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Completed

NCT Number: NCT05615584

Spectrometry (MRM) Versus I 125 Radioimmunoassay (RIA) for Quantification of Orexin-A of Patients With Hypersomnolence

In humans, selective loss of orexin neurons is responsible for type 1 narcolepsy (NT1), or narcolepsy with cataplexy, or orexin deficiency syndrome.

The International Classification of Sleep Disorders 3rd edition (ICSD-3) distinguishes between hypersomnolence of central origin: NT1, narcolepsy type 2 (NT2), or narcolepsy without cataplexy, and idiopathic hypersomnia (HI). These rare conditions are all characterised by hypersomnolence (excessive daytime sleepiness, or excessive need for sleep), which is the primary and often most disabling symptom. A level of ORX-A in cerebrospinal fluid (CSF) (<110 pg/mL) is a very sensitive and specific biomarker of NT1, currently sufficient for the diagnosis of this condition. In contrast, ORX neurons are thought to be intact in IH and NT2, and the pathophysiological mechanisms underlying these diseases remain unknown. Thus, their diagnosis is based solely on clinical and electrophysiological criteria.

The objective of this project is to determine the validity of a mass spectrometric technique for the determination of ORX-A in the cerebral spinal fluid of patients suffering from hypersomnolence in comparison with the radioimmunoassay which is the reference technique.

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Key information

Age range

8 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

University Hospital of Montpellier

Montpellier, France

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Age ≥ 8 years
  • Complaint of hypersomnolence and suspected central hypersomnolence
  • Benefiting from a standardised assessment: clinical, biological and neurophysiological
  • Lumbar puncture necessary for the assessment
  • Sufficient cerebrospinal fluid taken for biological analysis (at least 1 ml)
  • Signed informed consent

Exclusion criteria

  • Contraindication to lumbar puncture
  • Secondary hypersomnolence
  • Refusal to participate in the study or refusal of the lumbar puncture
  • Adult protected by law, or subject deprived of liberty, by judicial or administrative decision or patient under guardianship or curatorship
  • Subject not affiliated to the French social security system
  • Pregnant or breastfeeding woman

Treatment and study plan

Quantitative mass spectrometry assay

Diagnostic Test

ORX-A determination by quantitative mass spectrometry

Primary outcomes

  1. Orexin-A dosage by Multiple Reaction Monitoring Mass Spectrometry

    Time frame: Day 1 (=day of inclusion)

    Multiple Reaction Monitoring mass spectrometry for orexin-A dosage in cerebrospinal fluid

  2. Orexin-A dosage by radioimmunoassay

    Time frame: Day 1

    Radioimmunoassay for orexin-A dosage in cerebrospinal fluid

Secondary outcomes

  1. Age of onset of hypersomnia symptoms

    Time frame: Day 1

  2. Frequency of cataplexy

    Time frame: Up to 24 hours

  3. Characteristics of cataplexy

    Time frame: Up to 24 hours

  4. Average duration of cataplexy

    Time frame: Up to 24 hours

  5. Epworth sleepiness scale (ESS)

    Time frame: Day 1

    the score will be between 0 and 24, higher scores mean a worse outcome

  6. Narcolepsy severity scale (NSS)

    Time frame: Day 1

    the score will be between 0 and 57, higher scores mean a worse outcome

  7. Hypersomnolence severity scale (IHSS)

    Time frame: Day 1

    the score will be between 0 and 50, higher scores mean a worse outcome

  8. Insomnia severity index

    Time frame: Day 1

    the score will be between 0 and 32, higher scores mean a worse outcome

  9. Iterative sleep latency tests (TILE)

    Time frame: Up to 24 hours

  10. Presence of the HLA allele DQB1*06:02

    Time frame: Day 1

Sponsors and collaborators

Lead sponsor

University Hospital, Montpellier

Other

Registry information

Official study title

Multiple Reaction Monitoring (MRM) Versus I 125 Radioimmunoassay (RIA) for the Quantification of Orexin-A/Hypocretin-1 Levels in Cerebrospinal Fluid: a Prospective Diagnostic Validation Study in Patients With Hypersomnolence

Acronym: MRM-OREX

Important dates

Study start
2023
Primary completion
2024
Study completion
2024
First posted
Nov 14, 2022
Registry last updated
Jul 9, 2026

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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