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Trial registered on ANZCTR
Registration number
ACTRN12618000193279
Ethics application status
Approved
Date submitted
31/01/2018
Date registered
7/02/2018
Date last updated
8/01/2019
Date data sharing statement initially provided
8/01/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
A study of the connectivity measures of a resting-state brain network in patients with Epilepsy.
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Scientific title
Assessing connectivity measures and neurotransmitter concentrations of the Default Mode Network (DMN) via functional Magnetic Resonance Imaging (fMRI) and Magnetic Resonance Spectroscopy (MRS) in patients with Epilepsy.
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Secondary ID [1]
293920
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Nil known.
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Universal Trial Number (UTN)
U1111-1208-7440
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Epilepsy
306407
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Condition category
Condition code
Neurological
305497
305497
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0
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Epilepsy
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
Participants will undergo a single 7-Tesla MRI scan that will consist of a high-resolution anatomical scan, magnetic resonance spectroscopy (MRS), and functional magnetic resonance imaging (fMRI). The total scanning time will be around 20 minutes.
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Intervention code [1]
300190
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Diagnosis / Prognosis
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Comparator / control treatment
The control group will consist of healthy volunteers previously scanned in a different study("Development of High Field Magnetic Resonance Imaging Methods
and Protocols" at The University of Melbourne) between 05/2017 and 01/2018.
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Control group
Historical
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Outcomes
Primary outcome [1]
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Glutamate concentrations as measured by MRS of the Posterior Cingulate Cortex.
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Assessment method [1]
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Timepoint [1]
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Single scan, concomitant with fMRI.
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Primary outcome [2]
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GABA concentration as measured by MRS of the Posterior Cingulate Cortex
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Assessment method [2]
304628
0
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Timepoint [2]
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Single scan, concomitant with fMRI.
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Primary outcome [3]
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Fisher-transformed correlation coefficient values between regions of the Default Mode Network and between the Posterior Cingulate Cortex to all brain regions via resting state fMRI.
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Assessment method [3]
304684
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Timepoint [3]
304684
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Single scan, concomitant with MRS.
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Secondary outcome [1]
342624
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Duration of epilepsy - will be defined from first seizure, self-reported by study participants.
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Assessment method [1]
342624
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Timepoint [1]
342624
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At enrolment.
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Secondary outcome [2]
342625
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Seizure frequency. It will be self-reported by the study participants and scored from 0 to 4:
0 = seizure-free (no seizures during the previous 3 months);
1 = =1 seizures during the last 3 months, but not within the past month;
2 = =1 seizures per month;
3 = =1 seizures per week;
4 = =1 seizures per day.
The past seizure frequency will be assessed during a period of only 3 months to reduce recall bias.
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Assessment method [2]
342625
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Timepoint [2]
342625
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At enrolment.
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Secondary outcome [3]
342626
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EEG characteristics - distribution, type and frequency of epileptiform discharges.
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Assessment method [3]
342626
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Timepoint [3]
342626
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EEG results will be checked immediately following enrolment.
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Secondary outcome [4]
342627
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Number of antiepileptic medications being used by the participant as self-reported by the participant (presently used at the time of enrolment).
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Assessment method [4]
342627
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Timepoint [4]
342627
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At enrolment.
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Eligibility
Key inclusion criteria
Diagnosis of Idiopathic Generalised Epilepsy (IGE) or Temporal Lobe Epilepsy (TLE), right-handedness, able to provide written informed consent in English.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Any contraindication to a 7-Tesla MRI scan (a detailed safety questionnaire will be used).
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Study design
Purpose
Screening
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Duration
Cross-sectional
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Selection
Convenience sample
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Timing
Prospective
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Statistical methods / analysis
After data acquisition the MRS metabolites will be quantified using the LCModel software package. Pre-processing of the fMRI data will be performed using the SPM12 software (Wellcome Trust Centre for Neuroimaging, UCL) and CONN toolbox version 17 (McGovern Institute of Brain Research, MIT). Predefined Regions-Of-Interest (ROIs) from the CONN-fMRI Functional Connectivity toolbox will be chosen based on a prior study as seeds to create connectivity maps of the default mode network.
Seed-to-voxel and ROI-to-ROI functional connectivity maps will be created for each subject. Maps of functional connectivity will be calculated by computing Pearson’s product moment correlation between each pair of ROIs (ROI-to-ROI) and between each ROI and all acquired voxels (Seed-to-voxel). For each ROI the values will be the mean of all voxels within the ROI. Correlation maps will be converted to z-maps using Fisher’s r-to-z transformation.
Results of exploratory analyses will be considered significant if they survived correction for multiple comparisons (FDR = 0.05).
Mean differences between clinical characteristics, GABA and glutamate concentration measurements and parameters of functional connectivity will be calculated using Student’s t-test for continuous variables and chi-square test or Fisher’s exact test for categorical data. The Mann–Whitney U-test will be used for nonparametric evaluations of the mean differences between the groups regarding seizure frequency and drug treatment. The level of significance will be set to a = 0.05 (two sided). Subgroup analysis of right versus left TLE and drug-responsive versus drug-resistant IGE patients will be performed.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
19/02/2018
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Actual
27/06/2018
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
60
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Accrual to date
13
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
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Royal Melbourne Hospital - City campus - Parkville
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Recruitment hospital [2]
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The Alfred - Prahran
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Recruitment postcode(s) [1]
18730
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3050 - Parkville
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Recruitment postcode(s) [2]
18731
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3004 - Prahran
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
298549
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The Royal Melbourne Hospital Neuroscience Foundation
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Address [1]
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4 East, Main Building
The Royal Melbourne Hospital
300 Grattan Street, Parkville 3050, VIC
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Country [1]
298549
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Australia
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Primary sponsor type
Hospital
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Name
The Royal Melbourne Hospital
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Address
300 Grattan Street
Parkville 3050, VIC
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
297695
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Address [1]
297695
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Country [1]
297695
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
299518
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Melbourne Health Human Research Ethics Committee
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Ethics committee address [1]
299518
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Office for Research Level 2 South West The Royal Melbourne Hospital 300 Grattan Street Parkville 3050, VIC
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Ethics committee country [1]
299518
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Australia
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Date submitted for ethics approval [1]
299518
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25/10/2017
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Approval date [1]
299518
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09/01/2018
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Ethics approval number [1]
299518
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HREC/17/MH/341
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Summary
Brief summary
Despite adequate treatment with two or more antiepileptic drugs, about one third of patients diagnosed as having epilepsy are not seizure-free. It is imperative to promptly diagnose and manage these patients, as recurrent seizures are correlated with important clinical, cognitive and socioeconomic consequences. The current project aims to recruit patients with temporal lobe epilepsy and idiopathic generalised epilepsy, and to study the connectivity measures of a resting-state brain network called the Default Mode Network (DMN) in these patients via functional Magnetic Resonance Imaging (fMRI). In addition, the concentration of various metabolites in one the key nodes of this network will be measured via Magnetic Resonance Spectroscopy (MRS). The results of these scans will be compared to data already collected from healthy controls to create a predictive model that will facilitate the diagnosis of patients with different types of epilepsy, and to distinguish between drug-resistant and drug-responsive cases, via a brief MRI scan.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Ofer Gonen
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Address
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Neurology Department
The Royal Melbourne Hospital
300 Grattan Street
Parkville 3050, VIC
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Country
80694
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Australia
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Phone
80694
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+61 3 93427722
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Fax
80694
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+61 3 93428628
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Email
80694
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[email protected]
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Contact person for public queries
Name
80695
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Ofer Gonen
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Address
80695
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Neurology Department
The Royal Melbourne Hospital
300 Grattan Street
Parkville 3050, VIC
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Country
80695
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Australia
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Phone
80695
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+61 3 93427722
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Fax
80695
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+61 3 93428628
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Email
80695
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[email protected]
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Contact person for scientific queries
Name
80696
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Ofer Gonen
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Address
80696
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Neurology Department
The Royal Melbourne Hospital
300 Grattan Street
Parkville 3050, VIC
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Country
80696
0
Australia
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Phone
80696
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+61 3 93427722
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Fax
80696
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+61 3 93428628
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Email
80696
0
[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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