Multiple SclerosisPhase 1/2NCT04144257
Role of Microglial Activation and Norepinephrine Transporter Abnormalities in Pathogenesis of MS-related Fatigue
A Phase 1/2 study testing [F-18]PBR06 and [C-11]Methylreboxetine in people with Multiple Sclerosis, run by Brigham and Women's Hospital at 1 site in United States.
Trial summary
The overarching aim is to assess the role of microglial activation and norepinephrine transporter binding in pathogenesis of MS-related fatigue, using novel Positron Emission Tomography (PET) radiotracers, [F-18]PBR06 and [C-11]MRB. Read more about this study
- Who is it for?
- Ages 18 to 60 years
- Conditions the study is for
- Multiple Sclerosis
- What is being tested?
- [F-18]PBR06 and [C-11]Methylreboxetine
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 14 participants
- Where
- 1 siteUnited States
- Study dates
- 12 Mar 2020to 13 Apr 2021
- Phase
- Phase 1/2
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 18 to 60 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Subjects meeting the definition for RRMS or SPMS by International Panel (2017 McDonald) Criteria.
- We will recruit patients with RRMS, recently diagnosed in the last 2 years. There will be no disease modifying therapy restrictions for RRMS or SPMS patients.
- Male and female subjects age 18 to 60 years.
- Patients able to withhold medication that may interfere with C-11[MRB] radiotracer uptake for 24 hours before the scan.
Who cannot join
- Relapse/Corticosteroid treatment in the past 4 weeks to avoid transient effects on imaging
- Individuals with a known alternate neurologic disorder, previous head injury, or substance abuse.
- Individuals with bipolar disease and schizophrenia
- Concurrent medical conditions that contraindicate study procedures.
- Women who are pregnant or nursing. Also, any woman who is seeking to become pregnant or suspects she is pregnant will be excluded from enrollment.
- Claustrophobia
- Non-MRI compatible implanted devices
- Low affinity binders
Trial locations and contacts
1 site in 1 country.
United States1 site
Brigham MS Center, 60 Fenwood Road
Boston, Massachusetts, 02115
About this study
The overarching aim is to assess the role of microglial activation and norepinephrine transporter binding in pathogenesis of MS-related fatigue, using novel Positron Emission Tomography (PET) radiotracers, [F-18]PBR06 and [C-11]MRB.
Specific Aims:
Read more
Specific Aim 1: To determine the relationship of cerebral microglial activation, as assessed by [F-18]PBR06 PET, with MS-related fatigue.
Specific Aim 2: To determine the relationship of norepinephrine transporter (NET) binding, as assessed by [C-11]MRB PET, with MS-related fatigue.
Specific Aim 3: To determine the relationship of microglial activation and NET binding, with grey matter pathology (lesion load and brain atrophy) assessed using 7T MRI, and evaluate their independent contribution in development of MS-related fatigue.
Read the detailed description
Design: This is a single center, cross-sectional study of patients with multiple sclerosis, who will each, undergo both, [C-11]MRB-PET (norepinephrine transporter binding) and [F-18]PBR06-PET (microglial activation), in addition to 7 Tesla brain MRIs. Patients will also undergo cross-sectional estimations of blood markers.
Genotype Testing:
Blood sample drawn on the initial screening visit will be used to obtain genomic DNA for genotyping for polymorphism within the TSPO gene on chromosome 22q13.2, using a Taqman assay. High affinity and medium affinity binders will be included while the low affinity binders will be excluded from the study.
PET Scanning:
During the PET scan visits, all women subjects of child bearing age will undergo a stat quantitative serum hCG pregnancy test and only women with a negative test will undergo the radiopharmaceutical injection. The radiotracers will be produced using standardized procedures. At the time of imaging, the subjects will be positioned in the gantry of a high-resolution PET/CT camera. Head alignment will be made, relative to the canthomeatal line, using projected laser lines whose positions are known with respect to the slice positions of the scanner. A head support apparatus will be used to minimize head motion.Dynamic data over 120 minutes for PET quantification will be acquired, according to previously described methods for both tracers.
MRI Scanning:
High resolution MRI scanning will be performed using the 7T Siemens MAGNETOM Terra MRI unit at Brigham \& Women's Hospital (BWH).
Serum assays:
Serum measurements for inflammatory markers and relevant neurochemicals will be performed according to established procedures.
Clinical Data
The following non-imaging, clinical data will be obtained:
Modified fatigue Impact Scale (MFIS) Fatigue Severity Status Scale (FSSS) Expanded Disability Status Scale (EDSS) Timed 25-feet walk (T25W) MS Functional Composite (MSFC) Symbol digit modalities test (SDMT) MSQOL-54 scale (QOL) Pittsburgh Sleep Quality Index (PSQI) Beck's Depression Inventory (BDI) Center for Epidemiological Studies-Depression Scale (CES-D) Hospital Anxiety and Depression Scale (HADS)
- Conditions
- Multiple Sclerosis
- Being tested
- [F-18]PBR06, [C-11]Methylreboxetine
- Medical subject headings
- Multiple Sclerosis
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
[F-18]PBR06Drug
Also called [18F]PBR06
PET radiopharmaceutical. Subjects will undergo [F-18]PBR06-PET (microglial activation).
[C-11]MethylreboxetineDrug
Also called [C-11]MRB
PET radiopharmaceutical. Subjects will undergo [C-11]MRB-PET (norepinephrine transporter binding).
| Study group | Role | What they receive |
|---|---|---|
| Subjects diagnosed with multiple sclerosis | Experimental | We plan to enroll 12 subjects with multiple sclerosis (6 with relapsing-remitting multiple sclerosis and 6 with secondary progressive multiple sclerosis). Receives: Drug: [F-18]PBR06; Drug: [C-11]Methylreboxetine |
What is being measured
The primary outcome is the main question the study is designed to answer.
Standardized Uptake Value Ratio (SUVR)
PET outcome measure for [F-18]PBR06 radioligand used to quantify microglial activation.
Measured: Baseline
Area Under the Curve Ratio (AUCR)
PET outcome measure for [C-11]MeNer radioligand used to quantify norepinephrine transporter binding in brain regions of interest (e.g, putaminal, pallidal, and white matter).
Measured: Baseline
Secondary outcomes (2)
Correlations Between Modified Fatigue Impact Scale (MFIS) and PET Outcome Measures
MFIS is a fatigue rating scale. Scores range from 0-84. Higher values indicate worse fatigue.
Measured: Baseline
Correlations Between Expanded Disability Status Scale (EDSS) and PET Outcome Measures
EDSS is a disability rating scale. Scores range from 0-10. Higher values indicate worse clinical function.
Measured: Baseline
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted30 Oct 2019
- Study start12 Mar 2020
- Primary completion13 Apr 2021
- Study completion13 Apr 2021
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for Multiple SclerosisStudies of the same condition, open and under way.
- More trials run by Brigham and Women's HospitalThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 1/2
- Primary purpose
- Diagnosis
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 14 participants (actual)
Sponsor and investigators
- Lead sponsor
- Brigham and Women's Hospital
- Sponsor type
- University, hospital or other
- Collaborators
- U.S. Army Medical Research Acquisition Activity
- Responsible party
- Principal investigator, TARUN SINGHAL, Brigham and Women's Hospital
- Investigators
- Tarun Singhal, MD, Principal investigator, Brigham and Women's Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04144257
- Sponsor's protocol ID
- 2019P002356
- Status last verified
- Sep 2026
- First submitted
- 28 Oct 2019
- Last updated
- 15 Oct 2026
- Results posted
- Yes, on ClinicalTrials.gov
- FDA-regulated drug
- Yes
- FDA-regulated device
- No