Permeability MRI in Cerebral Cavernous Malformations Type 1 in New Mexico: Effects of Statins

Study Overview
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Brief Summary
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Cerebral cavernous malformations (CCMs) are clusters of abnormal blood vessels in the brain and spine. CCMs can bleed and cause strokes, seizures, and headaches. In some patients, CCMs affect the blood brain barrier (BBB). The BBB is the body's separation of blood and its contents in the brain from the brain tissue itself. Abnormal leakiness or permeability of this barrier can cause disease. We will measure the permeability (leakiness) of the BBB using a magnetic resonance imaging (MRI) technique called dynamic contrast-enhanced MRI (DCEMRI). The purpose of this study is to look at whether statin medications change the permeability (leakiness) of the blood brain barrier in CCM patients. Statin medications are used to lower cholesterol levels and prevent heart attack and stroke. In addition, this medication may decrease the risk of brain hemorrhage or bleeding in patients with CCM. This study will examine whether the permeability of the BBB changes following the administration of simvastatin for three months.

Official Title
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Permeability MRI in Cerebral Cavernous Malformations Type 1 in New Mexico: Effects of Statins

Conditions
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Cavernous Angioma, Familial, Cerebral Cavernous Malformations, Cerebral Cavernous Hemangioma

Intervention / Treatment
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* Drug: Simvastatin


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Diagnosis of cerebral cavernous malformations-common Hispanic mutation (CCM1-CHM) Must be willing to travel to the University of New Mexico in Albuquerque, NM for 5 visits over the course of three months. Exclusion Criteria: Incarceration Unable to pass MRI safety screening (pregnant females, claustrophics, or those with certain metallic items implanted in their bodies) Low kidney function or transplants, an eGFR below 60 mL/min Currently taking statin medications or have taken statin medications in the past 6 months Known allergy or intolerance to statins Known allergy or intolerance to gadolinium Liver dysfunction at baseline, AST > 47 and/or ALT > 49 Consumption of large quantities of alcohol, men who consume more than 2 daily drinks and women who consume more than one daily drink CK level of 232 or higher Triglycerides greater than or equal to 500. Medications: gemfibrozil, cyclosporine, danazol, itraconazole, ketoconazole, posaconazole, ethromycin, clarithomycin, telithromycin, HIV protease inhibitors, nefazoldone, amiodarone, verapamil, dilitiazem, amlodipine, or ranalazine

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Simvastatin<br>20-40 mg tablet taken daily by mouth. Month 1: 20 mg; Months 2 and 3: 40 mg. | Drug: Simvastatin<br> <br> * Other names: Zocor;|
| No Intervention: No Treatment<br> | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in blood brain barrier permeability over three months for the treatment group compared to the control group. | We will measure the change in blood brain barrier permeability with dynamic contrast enhanced MRI from baseline to three months. We will compare the change in permeability for a group of CCM patients placed on statin medication (treatment group) with a group of CCM patients not on statin medication (control group). | Baseline, Three Months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Correlation of physiologic permeability data with anatomic lesion data | Use dynamic contrast-enhanced MRI to detect abnormalities in brain permeability in CCM patients and correlate with anatomic lesion information. | Baseline, Three months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Hispanic