REVIPSY: REtinal and VIsual Cortical Response in Early PSYchosis
Study Details
Study Description
Brief Summary
The purpose of the REVIPSY study is to measure retinal and the visual cortical electrophysiological responses in situations at risk of psychosis in patients who have experienced a first psychotic episode. A perspective of this project will be to create new electrophysiological biomarkers predictive of the risk of conversion to psychosis
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
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N/A |
Detailed Description
The severity of psychotic disorders and their disabling potential in young patients represent a major public health problem. These populations are affected by high-level cognitive disorders associated with highly integrative functions. However, there is increasing evidence of lower-level impairments, including vision. Indeed, the literature reports electrophysiological abnormalities at the retinal level, reflected by an alteration of the signal transmission in the retinal ganglion cells (RGC), photoreceptors and bipolar cells. At the cortical level, numerous studies report electrophysiological abnormalities associated with the activity of the primary visual areas. These both electrophysiological measurements have the advantage of being objective, reliable and reproducible, thus leading to new research perspectives concerning the link between retinal and cortical measures in psychosis. These measures could also be interesting for the detection of the risk of conversion to psychosis, before it develops.
The transition to a state of psychosis is in fact marked by the appearance of symptoms, which can occur several years before the diagnosis and impact the duration of the untreated psychosis. Thus, the notion of a clinical state at high risk of psychosis (CHRP) defines a population of patients said to be at risk of psychosis. These symptoms precede the occurrence of the first psychotic episode (FEP), indicating the clear transition to psychotic illness. The questions that arise at the present time concerned the early detection and intervention of psychosis during this prodromal phase. This detection could be done via electrophysiological measures associated to the visual processing, but also via measures of neuropsychological evaluations and behavioral measures.
That is why, a study on retinal and visual cortical alterations coupled with neuropsychological assessments and behavioral measures in populations at risk of populations at risk of CHRP psychosis and in FEP would potentially reveal predictive biomarkers of the pathology. Such a project could lead to the development of retino-cortical biomarkers in mental health and will eventually lead to to create ultra-portable, reliable and routinely usable measurement devices for the early detection of psychosis in clinic.
Main objective: To measure retinal and visual cortical electrophysiological responses in clinical subjects at high risk of psychosis (CHRP) in comparison with first-episode psychotic patients (FEP) and healthy controls (CS)
Secondary objective(s) :
Compare ERG traces obtained from the "Retinaute" portable ERG device produced by the company BioSerenity with ERG traces obtained from a standard device ERG measurement device "MyPackOne" produced by the company Metrovision among healthy controls
To measure performance on neuropsychological tests in clinical subjects at high risk of psychosis (CHRP) compared to patients with a first episode of psychosis (FEP)
Measuring temporal prediction in tactile modality (unimodal) with a motor task, in clinical subjects at high risk of psychosis (CHRP) in comparison with first-episode patients (FEP) and healthy controls (CS)
Measuring temporal prediction in visual and tactile (multimodal) modalities/Measuring temporal prediction in visual modality (unimodal) with a classical perceptual task in clinical subjects at high risk of psychosis (CHRP) in comparison with patients with a first psychotic episode with a first episode of psychosis (FEP) and healthy controls (CS)
To compare the sensitivity of behavioural and EEG measures to the prediction of tactile vs. visual stimuli, and multimodal vs. unimodal
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Healthy Controls (HC) n=90 |
Device: Retinaute (BioSerenity)
Wearable device in the form of a virtual reality headset for the recording of electrophysiological measurements such as electroretinogram (ERG) and electrocenphalogram (EEG), ISCEV standards
Device: EEG Headset 64 electrodes (BioSemi)
EEG headset with 64 electrodes for the recording of visual cortical electrophysiological signals
Device: MonPackOne (Metrovision)
Standard device for the recording of electroretinography (ERG) measurements, ISCEV standards
WARNING : Device used only in 3 healthy controls to address the secondary objective
|
| Experimental: Clinical High Risk of Psychosis (CHRP) n=30 |
Device: Retinaute (BioSerenity)
Wearable device in the form of a virtual reality headset for the recording of electrophysiological measurements such as electroretinogram (ERG) and electrocenphalogram (EEG), ISCEV standards
Device: EEG Headset 64 electrodes (BioSemi)
EEG headset with 64 electrodes for the recording of visual cortical electrophysiological signals
|
| Experimental: First Episode Psychosis (FEP) n=30 |
Device: Retinaute (BioSerenity)
Wearable device in the form of a virtual reality headset for the recording of electrophysiological measurements such as electroretinogram (ERG) and electrocenphalogram (EEG), ISCEV standards
Device: EEG Headset 64 electrodes (BioSemi)
EEG headset with 64 electrodes for the recording of visual cortical electrophysiological signals
|
Outcome Measures
Primary Outcome Measures
- N95 wave [Day1]
Amplitude
- a wave [Day1]
Amplitude
- b wave [Day1]
Amplitude
- P100 wave [Day1]
Amplitude
Secondary Outcome Measures
- Visual Object and Space Perception (VOSP) [Day1]
Score
- Verbal Fluency [Day1]
Score
- Working Memory [Day1]
Score
- Betarythm (EEG oscillatory responses) [Day1]
Amplitude
- Contingent Negative Variation (CNV) [Day1]
Amplitude reaction time between a warning and a go signal as measured by electroencephalography (EEG)
- CPT-AX (Continuous Performance Task version AX) [Day1]
Score
- fNART (French adaptation of National Adult Reading Test) [Day1]
Score
- TAP (Test of Attentional Performance) [Day1]
Score
Eligibility Criteria
Criteria
-
Inclusion Criteria:
-
All groups
Age and gender matching
Age between 18 and 40
Enrolled in a social security plan
Normal or corrected-to-normal visual acuity verified by Monoyer test
In women of childbearing age: negative urine pregnancy test at the inclusion visit
Person who has received and understood prior information about the study
Person who has given free and informed written consent prior to any participation in the study
- Healthy control group (HC; n=30)
Met "all groups" criteria
No current disorders as assessed by the MINI global assessment
No lifetime (hypo)manic episodes or psychotic disorders and current
No current or past disorders by CAARMS assessment
No current disorders according to ICD-10 criteria
No positive family history (parents/first degree) for affective affective, non-affective psychoses or major affective disorders
No regular use (more than 3 psychotropic medications: benzodiazepines, hypnotics,antidepressants, antipsychotics or mood regulators or psychostimulants) during the past last 12 months
- High clinical risk group for psychosis (CHRP; n=30)
Met "all groups" criteria, Assessment at CAARMS:
-
Attenuated positive symptoms (APS)
-
OR Brief Intermittent Psychotic Symptoms (BIPS)
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OR Attenuated psychosis of sub-laminar frequency
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OR sub-laminar attenuated psychosis
Antipsychotic treatment with a cumulative dose of equivalent chlorpromazine <2500mg lifetime (1)
- First Episode Psychosis (FEP; n=30)
All-group criteria met CAARMS assessment: Psychosis/antipsychotic treatment threshold treatment threshold achieved at CAARMS
Antipsychotic treatment with a cumulative dose of equivalent chlorpromazine <2500mg lifetime (1)
- Exclusion Criteria (all groups):
Impairment of the subject that makes it difficult or impossible to participate in the or comprehension of the information provided to him/her
Dyslexia
Substance use disorder according to CIM-10
Neurological history including progressive neurological pathology
Progressive retinal disease
Chronic glaucoma
Ophthalmologic pathology affecting visual acuity
Current ocular infection
Major under guardianship, curatorship or safeguard of justice
Pregnant or breastfeeding women
Persons in a life-threatening emergency situation
Result of the preliminary medical examination incompatible with the research
Patient presenting a suicidal risk.
Criteria incompatible with the use of the Retinaute:
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Allergy to silver
-
Known or suspected allergy to any of the following components:
polyamide, polyester, elastane, latex, rubber, silicone, or any synthetic material as well as to cotton in case the device is used without the device is used without a protective head covering
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Sensory disorders making the patient insensitive to pain on the skin.
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Behavioral problems making the patient extremely agitation or aggression.
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Mental disorders incompatible with the use of the device.
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Seizure disorder.
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Open wound in an area covered or wrapped by the device.
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User at high risk of contagion.
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Wearing an implantable medical device (e.g. pacemaker)
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Pregnant women, women in labor or nursing mothers.
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Allergy or skin sensitivity to one of the components of the cream Elefix or equivalent on the market: coconut oil, egg oil, propylene glycol egg oil, propylene glycol, glycerin, lanolin...
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Allergy or skin sensitivity to one of the components of the cream NuPrep or market equivalent
Participation in another interventional study (exclusion period included)
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Centre Psychothérapeutique de Nancy | Laxou | France | 54520 |
Sponsors and Collaborators
- Centre Psychothérapique de Nancy
- BioSerenity
- Institut National de la Santé Et de la Recherche Médicale, France
Investigators
- Principal Investigator: Vincent LAPRÉVOTE, Pr. MD PhD, Centre Psychothérapique de Nancy
Study Documents (Full-Text)
None provided.More Information
Publications
- Butler PD, Martinez A, Foxe JJ, Kim D, Zemon V, Silipo G, Mahoney J, Shpaner M, Jalbrzikowski M, Javitt DC. Subcortical visual dysfunction in schizophrenia drives secondary cortical impairments. Brain. 2007 Feb;130(Pt 2):417-30. Epub 2006 Sep 19.
- Demmin DL, Davis Q, Roché M, Silverstein SM. Electroretinographic anomalies in schizophrenia. J Abnorm Psychol. 2018 May;127(4):417-428. doi: 10.1037/abn0000347.
- Kim DW, Shim M, Song MJ, Im CH, Lee SH. Early visual processing deficits in patients with schizophrenia during spatial frequency-dependent facial affect processing. Schizophr Res. 2015 Feb;161(2-3):314-21. doi: 10.1016/j.schres.2014.12.020. Epub 2014 Dec 29.
- Knebel JF, Javitt DC, Murray MM. Impaired early visual response modulations to spatial information in chronic schizophrenia. Psychiatry Res. 2011 Sep 30;193(3):168-76. doi: 10.1016/j.pscychresns.2011.02.006. Epub 2011 Jul 20.
- Laprevote V, Heitz U, Di Patrizio P, Studerus E, Ligier F, Schwitzer T, Schwan R, Riecher-Rössler A. [Why and how to treat psychosis earlier?]. Presse Med. 2016 Nov;45(11):992-1000. doi: 10.1016/j.lpm.2016.07.011. Epub 2016 Aug 21. Review. French.
- Moghimi P, Torres Jimenez N, McLoon LK, Netoff TI, Lee MS, MacDonald A 3rd, Miller RF. Electoretinographic evidence of retinal ganglion cell-dependent function in schizophrenia. Schizophr Res. 2020 May;219:34-46. doi: 10.1016/j.schres.2019.09.005. Epub 2019 Oct 12.
- Tan A, Schwitzer T, Conart JB, Angioi-Duprez K. [Retinal investigations in patients with major depressive disorder, bipolar disorder or schizophrenia: A review of the literature]. J Fr Ophtalmol. 2020 Sep;43(7):586-597. doi: 10.1016/j.jfo.2019.10.029. Epub 2020 Jul 4. Review. French.
- RIPH 2021-04
- n° IDRCB 2021-A01700-41