Enrolling by invitation
Observational
Digitally-enhanced, Decentralized, Multi-omics Observational Cohort
Condition(s) studied
Presymptomatic DiseaseMild Cognitive ImpairmentMemory Loss (Excluding Dementia)Cognitive ChangeDementiaAlzheimer DiseaseParkinson's Disease and Parkinsonism
Investigational drug(s) / intervention(s)
Teleph0s digital phenotyping platform
Teleph0s digital phenotyping platform: Computerized multimodal assessment of complex neurological and psychiatric interviews (AI-COPE).
Study summary
The study is carried out as part of the GR2021 Priority project "Healthy Brains for life (Age 20-99): Digitally-enhanced personalized medicine study ANANEOS" and code numbered GR-00546 and it will look at the decentralized and remote assessment of the symptoms of preclinical stages in Alzheimer's disease and movement disorders, e.g. Parkinson's. For this study we are looking for participants aged over 45 without cognitive complaints or with subjective perception of cognitive decline or with mild cognitive complaints. Specific aims for the proposed study: a) to develop novel sensitive measures that can provide an early identification of those SCD and MCI individuals harboring AD pathology that are at high risk of cognitive worsening over time; b) to track pre-motor stages in Parkinson's disease and trials that enable active digital functional biomarkers; c) to track disease progression during pre-dementia and pre-motor stages in clinical practice and trials with measures that enable to capture subtle changes.
Eligibility
Inclusion Criteria for Cohort participants:
* Male or female over 45 years of age.
* Subject is seen at a memory clinic or is part of an observational study.
* An informant (caregiver/family member) is available to collaborate.
* Diagnosis of individuals in the AD biological continuum with evidence of amyloid-beta accumulation based on the presence of Aβ load AD biomarkers (either in CSF or PET scan), MMSE, CDR score and cognitive tests as defined by the Guidance document of EMA (2016) or FDA (2018):
* preclinical AD: MMSE≥27 and CDR=0, either none or borderline cognitive deficits (compatible with FDA stages 1 and 2, with positive AD biomarkers). Patients reporting subjective cognitive decline who meet the criteria above are eligible for assignment to the preclinical AD group.
* prodromal AD/MCI due to AD: MMSE \>23, CDR=0.5, impairment on cognitive testing with RBANS (compatible with stage 3 FDA, with positive AD biomarkers).
* Prodromal PD: Male or female age 60 years or older (except age 30 years or older for SNCA, or rate genetic mutations (such as Parkin or Pink1) participants).
* Individuals taking any of the following drugs: alpha methyldopa, methylphenidate, amphetamine derivatives or modafinil, must be willing and medically able to hold the medication for at least 5 half-lives before DaTscan imaging.
* Informed consent signed by the subject and informant.
* Informant should be able to read and communicate in the language of the recruitment centre and available to actively engage in tests and questionnaires.
* Subject and the informant own a smartphone.
Inclusion Criteria for Healthy volunteers:
* Male or female over 45 years of age.
* Individuals with no evidence of amyloid-beta accumulation based on the presence of Aβ load AD biomarkers (either in CSF or PET scan).
* Approximately age and gender matched to AD subjects on a group level.
* An informant is available to collaborate.
* MMSE \>27, CDR=0.
* In otherwise good health conditions, or with diagnosis mild chronic disorders (of metabolic, respiratory, immunological, cardiologic, and metabolic origin) or any other affections that are controlled by the therapy and do not importantly limit ADLs or social interactions.
* Able to read and to communicate in the language of the recruitment centre.
* nformed consent signed by the subject and caregiver.
* Subject and informant own a smartphone.
Exclusion Criteria for Cohort participants:
* Presence of an additional neurological or psychiatric disease that may affect ADL, cognitive function or social interactions.
* Clinical diagnosis of PD, other parkinsonism, or dementia.
* Received any of the following drugs: dopamine receptor blockers (neuroleptics), metoclopramide and reserpine within 6 months of Screening visit.
* Current treatment with anticoagulants (e.g. coumadin, heparin) that might preclude safe completion of the lumbar puncture.
* Abnormal VB12 value.
* Any other kind of disorders that relevantly affect mobility and/or ADL, cognitive function or social interactions (e.g., immune-mediated inflammatory disorders, recovery from recent trauma, stroke, etc.).
* TSH above normal range
* T3 or T4 outside normal range with clinically significant.
Exclusion Criteria for Healthy volunteers:
* Presence of an additional neurological or psychiatric disease that may affect ADL, cognitive function or social interactions.
* Diagnosis of any disorders or post traumatic conditions that are not fully controlled by the therapy and produce relevant limitations of ADL, cognitive function or social interactions.
Primary outcome measure(s)
- Establish standardized protocols for acquisition, transfer & analysis of clinical, digital, imaging, biologic and genetic data that can be used in the AD & PD research community. — baseline to 60 months
This protocol will build on the existing Greek Brain Registry infrastructure
- Comprehensive and uniformly acquired dataset — baseline to 60 months
Develop a comprehensive and uniformly acquired clinical, digital and imaging dataset and repository of biological and genetic samples that would be available to the PD research community to test hypotheses of the underlying molecular pathobiology of PD, enable modeling of PD progression to identify clinical and/or data driven PD progression sub-sets, and inform studies testing PD therapeutics (for examples, clinical trials targeting synuclein, LRRK2, GBA as well as other targets)
- Change in Diagnostic Area Under the Receiver Operating Characteristic Curve (ROC-AUC) — 60 months of follow up
The machine learning models capturing voice data, hands micromovements \& micro-errors, posture changes, eye tracking, visuospatial navigation micro-errors and spatio-temporal gait parameters developed for the Altoida system will be tested in this prospective cohort. Sensitivity, specificity and accuracy of the model will be tested in differential diagnosis between the study groups as well as the accuracy of predicting cognitive trajectories as measured by neuropsychological test battery in both groups.
Trial sites (4)
| Facility | City | Region | Status |
| Ionian University |
Corfu |
Corfu |
|
| Panhellenic Federation Of Alzheimer's Disease And Related Disorders |
Thessaloniki |
Greece |
|
| Greek Alzheimer's Association and Related Disorders |
Thessaloniki |
Greece |
|
| Hospital Clinic Barcelona |
Barcelona |
Spain |
|
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