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Spastic AtaxiaSPAX-PBPNCT04297891

Phenotypes, Biomarkers and Pathophysiology in Spastic Ataxias

An observational study of Spastic Ataxia, run by Dr. Rebecca Schule at 9 sites in 7 countries.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

The aim of this study is to determine the clinical spectrum and natural progression of Spastic Ataxias (SPAX) and related disorders in a prospective multicenter natural history study, identify digital, imaging and molecular biomarkers that can assist in diagnosis and therapy development and study the genetic etiology… Read more about this study

Who is it for?
Any ageHealthy volunteers can take part
Conditions the study is for
Spastic Ataxia
What is being tested?
Clinical rating scale to measure Ataxia disease severity and progression, Clinical rating scale to measure spastic paraplegia disease severity and progression and Disease-specific severity index for adults with autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS)
How many people
250 participants
Where
9 sitesin 7 countries
Study dates
1 Sep 2020to Jun 2025
How long will I take part?
24 Months
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages Any age
  • All sexes
  • Healthy volunteers accepted
  • Child, Adult, Older adult

Study population: Probands with clinically manifest and genetically confirmed spastic ataxia (genetic subtypes: ARSACS, SPG7) will be enrolled in this study. Additionally, healthy unrelated controls will be enrolled; these are necessary to contrast unspecific, gender- or age-related findings to disease specific findings.

Who may be able to join

  • ARSACS cohort: genetic diagnosis of ARSACS and clinically manifest disease
  • SPG7 cohort: genetic diagnosis of SPG7 and clinically manifest disease
  • Unrelated healthy controls: no signs or history of neurological or psychiatric disease
  • AND
  • written informed consent provided
  • AND
  • Participants are willing and able to comply with study procedures

Who cannot join

  • Missing informed consent
  • For controls: evidence of a neurodegenerative disease or movement disorders; inability to give informed consent

Trial locations and contacts

9 sites in 7 countries.

9 sites in 7 countries

Canada2 sites, 2 recruiting
  • Montreal Neurological Institute of McGill University, Department of Neurology and Neurosurgery and Human Genetics

    Montreal, Quebec, H3A 2B4

    Bernard Brais, MD, PhD, +1-514-398 ext. 3334, bernard.brais@mcgill.ca

    Bernard Brais, MD, PhD

    Recruiting
  • Université de Sherbrooke

    Saguenay, Quebec, G7X 7X2

    Cynthia Gagnon, PhD, 1-418-695-7700, cynthia.gagnon4@usherbrooke.ca

    Isabelle Côté, M.Sc., 1-418-695-7700, Isabelle.Cote7@USherbrooke.ca

    Recruiting

Other trials in Canada

Germany2 sites, 2 recruiting
  • University Hospital Essen (AöR)

    Essen, 45147

    Stephan Klebe, Prof. Dr., +49-201-723-6513, Stephan.Klebe@uk-essen.de

    Dagmar Timmann-braun, Prof. Dr., (+)49 (0)201 7232180, Dagmar.Timmann-braun@uk-essen.de

    Recruiting
  • Center for Neurology & Hertie-Institute for Clinical Brain Research, Dept. for Neurodegenerative Diseases

    Tübingen, Baden-Wurttemberg, 72076

    Selina Reich, M.Sc, +49 7071 29 ext. 85548, selina.reich@uni-tuebingen.de

    Katrin Dillmann-Jehn, +49 7071 29 ext. 85653, katrin.dillmann@med.uni-tuebingen.de

    Recruiting

Other trials in Germany

France1 site, 1 recruiting
  • Département d'information médicale (DIM); Département de Biostatistique, Santn 3emé Publique et Information Médicale (BIOSPIM)- Bâtiment Mazarie étage; Hôpitaux Universitaires Pitié Salpêtrière

    Paris, 75013

    Hortense Hurmic, (33)1 57 27 42 22, hortense.hurmic@icm-institute.org

    Sophie Tezenas Du Montcel, MD, PhD, (33) 1 42 16 05 82, sophie.tezenas@aphp.fr

    Recruiting

Other trials in France

Italy1 site, 1 recruiting
  • IRCCS Fondazione Stella Maris

    Pisa, 56128

    Filippo M. Santorelli, MD, +39 050 886275, filippo.santorelli@fsm.unipi.it

    Sirio Cocozza, MD, +39 081 7462560, sirio.cocozza@unina.it

    Recruiting

Other trials in Italy

Netherlands1 site, 1 recruiting
  • Radboud University Medical Center; Department of Neurology & Donders Institute for Brain, Cognition, and Behaviour

    Nijmegen, 6525 GC

    Bart van de Warrenburg, MD, PhD, 0031-24-3613396, Bart.vandeWarrenburg@radboudumc.nl

    Bart van de Warrenburg, MD, PhD

    Recruiting

Other trials in Netherlands

Turkey (Türkiye)1 site, 1 recruiting
  • Koç Univ. Hospital, KUTTAMNDAL

    Istanbul, 34010

    Nazli BAŞAK, PhD, +90-850-250825023811, nbasak@ku.edu.tr

    Atay Vural, MD, PhD, +90 850 250 8250, atayvural@ku.edu.tr

    Recruiting

Other trials in Turkey (Türkiye)

United Kingdom1 site, 1 recruiting
  • Department of Clinical Neurosciences, University of Cambridge; John Van Geest Cambridge Centre for Brain Repair

    Cambridge, CB2 0PY

    Rita Horvath, MD, PhD, +44 (0) 1223 331165, rh732@medschl.cam.ac.uk

    Rita Horvath, MD, PhD

    Recruiting

Other trials in United Kingdom

About this study

The aim of this study is to determine the clinical spectrum and natural progression of Spastic Ataxias (SPAX) and related disorders in a prospective multicenter natural history study, identify digital, imaging and molecular biomarkers that can assist in diagnosis and therapy development and study the genetic etiology and molecular mechanisms of these diseases.

Read the detailed description

The investigators will perform a registry-based standardized prospective Natural History Study (NHS) in SPAX and related disorders. Participants will be seen annually. At study visits a standardized clinical examination will be performed including application of clinical rating scales (selection of rating scales may vary depending on the individual phenotype and specific genotype); data will be entered into a clinical database (HSP Registry; https://www.hsp-registry.net and ARCA Registry; www.ARCA-registry.org). At all study visits, patients will be asked to donate biosamples; biomaterial collection is optional and participants can elect to participate in sampling of blood, urine, CSF, and/or a skin biopsy.

Optionally, additional examinations may be performed including imaging, quantitative movement analysis, neuropsychological examinations, analysis of patient or observer reported outcomes and OMICS analysis to characterize molecular biomarkers.

In participants without a genetic diagnosis, next generation sequencing may be performed.

Thus this study will establish a model of disease progression and mechanistic evolution in SPAX, which will allow to track and understand selective as well as overlapping dysfunction of the cerebellum and corticospinal tract. In a transatlantic natural history study we will longitudinally validate clinician- and patient-reported, digital and molecular outcomes. In addition, we will improve on existing and develop new outcome parameters that show superior sensitivity to change. These include a novel clinical SPAX composite score, a smartphone mHealth toolbox combining remote assessment of daily living by wearable sensors with app-based patient-entered outcomes (SPAX.app), and multimodal MRI radiomics with an innovative machine learning approach for multisite MRI analysis, including in particular the infratentorial space. Longitudinal validation of targeted fluid biomarker candidates will aslo be an important part.

Conditions
Spastic Ataxia
Being tested
Clinical rating scale to measure Ataxia disease severity and progression, Clinical rating scale to measure spastic paraplegia disease severity and progression, Disease-specific severity index for adults with autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS), Next-Gen Sequencing (NGS)
Keywords
Spastic Ataxia, Biomarker, Genetic etiology, Molecular mechanisms, Natural History Study
Medical subject headings
Spastic Ataxia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Clinical rating scale to measure Ataxia disease severity and progressionOther

    Also called Scale for the Assessment and rating of Ataxia (SARA)

    SARA is a clinical scale developed by Schmitz-Hübsch et al which assesses a range of different impairments in cerebellar ataxia. The scale is made up of 8 items related to gait, stance, sitting, speech, finger-chase test, nose-finger test, fast alternating movements and heel-shin test.

  • Clinical rating scale to measure spastic paraplegia disease severity and progressionOther

    Also called Spastic Paraplegia Rating Scale (SPRS)

    A 13-item scale to rate functional impairment occurring in pure forms of spastic paraplegia (SP). Additional symptoms constituting a complicated form of SP are recorded in an inventory.

  • Disease-specific severity index for adults with autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS)Other

    Also called DSI-ARSACS

    The DSI-ARSACS is a valid measure of disease severity for the adult ARSACS population that is able to distinguish between patients with different clinical profiles.

    It considers the 3 components (pyramidal, cerebellar, neuropathic) of the disease, and documents its content validity, internal consistency, and construct validity.

  • Next-Gen Sequencing (NGS)Diagnostic test

    Whole Genome Sequencing, Whole Exome Sequencing, Transcriptomics, Proteomics, Metabolomics

Study groups in NCT04297891
Study groupRoleWhat they receive
ARSACSParticipants with genetically confirmed ARSACS (ORPHA:98) will be recruited. Target sample size for the ARSACS cohort is 120.
Receives: Other: Clinical rating scale to measure Ataxia disease severity and progression; Other: Clinical rating scale to measure spastic paraplegia disease severity and progression; Other: Disease-specific severity index for adults with autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS); Diagnostic Test: Next-Gen Sequencing (NGS)
SPG7Participants with genetically confirmed SPG7 (ORPHA:99013) will be recruited. Target sample size for the SPG7 cohort is 72.
Receives: Other: Clinical rating scale to measure Ataxia disease severity and progression; Other: Clinical rating scale to measure spastic paraplegia disease severity and progression; Other: Disease-specific severity index for adults with autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS); Diagnostic Test: Next-Gen Sequencing (NGS)
Unrelated healthy controlUnrelated healthy controls Healthy controls may undergo the same study procedures as the ARSACS and SPG7 cohort. Target sample size for the control cohort is 50.
Receives: Other: Clinical rating scale to measure Ataxia disease severity and progression; Other: Clinical rating scale to measure spastic paraplegia disease severity and progression; Other: Disease-specific severity index for adults with autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS); Diagnostic Test: Next-Gen Sequencing (NGS)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change of Scale for the Assessment and Rating of Ataxia (SARA) from baseline to 2-year follow-up

    Severity of the ataxia component of the disease will be assessed by application of the Scale for the Assessment and Rating of Ataxia (SARA). The total score is calculated as the sum of al items, yielding a total score between 0 and 38. Hereby, higher SARA scores indicate more severe disease.

    Measured: 24 months

  2. Change of Spastic Paraplegia Rating Scale (SPRS) from baseline to 2-year follow-up

    Severity of the spasticity component of the disease will be assessed by application of the Spastic Paraplegia Rating Scale. The total score is calculated as the sum of al items, yielding a total score between 0 and 52. Hereby, higher SPRS scores indicate more severe disease.

    Measured: 24 months

Secondary outcomes (1)
  1. Change of Disease severity index - Autosomal recessive spastic ataxia of Charlevoix-Saguenay(DSI-ARSACS) from baseline to 2-year follow-up

    The DSI-ARSACS is a clinical rating scale consisting of 8 items reflecting the 3 main components of the disease (pyramidal, cerebellar, and neuropath systems) specifically developed to measure disease progression in ARSACs. The DSI-ARSACS total score can range from 0 to 38. Hereby, higher DSI-ARSACS scores indicate more severe disease.

    Measured: 24 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted6 Mar 2020
  2. Study start1 Sep 2020
  3. Primary completionJun 2024 (estimated)
  4. Study completionJun 2025 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
250 participants (estimated)
Target duration
24 Months
IDs, dates and publications
ClinicalTrials.gov ID
NCT04297891
Sponsor's protocol ID
SPAX-PBP
Other IDs
441409627
Acronym
SPAX-PBP
Status last verified
May 2022
First submitted
27 Feb 2020
Last updated
18 May 2022
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Hamdan A, Traschutz A, Beichert L, Chen X, Gagnon C, van de Warrenburg BP, Santorelli FM, Basak N, Coarelli G, Horvath R, Klebe S; PROSPAX consortium; EVIDENCE-RND consortium; Schule R, Hooker AC, Synofzik M, Karlsson MO. Integrated Modeling of Digital-Motor and Clinician-Reported Outcomes Using Item Response Theory: Towards Powerful Trials for Rare Neurological Diseases. CPT Pharmacometrics Syst Pharmacol. 2025 Nov;14(11):1857-1868. doi: 10.1002/psp4.70081. Epub 2025 Jul 21.

    PubMed 40685914

Questions about this trial

What is this clinical trial studying?

An observational study of Spastic Ataxia, run by Dr. Rebecca Schule at 9 sites in 7 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 18 May 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 9 sites in Canada, Germany, France, Italy, Netherlands and 2 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Rebecca Schüle, PD Dr. (+49 7071 29 ext. 85653, rebecca.schuele-freyer@uni-tuebingen.de), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change of Scale for the Assessment and Rating of Ataxia (SARA) from baseline to 2-year follow-up (time frame: 24 months). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04297891, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 May 2022.

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