or breastfeeding.

  • Contraindication to MRI, such as presence of metal devises or implants, metal deposited in the body, or metal grains in the eyes.

  • History of cancer within the last five years.

  • Subject has received significant exposure to ionising radiation as part of research study such that with the exposure in this study they will have received >10mSv within the previous 12 months.

  • Claustrophobia and history of back pain that makes prolonged laying on the PET or MRI scanner intolerable.

  • Contraindication to arterial cannulation, such as history of bleedings, haemorrhage etc.

  • When available, positive genetic testing for familial ALS (C9orf72, TARDBP, SOD1, FUS etc).

  • Presence of PEG, NIV or tracheotomy at baseline.

  • Patients who fulfil diagnostic criteria for FTD or non-FTD dementia.

  • Participation to any other clinical trial involving new ALS drugs.

Current status

Active – recruiting

Locations

  • Royal Devon and Exeter Hospital (Wonford)

  • Imperial College Healthcare NHS Trust

Information about study sites

Contact details

Study team: Dr Edoardo R. de Natale

Email: e.de-natale@exeter.ac.uk

Recruitment group(s)

Patients with MND

Recruitment target(s)

16 patients

Key dates

Actual opening date: 3 October 2019

Recruitment planned end date: 1 January 2023

Funder(s)

Invicro UK Holdings Ltd (Industry-funded, non-industry sponsored trial)

Sponsor University of Exeter

Study design

Cohort observational

Intervention (if applicable)

Not applicable

Phase (if applicable)

Not applicable

Outcome measures

We aim compare mitochondrial and synaptic function between people with ALS and sex- and age-matched healthy volunteers (from previous database). We will also investigate for associations between mitochondrial and synaptic dysfunction and severity of symptoms.

Publications / Results reports

Links will be provided when papers are published.

Participant information sheet

MIND-MAPS-ALS patient information sheet (PDF, 263KB)