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NCT Number: NCT03090854

Cholinergic Markers Alzheimer's Disease

Several previous studies have assessed acetylcholine (Ach) and acetylcholinesterase activity (AchE-a) levels in Alzheimer's disease (AD) pathophysiology. The cerebrospinal fluid (CSF) Ach level was significantly decreased in AD patients, and correlated positively with dementia score and MMSE (1, 2). Two studies have demonstrated positive correlations between CSF AchE-a and CSF Tau, phosphorylated-Tau (P-Tau) and AB 1-42 peptide (3,4). ChEIs (cholinesterase inhibitors) have been approved for the treatment of AD but only 20 to 30 % of patients are responders (5). Any consistent data allow the clinician to predict the response to the treatment. The link between basal cholinergic status and ChEIs efficiency has never been done. Even if, there is a wild research in AD treatment, ChEIs or treatment acting on the Ach pathways will remain a long time valuable treatment particularly in moderate AD in which disease modifying therapies did not show any efficiency.

The investigators's objective is to prospectively explore the predicting value of CSF Ach and AchE-a levels on ChEIs response in AD patients.

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Key information

Conditions

Alzheimer Disease Brain Diseases Central Nervous System Diseases Dementia Mental Disorders Nervous System Diseases Neurocognitive Disorders Neurodegenerative Diseases Tauopathies

Age range

50 year and older

Sex eligibility

All sexes

Study type

Observational

Primary location

Centre Mémoire de Ressources et de Recherche Paris Nord

Paris, 75010, France

About this study

Strategy: Within the framework of the usual management, the investigators propose the protocol to patients who had an assay of the CSF biomarkers with a CSF AD biological profile before the introduction of an IChEs and having accepted Their CSF will stocked in our biobank. Patients will only have additional neuropsychological assessments. The rest of the care comes under the current care.

The quantification of ACh in the CSF will be performed in tandem mass spectrometry after separation by liquid chromatography (LC-MS / MS). AChE activity will be determined by colorimetric determination.

The investigators's objective is to prospectively explore the predicting value of CSF Ach and AchE-a levels on ChEIs response in AD patients.

The evaluation criteria will be

  • Difference of the mean value of the ACh level and AChE activity in the CSF between the responder and non-respondier groups of patients.
  • "Responder" patients are defined by an improvement of at least 4 points on the ADAS-Cog (cognitive part) ADAS-Cog after 6 months of treatment.
  • "Non-responders" are defined as aggravation, lack of improvement or improvement <4 points on the ADAS-Cog scale.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Inclusion criteria

  • Male or Female aged ≥ 50 years
  • Patients with a biological profile of CSF biomarkers in favor of Alzheimer's disease
  • Alzheimer's disease diagnosed according to McKahnn 2011 criteria [1] at mild to moderate stage Clinical Dementia Rating (CDR) ≤2
  • Indication to treatment with inhibitor of acetycholinesterase
  • Patients benefiting from national health coverage
  • Patients not subject to legal protection
  • Fluent in French language

Exclusion criteria

  • No indication or contraindication to PL
  • Contraindications to IChEs
  • Patient included in other anti-Alzheimer drug clinical trial
  • Clinical Dementia Rating CDR> 2
  • Another cause of neurocognitive decline
  • Serious psychiatric disorders
  • Other serious life-threatening conditions

Treatment and study plan

ADASCog

Diagnostic Test

Neuropsychological test

Primary outcomes

  1. Neuropsychological test (ADASCog)

    Time frame: between baseline and month 6

    "Responder" patients are defined by an improvement of at least 4 points on the ADAS-Cog (cognitive part) ADAS-Cog after 6 months of treatment. "Non-responders" are defined as aggravation, lack of improvement or improvement <4 points on the ADAS-Cog scale

Secondary outcomes

  1. Rate of responder AD in this cohort included according to the new AD criteria and comparison of the current rate with the previous rate published using former AD criteria

    Time frame: month 6

    Alzheimer disease (AD)

  2. Difference of CSF Ach AND AChE activity between responder and non responder groups

    Time frame: month 6

    biological test

  3. Statistical evaluation of the link between CSF Ach, AChE activity, total and phosphorylated Tau, Aß40 and Aß42.

    Time frame: month 6

    biological test

Sponsors and collaborators

Lead sponsor

Assistance Publique - Hôpitaux de Paris

Other

Registry information

Official study title

Cholinergic Markers as Predictive Tools of Therapeutic Response in Alzheimer's Disease (CHOLINE)

Acronym: CHOLINE

Important dates

Study start
2017
Primary completion
2021
Study completion
2021
First posted
Mar 27, 2017
Registry last updated
Feb 18, 2021

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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