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NCT Number: NCT07202494

Integrating Metabolism, Connectivity, and Mesoscale Imaging at Ultra-high Field to Decipher Mechanisms of Resilience and Neurodegeneration in Neurological Diseases and Healthy Aging

The MESO7 study is a prospective observational research project designed to investigate the mechanisms of resilience and neurodegeneration in neurological diseases and healthy aging. It leverages advanced multiparametric brain and spinal cord imaging at high (3T) and ultra-high magnetic fields (7T) to assess structural, functional, metabolic, and mesoscale changes in the central nervous system (CNS). Particular emphasis is placed on sodium (23Na-MRI) and phosphorus (31P-MRI) imaging, along with layer-dependent brain connectivity analysis.

The primary objective is to evaluate the impact of neuronal energy failure, measured via sodium concentration, on functional and structural reorganization in both healthy individuals and patients with various neurological conditions. Directed brain network models will be constructed from MRI data to quantify the connectivity strength (in- and out-degree) of cortical nodes. These connectivity metrics will be correlated with sodium concentrations to assess energy failure and its role in network reorganization. Longitudinal follow-up over two years is planned for subgroups with clinically progressive diseases.

Secondary objectives include decoding metabolic, microstructural, and functional signatures of successful aging at the laminar level; characterizing disease-specific patterns of cortical and spinal microstructure associated with physical and cognitive dysfunction; describing longitudinal mesoscale and metabolic changes; and generating representative normative imaging datasets for the neuroscience community.

The study plans to enroll a total of 540 patients across 9 neurological conditions:Multiple Sclerosis (MS), Neuromyelitis Optica Spectrum Disorders (NMOSD), MOG Antibody Disease (MOGAD), Alzheimer's disease, Parkinson's disease, Amyotrophic Lateral Sclerosis (ALS), temporal and non-temporal epilepsy, and mild traumatic brain injury (mTBI),in addition to 160 age- and sex-matched healthy controls, totaling 700 participants. Imaging and clinical assessments will be performed at the CEMEREM center at Timone University Hospital, AP-HM, Marseille, France.

Each participant will undergo multiparametric brain and spinal cord MRI, including DTI, BOLD, MP2RAGE, SWI, quantitative sodium and phosphorus imaging, and functional assessments including neuropsychological testing, visual and motor function tests. Disease-specific assessments such as OCT, evoked potentials, and disability scores (e.g., EDSS for MS) will also be included when appropriate.

The study is expected to improve understanding of CNS adaptation mechanisms and support the development of more accurate diagnostic and prognostic tools for neurodegenerative diseases

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Key information

Conditions

Multiple Sclerosis Alzheimer Disease Amyotrophic Lateral Sclerosis Amyotrophic Lateral Sclerosis (ALS) Autoimmune Diseases Autoimmune Diseases of the Nervous System Basal Ganglia Diseases Brain Concussion Brain Diseases Brain Injuries Brain Injuries, Traumatic Central Nervous System Diseases Cranial Nerve Diseases Craniocerebral Trauma Dementia Demyelinating Autoimmune Diseases, CNS Demyelinating Diseases Epilepsies, Partial Epilepsy Epilepsy, Temporal Lobe Epileptic Syndromes Eye Diseases Head Injuries, Closed Healthy Aging Immune System Diseases Mental Disorders Metabolic Diseases Mild Traumatic Brain Injury Motor Neuron Disease Movement Disorders Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD) Myelitis, Transverse Nervous System Diseases Neurocognitive Disorders Neurodegenerative Diseases Neuromuscular Diseases Neuromyelitis Optica Neuromyelitis Optica Spectrum Disorders Nutritional and Metabolic Diseases Optic Nerve Diseases Optic Neuritis Parkinson Disease Parkinsonian Disorders Proteostasis Deficiencies Spinal Cord Diseases Synucleinopathies TDP-43 Proteinopathies Tauopathies Temporal Lobe Epilepsy Trauma, Nervous System Wounds and Injuries Wounds, Nonpenetrating

Age range

18 year–90 year

Sex eligibility

All sexes

Study type

Observational

Primary location

Chu Timone

Marseille, France

Location status: Recruiting

Who can participate

Healthy volunteers accepted: Yes

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

Inclusion criteria

  • Age:Female or male, aged 18 years or older.
  • Health Status: No uncontrolled general diseases, such as cancer, autoimmune diseases, liver failure, severe or untreated high blood pressure, or severe rhythm disorders. No chronic psychiatric illnesses, including severe dementia.
  • MRI Compatibility: No contraindications for MRI exams (e.g., claustrophobia, metal foreign bodies, pacemakers, severe kidney failure).
  • Social Security Coverage: Participants must have social security coverage.
  • Informed Consent: The participant must have read, understood, and signed the informed consent after being adequately informed about the study.
  • Specific Disease Criteria (For Disease Groups): Specific inclusion criteria apply to each pathology, such as MS (based on McDonald criteria), NMOSD (Wingerchuk 2015), Alzheimer's (meeting NINCDS-ADRDA criteria), etc.

Exclusion criteria

  • Pregnancy: Pregnant women are excluded from the study.
  • Inability to Provide Informed Consent:
  • Any participant who refuses to sign the informed consent or is unable to do so due to mental or physical conditions.
  • Refusal of MRI: Individuals who refuse to undergo brain MRI.
  • Contraindications for MRI:Participants with contraindications for MRI exams, such as claustrophobia, metal foreign bodies, pacemakers, or severe kidney failure.
  • Medical Conditions: Known allergy to Dotarem (contrast agent) for neuroinflammatory patients. Individuals with severe renal insufficiency or other conditions that prevent MRI scanning.

Cognitive or Psychiatric Issues:

Chronic psychiatric conditions, including severe dementia or cognitive dysfunction that could hinder participation.

Legal or Institutional Restrictions:

Adults under legal protection (e.g., under guardianship or curatorship). Individuals deprived of their liberty.

Other Medical Conditions:

Individuals with neurological diseases such as ischemic accidents, brain trauma, or encephalitis.

Patients on treatments that would interfere with the study, as outlined for each disease.

Allergy to Contrast Agent:

Allergy to Dotarem for neuroinflammatory patients (MS, NMOSD, etc.).

Inability to Adhere to Protocol:

Participants who are unable or unwilling to comply with the study protocol.

Treatment and study plan

Imaging Techniques (MRI 3T & 7T, Functional, Structural, and Metabolic Imaging)

Other

Functional MRI (fMRI) Diffusion Tensor Imaging (DTI) Sodium Imaging (23Na-MRI) Phosphorus Imaging (31P-MRI)

Primary outcomes

  1. Nodal Connectivity measured by resting-state BOLD fMRI and diffusion MRI tractography (graph-theoretical metrics)

    Time frame: Baseline and 24 months (longitudinal follow-up)

    Nodal connectivity will be assessed using graph-theoretical measures (in-degree, out-degree, and strength).

  2. Sodium Concentration as Indicators of Neuronal Energy Failure

    Time frame: Baseline and 24 months (longitudinal follow-up)

Secondary outcomes

  1. Regional sodium concentration and phosphorus metabolism in brain and spinal cord measured by 23Na-MRI and 31P-MRI

    Time frame: Baseline and 24 months (longitudinal follow-up)

    Metabolic changes will be quantified from quantitative 23Na-MRI (sodium concentration, indicator of neuronal energy failure) and 31P-MRI (phosphorus metabolism, indicator of energy consumption).

  2. Network Metrics

    Time frame: Baseline and 24 months (longitudinal follow-up)

    number of significant connections per node (in/out) and sum of edge weights per node (based on FA values).

  3. distance between the gray matter-white matter boundary and the pial surface (outer cortical surface). (Cortical Thickness)

    Time frame: Baseline and 24 months (longitudinal follow-up)

    distance between the gray matter-white matter boundary and the pial surface (outer cortical surface).

  4. Iron Accumulation (Concentration) in Cortical Layers

    Time frame: Baseline and 24 months (longitudinal follow-up)

    Iron accumulation is inferred from increased susceptibility values in specific laminar regions.

  5. Cortical thickness measured by structural MRI (MP2RAGE) and processed with FreeSurfer

    Time frame: Baseline and 24 months (longitudinal follow-up)

    Structural changes in brain gray matter will be assessed through quantitative cortical thickness measurements.

Study contacts

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

Jan-Patrick STELLMANN

CONTACT

[email protected]

+33 (0) 4 91 38 48 07

Sponsors and collaborators

Lead sponsor

Assistance Publique Hopitaux De Marseille

Other

Registry information

Acronym: MESO7

Important dates

Study start
2025
Primary completion
2030
Study completion
2030
First posted
Oct 1, 2025
Registry last updated
Oct 1, 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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