Landwehrmeyer Georg B, Fitzer-Attas Cheryl J, Giuliano Joseph D, Gonçalves Nilza, Anderson Karen E, Cardoso Francisco, Ferreira Joaquim J, Mestre Tiago A, Stout Julie C, Sampaio Cristina
Department of Neurology University of Ulm Ulm Germany.
CHDI Management/CHDI Foundation Princeton New Jersey USA.
Mov Disord Clin Pract. 2016 Jun 22;4(2):212-224. doi: 10.1002/mdc3.12388. eCollection 2017 Mar-Apr.
The study of complex neurodegenerative diseases is moving away from hypothesis-driven biological methods toward large scale multimodal approaches, requiring standardized collaborative efforts. Enroll-HD exemplifies such an integrated clinical research platform, designed and implemented to meet the research and clinical needs of Huntington's disease (HD). The aim of this study was to describe the unique organization of Enroll-HD and report baseline data analyses of its core study.
The Enroll-HD platform incorporates electronic data capture, biosampling, and a longitudinal observational study spanning four continents (ClinicalTrials.gov Identifier: NCT01574053). The primary study population includes HD gene expansion carriers (HDGECs; CAG expansion ≥36), subdivided into manifest/premanifest HD. The control population consists of genotype-negative first-degree relatives and family controls not genetically related. The study includes 10 core clinical assessments covering motor, cognitive, and behavioral domains.
This data set comprises 1,534 participants (HDGEC = 1,071; controls = 463). Participant retention was high; 42 participants prematurely withdrew from the study. Mean ± standard deviation SD CAG repeat size was 43.5 ± 3.5 for HDGECs and 19.8 ± 3.4 for controls. Motor and behavioral assessments identified numerical differences between controls and HDGECs (manifest > premanifest > controls). Functional and independence assessments were generally similar for the premanifest and control groups with overlap in range of scores obtained. For the majority of cognitive tests, there were large differences between participants with manifest HD and all other groups.
These first data from the Enroll-HD clinical research platform demonstrate the maturity and potential of the platform in collecting high-quality, clinically relevant data. Future data sets will be substantially larger as the platform expands longitudinally and regionally.
复杂神经退行性疾病的研究正从假设驱动的生物学方法转向大规模多模态方法,这需要标准化的协作努力。“注册亨廷顿病研究(Enroll-HD)”就是这样一个综合临床研究平台,其设计和实施旨在满足亨廷顿病(HD)的研究和临床需求。本研究的目的是描述Enroll-HD的独特组织架构,并报告其核心研究的基线数据分析。
Enroll-HD平台整合了电子数据采集、生物样本采集以及一项覆盖四大洲的纵向观察性研究(ClinicalTrials.gov标识符:NCT01574053)。主要研究人群包括亨廷顿病基因扩展携带者(HDGECs;CAG扩展≥36),再细分为显性/症状前HD。对照人群由基因型阴性的一级亲属和无遗传关系的家族对照组成。该研究包括10项核心临床评估,涵盖运动、认知和行为领域。
该数据集包含1534名参与者(HDGECs = 1071;对照 = 463)。参与者保留率很高;42名参与者提前退出研究。HDGECs的平均±标准差CAG重复长度为43.5±3.5,对照为19.8±3.4。运动和行为评估确定了对照组与HDGECs之间的数值差异(显性>症状前>对照)。症状前组和对照组的功能及独立性评估总体相似,得分范围有重叠。对于大多数认知测试,显性HD参与者与所有其他组之间存在很大差异。
来自Enroll-HD临床研究平台的这些首批数据证明了该平台在收集高质量、临床相关数据方面的成熟度和潜力。随着该平台在纵向和区域上的扩展,未来的数据集将大幅增加。