There are 2 clinical trials
The main objective of this study is to evaluate the efficacy and tolerance of 2 years of treatment with cholecalciferol (vitamin D3) in patients with a clinically isolated syndrome at high risk for MS (CIS).
Normalized cerebral volume (SIENAX) obtained from a T13D sequence. --- T13D ---
Description: Conversion to MS according to criteria described by McDonald (Polman et al 2005)
Measure: Conversion to MS yes/no Time: 24 monthsDescription: qualitative variable: 0, 1, or >1
Measure: Number of new T1 lesions taking on Gadolinium highlighting Time: 3 monthsDescription: qualitative variable: 0, 1, or >1
Measure: Number of new T1 lesions taking on Gadolinium highlighting Time: 12 monthsDescription: qualitative variable: 0, 1, or >1
Measure: Number of new T1 lesions taking on Gadolinium highlighting Time: 24 monthsDescription: Exact number (semiautomatic measure)
Measure: Total number of Gadolinium highlighted lesions on T1 images Time: 3 monthsDescription: Exact number (semiautomatic measure)
Measure: Total number of Gadolinium highlighted lesions on T1 images Time: 12 monthsDescription: Exact number (semiautomatic measure)
Measure: Total number of Gadolinium highlighted lesions on T1 images Time: 24 monthsDescription: mm^3
Measure: Normalized cerebral volume (SIENAX) obtained from a T13D sequence Time: 3 monthsDescription: mm^3
Measure: Normalized cerebral volume (SIENAX) obtained from a T13D sequence Time: 12 monthsDescription: mm^3
Measure: Normalized cerebral volume (SIENAX) obtained from a T13D sequence Time: 24 monthsDescription: Presence/absence of adverse events the severity of which will be graded according to Common Terminology Criteria for Adverse Events (CTCAE) version 3. Grades I, II, III, IV, V.
Measure: Presence/absence of adverse events Time: baselineDescription: Presence/absence of adverse events the severity of which will be graded according to Common Terminology Criteria for Adverse Events (CTCAE) version 3. Grades I, II, III, IV, V.
Measure: Presence/absence of adverse events Time: 3 monthsDescription: Presence/absence of adverse events the severity of which will be graded according to Common Terminology Criteria for Adverse Events (CTCAE) version 3. Grades I, II, III, IV, V.
Measure: Presence/absence of adverse events Time: 6 monthsDescription: Presence/absence of adverse events the severity of which will be graded according to Common Terminology Criteria for Adverse Events (CTCAE) version 3. Grades I, II, III, IV, V.
Measure: Presence/absence of adverse events Time: 12 monthsDescription: Presence/absence of adverse events the severity of which will be graded according to Common Terminology Criteria for Adverse Events (CTCAE) version 3. Grades I, II, III, IV, V.
Measure: Presence/absence of adverse events Time: 18 monthsDescription: Presence/absence of adverse events the severity of which will be graded according to Common Terminology Criteria for Adverse Events (CTCAE) version 3. Grades I, II, III, IV, V.
Measure: Presence/absence of adverse events Time: 24 monthsDescription: The number of days that pass from the beginning of treatment to conversion to MS according to McDonald 2005 criteria (Polman et al 2005)
Measure: Delay until conversion to MS Time: 24 monthsObsessive-Compulsive Disorder (OCD) patients have a response rate of 50-60% to exposure and response prevention (ERP) therapy and SSRI antidepressants. Mindfulness-Based Cognitive Therapy (MBCT) consists of training the participant to non-react to negative thoughts and emotions. Applying MBCT to OCD patients may help them behave with equanimity in response to their obsessions, and therefore acknowledge them with the same attention and intention as they admit any other disturbing thought without reacting to it. MBCT has demonstrated effectiveness in major depression, but much less attention has been given to MBCT in OCD. ERP and MBCT, although sharing aspects like exposure, are based on different theoretic and therapeutic factors. EPR is based on a direct anxiety habituation process whereas MBCT trains a holistic manner of becoming familiarized with distressful thoughts and emotions while learning to develop a new relationship to them. Thus, MBCT may decrease anxiety indirectly through a major attention awareness and non-reactivity to thoughts and emotions. OCD is characterized by altered cortical-striatal-thalamic-cortical (CSTC) circuit and default mode network (DMN) connectivity when performing different tasks and during the resting state. It has been establish that the ventral CSTC circuit is mostly associated with emotional processing, while the dorsolateral aspect of the CSTC circuit is preferentially involved in cognitive processing. In this regard, we hypothesized that clinical amelioration will be accompanied by a re-establishment of functional connectivity within dorsolateral and DMN circuits, which will in turn be associated with improvement of certain neuropsychological processes. CSTC and DMN circuits have also shown to be sensitive to prolonged stress situations. Specifically, childhood trauma has been related to larger brain volumes and it has been associated with different OCD clinical subtypes. Aims: 1. To assess MBCT effectiveness in treatment non-naive OCD patients. 2. To study cognitive and neuropsychological characteristics that mediate or moderate MBCT response. 3. To examine the changes in cognitive, neuropsychological and neuroimaging patterns associated with an MBCT intervention. 4. To identify a brain biomarker for positive response to MBCT in non-naïve OCD patients. 5. To study cognitive, neuropsychological and early stress expousure mediators or moderators of functional changes in CSTC and DMN patterns in response to MBCT.
• Structural acquisition: T13D. --- T13D ---
Description: • Clinical version of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) the severity and the checklist.
Measure: Change in Y-BOCS: Time: Baseline and at 14 weeks and at 6 months post-treatmentDescription: • Obsessive-Compulsive Inventory-Revised (OCI-R) assessing 6 dimensions (Washing, Checking, Ordering, Obsessing, Hoarding and Neutralizing).
Measure: Change in OCI-R: Time: Baseline, at 14 weeks and at 6 months post-treatmentDescription: • Obsessive Beliefs Questionnaire-44 (OBQ-44), a measure of three OCD-related belief domains (Perfectionism/Certainty, Importance/Control of thoughts, and Responsibility/Threat estimation).
Measure: Change in OBQ-44: Time: Baseline and at 14 weeksDescription: • Functional Magnetic Resonance Imaging: Resting state and during task performance (Autobiographical memory + N-Back) and self-reference.
Measure: Changes in functional brain circuits: Time: Baseline and at 14 weeksDescription: • Anxiety Sensitivity Index (ASI-3)
Measure: Change in anxiety: Time: Baseline and at 14 weeksDescription: • The Beck Depression Inventory (BDI-II)
Measure: Change in mood from baseline: Time: Baseline, at 14 weeks and at 6 months post-treatmentDescription: • Positive and Negative Affect trait (PANAS)
Measure: Change in positive and negative affect: Time: Baseline and at 14 weeksDescription: • Perceived Stress Scale (PSS)
Measure: Impact of current life events: Time: Baseline, 14 weeks and at 6 months post-treatmentDescription: • Childhood Trauma Questionnaire (CTQ)
Measure: Impact of past stressful life events: Time: BaselineDescription: • Conners' Continuous Performance Test II : CPT-II
Measure: Change in attentional domains: Time: Baseline and at 14 weeksDescription: • Wisconsin Card Sorting Test: WCST
Measure: Change in executive Functioning/Cognitive flexibility: Time: Baseline and at 14 weeksDescription: • Autobiographic Memory Task: 10 selected emotions (5 negative and 5 positive).
Measure: Autobiographical memories: Time: BaselineDescription: • Phonetic Fluency: PMR (Spanish version of the FAS)
Measure: Change in verbal fluency: Time: Baseline, 14 weeks and at 6 months post-treatmentDescription: • Word Task: Assessment of language fluency and thought content using a list of 10 seed words from the Spanish adaptation of the ANEW (Affective Norms for English Words) in terms of positive and negative valance and different degrees of arousal.
Measure: Speech analysis: Time: BaselineDescription: • ES-Questionnaire, designed by Drs. J. Andrews-Hanna and M. López-Solà (research collaborators of the project) from the USA. It is based on 23 questions that examines the thought content from the patient before, during and after the treatment.
Measure: Thought content: Time: Baseline, each week during the treatment period (10 sessions) and post-treatmentDescription: • Multicultural Quality of Life Index (MQLI).
Measure: Change in Quality of Life: Time: Baseline, 14 weeks and at 6 months post-treatmentDescription: • Mindfulness measures include: The Five Facet Mindfulness Questionnaire (FFMQ), used to measure the five constructs central to mindfulness (Observing, Describing, Acting with Awareness, Non-judgment of Inner Experience, and Non-reactivity to Inner Experience).
Measure: Change in Mindfulness variables: Time: Baseline, 14 weeks and at 6 months post-treatmentDescription: • Ruminative Responses Scale (RRS) to measure the degree and type of thought thinking.
Measure: Change in Rumination: Time: Baseline, 14 weeks and at 6 months post-treatmentDescription: • Credibility Expectancy Questionnaire (CEQ).
Measure: Treatment expectancy: Time: BaselineDescription: • Structural acquisition: T13D
Measure: Changes in structural brain regions: Time: Baseline and at 14 weeks