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Snijders BM, Mathijssen G, Peters MJ, Emmelot-Vonk MH, de Jong PA, Bakker S, Crommelin HA, Ruigrok YM, Brilstra EH, Schepers VP, Spiering W, van Valen E, Koek HL. The effects of etidronate on brain calcifications in Fahr's disease or syndrome: rationale and design of the randomised, placebo-controlled, double-blind CALCIFADE trial. Orphanet J Rare Dis 2024; 19:49. [PMID: 38326858 PMCID: PMC10851566 DOI: 10.1186/s13023-024-03039-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 01/19/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Fahr's disease and syndrome are rare disorders leading to calcification of the small arteries in the basal ganglia of the brain, resulting in a wide range of symptoms comprising cognitive decline, movement disorders and neuropsychiatric symptoms. No disease-modifying therapies are available. Studies have shown the potential of treatment of ectopic vascular calcifications with bisphosphonates. This paper describes the rationale and design of the CALCIFADE trial which evaluates the effects of etidronate in patients with Fahr's disease or syndrome. METHODS The CALCIFADE trial is a randomised, placebo-controlled, double-blind trial which evaluates the effects of etidronate 20 mg/kg during 12 months follow-up in patients aged ≥ 18 years with Fahr's disease or syndrome. Etidronate and placebo will be administered in capsules daily for two weeks on followed by ten weeks off. The study will be conducted at the outpatient clinic of the University Medical Center Utrecht, the Netherlands. The primary endpoint is the change in cognitive functioning after 12 months of treatment. Secondary endpoints are the change in mobility, neuropsychiatric symptoms, volume of brain calcifications, dependence in activities of daily living, and quality of life. RESULTS Patient recruitment started in April 2023. Results are expected in 2026 and will be disseminated through peer-reviewed journals as well as presentations at national and international conferences. CONCLUSIONS Fahr's disease and syndrome are slowly progressive disorders with a negative impact on a variety of health outcomes. Etidronate might be a new promising treatment for patients with Fahr's disease or syndrome. TRIAL REGISTRATION ClinicalTrials.gov, NCT05662111. Registered 22 December 2022, https://clinicaltrials.gov/ct2/show/NCT01585402 .
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Affiliation(s)
- Birgitta Mg Snijders
- Department of Geriatrics, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
| | - Gini Mathijssen
- Department of Geriatrics, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Mike Jl Peters
- Department of Geriatrics, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Department of Internal Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Marielle H Emmelot-Vonk
- Department of Geriatrics, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Pim A de Jong
- Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Susan Bakker
- Department of Geriatrics, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Department of Physiotherapy, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Heleen A Crommelin
- Department of Clinical Pharmacy, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Ynte M Ruigrok
- Department of Neurology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Eva H Brilstra
- Department of Genetics, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Vera Pm Schepers
- Department of Rehabilitation, Physical Therapy, Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Wilko Spiering
- Department of Internal Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Evelien van Valen
- Department of Geriatrics, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Huiberdina L Koek
- Department of Geriatrics, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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Harada T, Kudo K, Fujima N, Yoshikawa M, Ikebe Y, Sato R, Shirai T, Bito Y, Uwano I, Miyata M. Quantitative Susceptibility Mapping: Basic Methods and Clinical Applications. Radiographics 2022; 42:1161-1176. [PMID: 35522577 DOI: 10.1148/rg.210054] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Quantitative susceptibility mapping (QSM), one of the advanced MRI techniques for evaluating magnetic susceptibility, offers precise quantitative measurements of spatial distributions of magnetic susceptibility. Magnetic susceptibility describes the magnetizability of a material to an applied magnetic field and is a substance-specific value. Recently, QSM has been widely used to estimate various levels of substances in the brain, including iron, hemosiderin, and deoxyhemoglobin (paramagnetism), as well as calcification (diamagnetism). By visualizing iron distribution in the brain, it is possible to identify anatomic structures that are not evident on conventional images and to evaluate various neurodegenerative diseases. It has been challenging to apply QSM in areas outside the brain because of motion artifacts from respiration and heartbeats, as well as the presence of fat, which has a different frequency to the proton. In this review, the authors provide a brief overview of the theoretical background and analyze methods of converting MRI phase images to QSM. Moreover, we provide an overview of the current clinical applications of QSM. Online supplemental material is available for this article. ©RSNA, 2022.
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Affiliation(s)
- Taisuke Harada
- From the Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, N15 W7, Kita-ku, Sapporo, Japan (T.H., K.K., M.Y.); Center for Cause of Death Investigation (T.H.) and Global Center for Biomedical Science and Engineering (K.K.), Faculty of Medicine, Hokkaido University, Sapporo, Japan; Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan (T.H., K.K., N.F., M.Y., Y.I.); Innovative Technology Laboratory, Fujifilm Healthcare Corporation, Tokyo, Japan (R.S., T.S.); Fujifilm Healthcare Corporation, Chiba, Japan (Y.B.); Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, Yahaba, Japan (I.U.); and Department of Functional Brain Imaging, Institute for Quantum Medical Science, Quantum Life and Medical Science Directorate, National Institutes for Quantum Science and Technology, Chiba, Japan (M.M.)
| | - Kohsuke Kudo
- From the Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, N15 W7, Kita-ku, Sapporo, Japan (T.H., K.K., M.Y.); Center for Cause of Death Investigation (T.H.) and Global Center for Biomedical Science and Engineering (K.K.), Faculty of Medicine, Hokkaido University, Sapporo, Japan; Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan (T.H., K.K., N.F., M.Y., Y.I.); Innovative Technology Laboratory, Fujifilm Healthcare Corporation, Tokyo, Japan (R.S., T.S.); Fujifilm Healthcare Corporation, Chiba, Japan (Y.B.); Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, Yahaba, Japan (I.U.); and Department of Functional Brain Imaging, Institute for Quantum Medical Science, Quantum Life and Medical Science Directorate, National Institutes for Quantum Science and Technology, Chiba, Japan (M.M.)
| | - Noriyuki Fujima
- From the Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, N15 W7, Kita-ku, Sapporo, Japan (T.H., K.K., M.Y.); Center for Cause of Death Investigation (T.H.) and Global Center for Biomedical Science and Engineering (K.K.), Faculty of Medicine, Hokkaido University, Sapporo, Japan; Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan (T.H., K.K., N.F., M.Y., Y.I.); Innovative Technology Laboratory, Fujifilm Healthcare Corporation, Tokyo, Japan (R.S., T.S.); Fujifilm Healthcare Corporation, Chiba, Japan (Y.B.); Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, Yahaba, Japan (I.U.); and Department of Functional Brain Imaging, Institute for Quantum Medical Science, Quantum Life and Medical Science Directorate, National Institutes for Quantum Science and Technology, Chiba, Japan (M.M.)
| | - Masato Yoshikawa
- From the Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, N15 W7, Kita-ku, Sapporo, Japan (T.H., K.K., M.Y.); Center for Cause of Death Investigation (T.H.) and Global Center for Biomedical Science and Engineering (K.K.), Faculty of Medicine, Hokkaido University, Sapporo, Japan; Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan (T.H., K.K., N.F., M.Y., Y.I.); Innovative Technology Laboratory, Fujifilm Healthcare Corporation, Tokyo, Japan (R.S., T.S.); Fujifilm Healthcare Corporation, Chiba, Japan (Y.B.); Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, Yahaba, Japan (I.U.); and Department of Functional Brain Imaging, Institute for Quantum Medical Science, Quantum Life and Medical Science Directorate, National Institutes for Quantum Science and Technology, Chiba, Japan (M.M.)
| | - Yohei Ikebe
- From the Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, N15 W7, Kita-ku, Sapporo, Japan (T.H., K.K., M.Y.); Center for Cause of Death Investigation (T.H.) and Global Center for Biomedical Science and Engineering (K.K.), Faculty of Medicine, Hokkaido University, Sapporo, Japan; Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan (T.H., K.K., N.F., M.Y., Y.I.); Innovative Technology Laboratory, Fujifilm Healthcare Corporation, Tokyo, Japan (R.S., T.S.); Fujifilm Healthcare Corporation, Chiba, Japan (Y.B.); Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, Yahaba, Japan (I.U.); and Department of Functional Brain Imaging, Institute for Quantum Medical Science, Quantum Life and Medical Science Directorate, National Institutes for Quantum Science and Technology, Chiba, Japan (M.M.)
| | - Ryota Sato
- From the Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, N15 W7, Kita-ku, Sapporo, Japan (T.H., K.K., M.Y.); Center for Cause of Death Investigation (T.H.) and Global Center for Biomedical Science and Engineering (K.K.), Faculty of Medicine, Hokkaido University, Sapporo, Japan; Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan (T.H., K.K., N.F., M.Y., Y.I.); Innovative Technology Laboratory, Fujifilm Healthcare Corporation, Tokyo, Japan (R.S., T.S.); Fujifilm Healthcare Corporation, Chiba, Japan (Y.B.); Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, Yahaba, Japan (I.U.); and Department of Functional Brain Imaging, Institute for Quantum Medical Science, Quantum Life and Medical Science Directorate, National Institutes for Quantum Science and Technology, Chiba, Japan (M.M.)
| | - Toru Shirai
- From the Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, N15 W7, Kita-ku, Sapporo, Japan (T.H., K.K., M.Y.); Center for Cause of Death Investigation (T.H.) and Global Center for Biomedical Science and Engineering (K.K.), Faculty of Medicine, Hokkaido University, Sapporo, Japan; Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan (T.H., K.K., N.F., M.Y., Y.I.); Innovative Technology Laboratory, Fujifilm Healthcare Corporation, Tokyo, Japan (R.S., T.S.); Fujifilm Healthcare Corporation, Chiba, Japan (Y.B.); Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, Yahaba, Japan (I.U.); and Department of Functional Brain Imaging, Institute for Quantum Medical Science, Quantum Life and Medical Science Directorate, National Institutes for Quantum Science and Technology, Chiba, Japan (M.M.)
| | - Yoshitaka Bito
- From the Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, N15 W7, Kita-ku, Sapporo, Japan (T.H., K.K., M.Y.); Center for Cause of Death Investigation (T.H.) and Global Center for Biomedical Science and Engineering (K.K.), Faculty of Medicine, Hokkaido University, Sapporo, Japan; Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan (T.H., K.K., N.F., M.Y., Y.I.); Innovative Technology Laboratory, Fujifilm Healthcare Corporation, Tokyo, Japan (R.S., T.S.); Fujifilm Healthcare Corporation, Chiba, Japan (Y.B.); Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, Yahaba, Japan (I.U.); and Department of Functional Brain Imaging, Institute for Quantum Medical Science, Quantum Life and Medical Science Directorate, National Institutes for Quantum Science and Technology, Chiba, Japan (M.M.)
| | - Ikuko Uwano
- From the Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, N15 W7, Kita-ku, Sapporo, Japan (T.H., K.K., M.Y.); Center for Cause of Death Investigation (T.H.) and Global Center for Biomedical Science and Engineering (K.K.), Faculty of Medicine, Hokkaido University, Sapporo, Japan; Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan (T.H., K.K., N.F., M.Y., Y.I.); Innovative Technology Laboratory, Fujifilm Healthcare Corporation, Tokyo, Japan (R.S., T.S.); Fujifilm Healthcare Corporation, Chiba, Japan (Y.B.); Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, Yahaba, Japan (I.U.); and Department of Functional Brain Imaging, Institute for Quantum Medical Science, Quantum Life and Medical Science Directorate, National Institutes for Quantum Science and Technology, Chiba, Japan (M.M.)
| | - Mari Miyata
- From the Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, N15 W7, Kita-ku, Sapporo, Japan (T.H., K.K., M.Y.); Center for Cause of Death Investigation (T.H.) and Global Center for Biomedical Science and Engineering (K.K.), Faculty of Medicine, Hokkaido University, Sapporo, Japan; Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan (T.H., K.K., N.F., M.Y., Y.I.); Innovative Technology Laboratory, Fujifilm Healthcare Corporation, Tokyo, Japan (R.S., T.S.); Fujifilm Healthcare Corporation, Chiba, Japan (Y.B.); Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, Yahaba, Japan (I.U.); and Department of Functional Brain Imaging, Institute for Quantum Medical Science, Quantum Life and Medical Science Directorate, National Institutes for Quantum Science and Technology, Chiba, Japan (M.M.)
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