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AzTrials

Amyotrophic Lateral SclerosisNCT05747937

Longitudinal Assessment of Autonomic and Sensory Nervous System in ALS

A study testing Skin biopsy, Cardiovascular Reflexes testing and Administration of clinical scales evaluating autonomic symptoms, pain small fiber neuropathy symptoms in people with Amyotrophic Lateral Sclerosis, run by Istituti Clinici Scientifici Maugeri SpA at 2 sites in Italy.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The goal of this interventional non-pharmacological study is to evaluate, using a multimodal approach, the progression of autonomic and sensory involvement in in amyotrophic lateral sclerosis (ALS) patients enrolled within 18 months from motor onset and its relationship with the progression of overall clinical… Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
Conditions the study is for
Amyotrophic Lateral Sclerosis
What is being tested?
Skin biopsy, Cardiovascular Reflexes testing and Administration of clinical scales evaluating autonomic symptoms, pain small fiber neuropathy symptoms
Could I receive a placebo?
No, everyone receives an active treatment
How many people
100 participants
Where
2 sitesItaly
Study dates
15 May 2021to 30 Dec 2026
Phase
Interventional
Are there results?
Not yet: the study is under way

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 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • ALS patients will be recruited within 18 months from the motor symptoms onset

Who cannot join

  • glucose intolerance or conditions potentially affecting the peripheral nervous system

Trial locations and contacts

2 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Italy2 sites, 2 recruiting
  • Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II

    Naples, 80131

    Raffaele Dubbioso, MD, 0817464587, raffaele.dubbioso@unina.it

    Recruiting
  • ICS Maugeri - IRCCS of Telese Terme

    Telese Terme, Benevento, 82037

    Vincenzo Provitera, MD, +390824909257, vincenzo.provitera@icsmaugeri.it

    Recruiting

Other trials in Italy

About this study

The goal of this interventional non-pharmacological study is to evaluate, using a multimodal approach, the progression of autonomic and sensory involvement in in amyotrophic lateral sclerosis (ALS) patients enrolled within 18 months from motor onset and its relationship with the progression of overall clinical disability.

The main questions it aims to answer are:

Read more
  • Is autonomic dysfunction at diagnosis associated with disease progression and survival in patients with Amyotrophic Lateral Sclerosis ?
  • Can we identify in the skin biomarkers to be used as reliable measures of disease progression and to apply in future clinical trials for patient stratification and to assess response to drug treatment ? Participants at time 0 will receive a full clinical and instrumental examination and a blood sample testing to check inclusion and exclusion criteria, genetic screening for the most common genes associated with ALS (SOD1, FUS, TARDBP and c9orf72), questionnaires about clinical characteristics, quality of life, pain and a multidomain battery of neuropsychological tests, multimodal assessment of the autonomic nervous system including skin biopsy for morphological study. At follow-up we'll perform clinical scales and skin biopsy.

Researchers will compare results from ALS patients with data obtained from a population of age and sex matched healthy subjects.

Being tested
Skin biopsy, Cardiovascular Reflexes testing, Administration of clinical scales evaluating autonomic symptoms, pain small fiber neuropathy symptoms, Dinamic Sweat Test
Keywords
Autonomic nervous system, skin biopsy, biomarkers, cutaneous sensory an autonomic innervation
Medical subject headings
Amyotrophic Lateral Sclerosis

What participants receive

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

  • Skin biopsyDiagnostic test

    A punch skin biopsy of 3mm will be used to analyze cutaneous innervation

  • Cardiovascular Reflexes testingDiagnostic test

    Cardiovascular reflex tests including deep breathing, head-up Tilt, standing, isometric exercises, mental arithmetic and Valsalva maneuver.

  • Administration of clinical scales evaluating autonomic symptoms, pain small fiber neuropathy symptomsDiagnostic test

    We'll characterize patients' symptoms through the administration of clinical scales such as: SCOPA-AUT autonomic symptoms scale; Brief Pain Inventory questionnaire

  • Dinamic Sweat TestDiagnostic test

    Test for the functional assessment of postganglionic sudomotor pathway

Study groups in NCT05747937
Study groupRoleWhat they receive
Amyotrophic Lateral Sclerosis patientsExperimentalAmyotrophic Lateral Sclerosis (ALS) patients within 18 months from symptoms onset will be recruited
Receives: Diagnostic Test: Skin biopsy; Diagnostic Test: Cardiovascular Reflexes testing; Diagnostic Test: Administration of clinical scales evaluating autonomic symptoms, pain small fiber neuropathy symptoms; Diagnostic Test: Dinamic Sweat Test
Healthy controlsActive comparatorA population of healthy controls matched for sex and age will be enrolled
Receives: Diagnostic Test: Skin biopsy; Diagnostic Test: Cardiovascular Reflexes testing; Diagnostic Test: Administration of clinical scales evaluating autonomic symptoms, pain small fiber neuropathy symptoms; Diagnostic Test: Dinamic Sweat Test

What is being measured

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

  1. Sensory peripheral innervation (IENF)

    Quantification Intraepidermal Nerve Fibers (IENF ff/mm) in skin biopsy from fingertip, thigh and leg.

    Measured: At recruitment

  2. Autonomic peripheral innervation

    Quantification of nerves in sweat gland (fiber lenght/um3) in skin biopsy from fingertip, thigh and leg.

    Quantification of nerves in arrector pili muscle (ff/mm) in skin biopsy from thigh and leg.

    Measured: At recruitment

  3. Autonomic peripheral innervation

    Quantification sweat gland (fiber lenght/um3) and arrector pili muscle (ff/mm) innervation in skin biopsy from thigh.

    Measured: At follow-up, an average of 6 months

  4. Sensory peripheral innervation (IENF)

    Quantification Intraepidermal Nerve Fibers (IENF ff/mm) in skin biopsy from thigh.

    Measured: At follow-up, an average of 6 months

Secondary outcomes (4)
  1. Sensory and autonomic symptoms evaluated by clinical scales

    Data of sensory and autonomic symptoms (Small fiber neuropathy Symptoms inventory questionnaire (SFN-SIQ) and Scale for Outcomes in Parkinson's disease for Autonomic Symptoms (SCOPA AUT)) will be collected

    Measured: At the recruitment

  2. Sensory and autonomic symptoms evaluated by clinical scales

    Data of sensory and autonomic symptoms (Small fiber neuropathy Symptoms inventory questionnaire (SFN-SIQ) and Scale for Outcomes in Parkinson's disease for Autonomic Symptoms (SCOPA AUT)) will be collected

    Measured: At follow-up, an average of 6 months

  3. Assessment of Cardiovascular function

    Data from cardiovascular reflex test will be analyzed and compared with morphological data and clinical motor severity

    Measured: baseline

  4. Sudomotor function

    Data from dinamic sweat test will be analyzed and compared with morphological data and clinical motor severity

    Measured: baseline

Timeline

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

  1. First posted28 Feb 2023
  2. Study start15 May 2021
  3. Primary completion30 Sep 2026 (estimated)
  4. Study completion30 Dec 2026 (estimated)

Resources

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 N/A
Primary purpose
Basic science
Allocation
Non-randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
100 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05747937
Sponsor's protocol ID
SBLAB/SLA20
Status last verified
Apr 2026
First submitted
26 Jan 2023
Last updated
17 Apr 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Mahoney CJ, Ahmed RM, Huynh W, Tu S, Rohrer JD, Bedlack RS, Hardiman O, Kiernan MC. Pathophysiology and Treatment of Non-motor Dysfunction in Amyotrophic Lateral Sclerosis. CNS Drugs. 2021 May;35(5):483-505. doi: 10.1007/s40263-021-00820-1. Epub 2021 May 15.

    PubMed 33993457
  • Gentile F, Scarlino S, Falzone YM, Lunetta C, Tremolizzo L, Quattrini A, Riva N. The Peripheral Nervous System in Amyotrophic Lateral Sclerosis: Opportunities for Translational Research. Front Neurosci. 2019 Jun 25;13:601. doi: 10.3389/fnins.2019.00601. eCollection 2019.

    PubMed 31293369
  • Sassone J, Taiana M, Lombardi R, Porretta-Serapiglia C, Freschi M, Bonanno S, Marcuzzo S, Caravello F, Bendotti C, Lauria G. ALS mouse model SOD1G93A displays early pathology of sensory small fibers associated to accumulation of a neurotoxic splice variant of peripherin. Hum Mol Genet. 2016 Apr 15;25(8):1588-99. doi: 10.1093/hmg/ddw035. Epub 2016 Feb 9.

    PubMed 26908600
  • Weis J, Katona I, Muller-Newen G, Sommer C, Necula G, Hendrich C, Ludolph AC, Sperfeld AD. Small-fiber neuropathy in patients with ALS. Neurology. 2011 Jun 7;76(23):2024-9. doi: 10.1212/WNL.0b013e31821e553a.

    PubMed 21646630
  • Truini A, Biasiotta A, Onesti E, Di Stefano G, Ceccanti M, La Cesa S, Pepe A, Giordano C, Cruccu G, Inghilleri M. Small-fibre neuropathy related to bulbar and spinal-onset in patients with ALS. J Neurol. 2015;262(4):1014-8. doi: 10.1007/s00415-015-7672-0. Epub 2015 Feb 17.

    PubMed 25683764
  • Nolano M, Provitera V, Manganelli F, Iodice R, Caporaso G, Stancanelli A, Marinou K, Lanzillo B, Santoro L, Mora G. Non-motor involvement in amyotrophic lateral sclerosis: new insight from nerve and vessel analysis in skin biopsy. Neuropathol Appl Neurobiol. 2017 Feb;43(2):119-132. doi: 10.1111/nan.12332. Epub 2016 Jul 7.

    PubMed 27288647
  • deCarvalho M, Gromicho M, Andersen P, Grosskreutz J, Kuzma-Kozakiewicz M, Petri S, Uysal H, Pinto S. Peripheral neuropathy in ALS: phenotype association. J Neurol Neurosurg Psychiatry. 2021 Oct;92(10):1133-1134. doi: 10.1136/jnnp-2020-325164. Epub 2020 Dec 28. No abstract available.

    PubMed 33372053
  • Chio A, Mora G, Lauria G. Pain in amyotrophic lateral sclerosis. Lancet Neurol. 2017 Feb;16(2):144-157. doi: 10.1016/S1474-4422(16)30358-1. Epub 2016 Dec 8.

    PubMed 27964824
  • Fasolino A, Di Stefano G, Leone C, Galosi E, Gioia C, Lucchino B, Terracciano A, Di Franco M, Cruccu G, Truini A. Small-fibre pathology has no impact on somatosensory system function in patients with fibromyalgia. Pain. 2020 Oct;161(10):2385-2393. doi: 10.1097/j.pain.0000000000001920.

    PubMed 32897040
  • Finnerup NB, Haroutounian S, Kamerman P, Baron R, Bennett DLH, Bouhassira D, Cruccu G, Freeman R, Hansson P, Nurmikko T, Raja SN, Rice ASC, Serra J, Smith BH, Treede RD, Jensen TS. Neuropathic pain: an updated grading system for research and clinical practice. Pain. 2016 Aug;157(8):1599-1606. doi: 10.1097/j.pain.0000000000000492.

    PubMed 27115670
  • Damon-Perriere N, Foubert-Samier A, De Cock VC, Gerdelat-Mas A, Debs R, Pavy-Le Traon A, Senard JM, Rascol O, Tison F, Meissner WG. Assessment of the Scopa-Aut questionnaire in multiple system atrophy: relation to UMSARS scores and progression over time. Parkinsonism Relat Disord. 2012 Jun;18(5):612-5. doi: 10.1016/j.parkreldis.2011.12.009. Epub 2012 Jan 9.

    PubMed 22236582
  • Brooks BR, Miller RG, Swash M, Munsat TL; World Federation of Neurology Research Group on Motor Neuron Diseases. El Escorial revisited: revised criteria for the diagnosis of amyotrophic lateral sclerosis. Amyotroph Lateral Scler Other Motor Neuron Disord. 2000 Dec;1(5):293-9. doi: 10.1080/146608200300079536. No abstract available.

    PubMed 11464847

Questions about this trial

What is this clinical trial studying?

A study testing Skin biopsy, Cardiovascular Reflexes testing and Administration of clinical scales evaluating autonomic symptoms, pain small fiber neuropathy symptoms in people with Amyotrophic Lateral Sclerosis, run by Istituti Clinici Scientifici Maugeri SpA at 2 sites in Italy.

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 1 inclusion and 1 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: looking for participants now, as of the sponsor's last update on 17 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in Italy. 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?

This study is still under way. Results are not available in the source record yet.

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

Contact Maria Nolano, MD, PhD (+390824909257, maria.nolano@icsmaugeri.it), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Sensory peripheral innervation (IENF) (time frame: At recruitment). The study lists 4 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 NCT05747937, which also lists 12 linked publications.

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 17 Apr 2026.

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