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NCT Number: NCT05360082

Comparison Between [11C]UCB-J and [18F]SynVest-1 PET in HD.

Positron Emission Tomography (PET) is a functional imaging technique, which enables in vivo visualization of biological molecules expressed in human tissues. Brain PET is most powerful to study a vast range of neurological and psychiatric disorders in vivo, targeting neuronal and glial activity, metabolism, cerebral blood flow, receptor proteins or misfolded proteins.

In vivo imaging of synaptic density in the human brain has become feasible through development of [11C]UCB-J, a PET radioligand for the synaptic vesicle protein SV2A, which is ubiquitously and homogeneously present in presynaptic terminals throughout the brain. A first study in Huntington's disease (HD) mutation carriers showed loss of striatal [11C]UCB-J binding (also when corrected for atrophy), as well as in the neocortex (Delva et al, Neurology 2022). Moreover, regional synaptic loss was highly correlated to motor impairment.

In order to be able to use SV2A PET as widespread available biomarker tool to assess synaptic integrity, disease progression and/or response to mHTT lowering drugs, the short half-life of 11C (20 minutes) for [11C]UCB-J remains a hurdle. Recently, [18F]SynVesT-1, an optimized 18F-labeled analogue of [11C]UCB-J with similar kinetics, binding affinity, and test-retest precision properties has been evaluated in humans.

However, there is evidence from preclinical studies conducted at University of Antwerp that in the zQ175DN knock-in mouse model of HD, larger variability and lower effect-sizes are seen with [18F]SynVest-1 than with [11C]UCB-J.

In order to ascertain a similar effect size and quantification properties for [18F]SynVest-1 and [11C]UCB-J PET in human HD patients and to validate simplified measures (such as SUVR with white matter as reference region) and SynVest, this head-to-head fully quantitative study is performed.

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Key information

Age range

20 year–75 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

UZ Leuven

Leuven, 3000, Belgium

Location status: Recruiting

Location contact

Aline Delva, MD, PhD

SUB_INVESTIGATOR

Jolien Van Opstal, MD

SUB_INVESTIGATOR

Koen Van Laere, MD, PhD, DSc

CONTACT

[email protected]

+3216343714

Koen Van Laere, MD, PhD, DSc

PRINCIPAL_INVESTIGATOR

Wim Vandenberghe, MD, PhD

SUB_INVESTIGATOR

Who can participate

Healthy volunteers accepted: Yes

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

Inclusion criteria

  • Healthy controls (n = 10-20)
  • Subject is judged to be in good health by the investigator on the basis of medical history, physical examination including vital signs, clinical laboratory test and urinalysis.
  • No history or evidence of current major neurological, internal or psychiatric disorder, based on the medical assessment as described hereabove and neuropsychological assessment.
  • In subjects < 60 years of age, an unremarkable structural MRI scan as assessed by expert radiologist. In subjects >= 60 years of age white matter hyperintensities corresponding to a white matter lesion (WML) Fazekas score < 2 on the Age-Related White Matter changes scale are acceptable.
  • HD-ISS stage 3 HD mutation carriers (n = 10)
  • HTT CAG repeat expansion 40 - 50
  • stage 3 as determined by the HD-ISS staging criteria
  • UHDRS TFC >/= 10
  • HD-ISS stage 2 HD mutation carriers (n = 10)
  • HTT CAG repeat expansion 40 - 50
  • stage 2 as determined by the HD-ISS staging criteria
  • PIN score 0.47 - 1.84

Exclusion criteria

  • Neuropsychiatric diseases; for HD mutation carriers any neuropsychiatric diseases other than HD
  • Major internal medical diseases
  • White matter lesion load on FLAIR Fazekas score 2 or higher or other relevant MRI abnormalities
  • History of alcohol abuse or current alcohol abuse (chronic use of more than 15 units per week) or drug use
  • Contraindications for MR
  • Subject suffers from claustrophobia or cannot tolerate confinement during PET-MRI scanning procedures; subject cannot lie still for 30 minutes inside the scanner.
  • Subject is unwilling to avoid unusual, unaccustomed, or strenuous physical activity (i.e., weightlifting, running, bicycling) from the time of the pre-study visit until the end of scanning.
  • Subject does not understand the study procedures or does not have a guardian who understands the study procedures.
  • Subject (or guardian) is unwilling or unable to perform all of the study procedures or is considered unsuitable in any way by the principal investigator.
  • Subject is on anticoagulant therapy.
  • Subject is pregnant (according to Ulti Med hCG urine test) or breastfeeding.
  • Subject is a woman of childbearing potential who does not agree to apply appropriate contraception methods during study participation and continues to do so for at least 6 months after study completion.
  • Subject is a man with a pregnant or non-pregnant WOCBP partner, who does not agree to use a condom and continue to do so until 90 days after study completion. In addition, the non-pregnant WOCBP partner should use a highly effective method of contraception.

Treatment and study plan

[11C]UCB-J PET

Other

11C-labeled SV2A binding PET radioligand

[18F]SynVest-1 PET

Other

18F-labeled SV2A binding PET radioligand

Primary outcomes

  1. Compare Vt of [11C]UCB-J and [18F]SynVest-1 in manifest HD and healthy controls

    Time frame: A first data analysis will be done when all cohort 1 subjects have undergone evaluations. A go-no-go decision will then be made before proceeding with cohort 2. Data analysis of cohort 2 subjects will follow completion of cohort 2.

    Assess whether changes in total volume of distribution (Vt) are similar for [11C]UCB-J and [18F]SynVest-1 in manifest HD compared to healthy controls.

Secondary outcomes

  1. Compare variance in Vt within groups for [11C]UCB-J and [18F]SynVest-1

    Time frame: A first data analysis will be done when all cohort 1 subjects have undergone evaluations. A go-no-go decision will then be made before proceeding with cohort 2. Data analysis of cohort 2 subjects will follow completion of cohort 2.

    Compare the variance in total volume of distribution (Vt) between [11C]UCB-J and [18F]SynVest-1 in healthy volunteers and manifest HD patients.

  2. Compare simplified measures (BPND, SUVR) to assess group differences for [11]C-UCB-J and [18]F-SynVest-1

    Time frame: A first data analysis will be done when all cohort 1 subjects have undergone evaluations. A go-no-go decision will then be made before proceeding with cohort 2. Data analysis of cohort 2 subjects will follow completion of cohort 2.

    Compare volume of distribution (Vt), BPND and SUVR between [11C]UCB-J and [18F]SynVest-1 in HD patients and healthy controls.

Study contacts

Contact information is provided by the study sponsor or research team.

Koen Van Laere, MD, PhD, DSc

CONTACT

[email protected]

+3216343714

Wim Vandenberghe, MD, PhD

CONTACT

Sponsors and collaborators

Lead sponsor

Universitaire Ziekenhuizen KU Leuven

Other

Collaborators

  • CHDI Foundation, Inc.

Registry information

Official study title

Direct Quantitative Comparison Between [11C]UCB-J and [18F]SynVest-1 PET as Markers for Synaptic Density in Huntington's Disease.

Important dates

Study start
2024
Primary completion
2026
Study completion
2026
First posted
May 4, 2022
Registry last updated
Jul 30, 2025

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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