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NCT Number: NCT06864000

Phenotypic and Molecular Characterisation of Cerebral Amyloid Angiopathy

Cerebral Aβ amyloid angiopathy is a severe disease characterised by amyloid deposits in the cerebral vessels, manifested mainly by recurrent cerebral haematomas and cognitive impairment. Diagnostic criteria are based on brain imaging, but the usefulness of this imaging in predicting the course of the disease remains undetermined. The genetic component is largely understudied. Less than 5% of patients carry mutations or duplications of the APP gene. Susceptibility factors such as APOE genotypes and rare variants recently discovered in Alzheimer's disease within the SORL1, TREM2 or ABCA7, ABCA1 and ATP8B4 genes could play a role in the pathophysiology of cerebral amyloid angiopathy. There is currently no specific treatment available. Based on a national recruitment of patients with cerebral amyloid angiopathy, this project aims to assess the role of genetic variants in the diagnosis and progression of cerebral amyloid angiopathy. A better understanding of the mechanisms, particularly genetic, could help us to develop treatments in the era of gene therapy.

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Key information

Age range

18 year–99 year

Sex eligibility

All sexes

Study type

Observational

Primary location

University Hospital Rouen

Rouen, 76031, France

Location status: Recruiting

Location contact

Lou LG GRANGEON, Doctor

CONTACT

[email protected]

02 32 88 37 90 ext. +33

About this study

This research is carried out on the same blood sample taken during the treatment and sent to the Rouen University Hospital Genetics Laboratory for research into point mutations or duplication of the APP gene as part of the diagnosis of cerebral amyloid angiopathy (CAA). For each gene, the proportions of variant carriers will be compared between cases and controls using a Fisher exact test with R statistical software. To rule out any population stratification bias, the tests will also be carried out using logistic regression adjusted on the first PCA axes (principal component analysis) using the seqmeta function. A Bonferroni correction will then be used to adjust the significance threshold according to the number of genes tested.

Who can participate

Healthy volunteers accepted: Yes

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

Inclusion criteria

  • Patients with a diagnosis of cerebral amyloid angiopathy (CAA) whose genetic samples are initially sent to the Rouen or Paris-Lariboisière genetics laboratories for molecular diagnosis of a genetic cause, thanks to national recruitment and for whom the patients consent to continuing genetic analyses for research purposes without feedback.
  • Diagnosis of cerebral amyloid angiopathy (CAA) certain or probable according to the modified Boston diagnostic criteria (1) (except age)
  • Age of onset of symptoms <66 years
  • Absence of APP mutation/duplication (analysis must already have been carried out in the laboratory on receipt of the sample as part of routine care)
  • Signed consent for research
  • Patient covered by a social security scheme

Exclusion criteria

  • Age at first neurological symptom > 66 years
  • Minor patients
  • Other differential diagnosis that better explains the clinical situation
  • Identification of mutations or duplication of the APP gene
  • AAC possible but not probable according to the revised Boston criteria
  • Patient deprived of liberty by judicial or administrative decision

Treatment and study plan

Primary outcomes

  1. patients with APOE4 genetic risk factors

    Time frame: 1 day

    Define the proportion of patients with APOE4 genetic risk factors (%) in patients with early-onset cerebral amyloid angiopathy (CAA) (<66 years) and patients with causal mutations in the PSEN1 and PSEN2 genes.

  2. patients with rare variants of SORL1

    Time frame: 1 day

    Define the proportion of patients with rare variants (%) of SORL1, in patients with early-onset cerebral amyloid angiopathy (CAA) (<66 years) and patients with causal mutations in the PSEN1 and PSEN2 genes.

  3. patients with rare variants of TREM2

    Time frame: 1 day

    Define the proportion of patients with rare variants (%) of TREM2 in patients with early-onset cerebral amyloid angiopathy (CAA) (<66 years) and patients with causal mutations in the PSEN1 and PSEN2 genes.

  4. patients with rare variants of ABCA7

    Time frame: 1 day

    Define the proportion of patients with rare variants (%) of ABCA7 in patients with early-onset cerebral amyloid angiopathy (CAA) (<66 years) and patients with causal mutations in the PSEN1 and PSEN2 genes.

  5. patients with rare variants of ABCA1

    Time frame: 1 day

    Define the proportion of patients with rare variants (%) of ABCA1 in patients with early-onset cerebral amyloid angiopathy (CAA) (<66 years) and patients with causal mutations in the PSEN1 and PSEN2 genes.

  6. patients with rare variants of ATP8B4

    Time frame: 1 day

    Define the proportion of patients with rare variants (%) of ATP8B4 in patients with early-onset cerebral amyloid angiopathy (CAA) (<66 years) and patients with causal mutations in the PSEN1 and PSEN2 genes.

Secondary outcomes

  1. Genotype/clinical phenotype correlations

    Time frame: 12 months

    Establish genotype/clinical phenotype correlations concerning the age of onset, the severity of the disease and the risk of recurrence of haematomas (identified during follow-up visits at M6 and M12 as part of routine care).

  2. Biological characterisation of AACs (Aβ42,CSF biomarkers)

    Time frame: 12 months

    • assessment of the diagnostic value of assays for Aβ42 biomarkers currently validated in Alzheimer's disease and related neurocognitive disorders
  3. Biological characterisation of AACs (Aβ40, CSF biomarkers)

    Time frame: 12 months

    • assessment of the diagnostic value of assays for Aβ40, CSF biomarkers currently validated in Alzheimer's disease and related neurocognitive disorders
  4. Imaging characterisation of AACs (topography of cerebral bleeds)

    Time frame: 12 months

    • identification of biomarker profiles linked to the topography of cerebral bleeds
  5. Imaging characterisation of AACs (typology of cerebral bleeds)

    Time frame: 12 months

    • identification of biomarker profiles linked to the typology of cerebral bleeds
  6. Imaging characterisation of AACs (distribution of cerebral bleeds)

    Time frame: 12 months

    • identification of biomarker profiles linked to the distribution of cerebral bleeds

Study contacts

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

David DM MALLET, Director

CONTACT

[email protected]

+33 2 32 88 82 65

Vincent VF FERRANTI, Arc

CONTACT

[email protected]

+33 2 32 88 82 65

Sponsors and collaborators

Lead sponsor

University Hospital, Rouen

Other

Registry information

Official study title

Phenotypic and Molecular Characterisation of Early-onset Cerebral Amyloid Angiopathy

Acronym: GENERALITY2

Important dates

Study start
2023
Primary completion
2027
Study completion
2027
First posted
Mar 7, 2025
Registry last updated
Mar 7, 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.