Recruiting
Phase 1

Manganese MRI

Sponsor:

National Institute of Neurological Disorders and Stroke (NINDS)

Code:

NCT02531880

Conditions

Epilepsy

Eligibility Criteria

Sex: All

Age: 18 - 60

Healthy Volunteers: Not accepted

Interventions

Mangafodipir

Gadolinium

Study Details

Brief summary:

Background:

\- The blood-brain barrier separates the brain from the rest of the body. Epilepsy is a neurological disease that causes seizures. It can affect this barrier. Researchers think a contrast agent called mangafodipir might be better able to show areas of the brain that epilepsy affects.

Objective:

\- To see if mangafodipir is well tolerated and safe. To see if magnetic resonance imaging (MRI) using either mangafodipir or gadolinium can show areas of blood-brain barrier breakdown in people with epilepsy.

Eligibility:

  • People ages 18-60 who:
  • Have epilepsy not controlled by drugs
  • Prior or concurrent enrollment in 18-N-0066 is required

Design:

  • Participants will be screened with:
  • Medical history
  • Physical exam
  • Blood and urine tests
  • Participants will have up to 6 visits in 1-3 months. One visit is an inpatient stay lasting 2-10 days. Visits may include:
  • Video-EEG monitoring for participants with epilepsy
  • An IV catheter put in place: a needle guides a thin plastic tube into an arm vein.
  • Getting mangafodipir through the IV.
  • Getting gadolinium through the IV.
  • Up to 6 MRI scans over a 10-day period: a magnetic field and radio waves take pictures of the brain. Participants lie on a table that slides into a metal cylinder. They are in the cylinder for 45-90 minutes, lying still for up to 10 minutes at a time. The scanner makes loud knocking sounds. Participants will get earplugs.
  • A final MRI at least 2 weeks after receiving mangafodipir....

Conditions

Epilepsy

Study ID

NCT02531880

Start date

Nov 19, 2024

Status verified date

Jun 4, 2026

Completion date

Jul 1, 2030

Anticipated

Primary completion date

Jul 1, 2030

Anticipated

Eligibility Criteria

Eligibility Criteria

Sex: All

Age: 18 - 60

Healthy Volunteers: Not accepted

  • INCLUSION CRITERIA:
  • Age 18-60.
  • Able to give written informed consent directly.
  • Drug resistant epilepsy participants will be defined as having clinically documented seizures with consistent EEG evidence as defined by the 1981 International Classification of Epileptic Seizures, refractory to standard anti-seizure treatment for at least one year prior to enrolling in this study and with an average of at least one seizure per month. This criterion will be established by preliminary screening NINDS Epilepsy Service under protocol 18-N-0066. Seizure focus localization will be determined by standard clinical, neurophysiologic, and imaging studies. Prior or concurrent enrollment in 18-N-0066 is required.

EXCLUSION CRITERIA:

General exclusions:

  • Patients with epilepsy who are not surgical candidates
  • Significant structural brain abnormality such as a brain tumor, stroke, brain damage from head trauma or blood vessel abnormalities, on the baseline MRI scan.
  • Positive test for HIV
  • Pregnancy or breast-feeding
  • Claustrophobia to a degree that the subject would feel uncomfortable in the MRI machine.
  • Cannot lie on their back for at least two hours.
  • Risk for MRI scan, (e.g., any non-organic implant or other device such as a cardiac pacemaker or infusion pump or other metallic implants, objects or body piercings that cannot be removed, or history of being a welder or metal worker due to small metal fragments in the eye)
  • Unwilling to allow sharing and/or use in future studies of coded data that are collected for this study

MEMRI component specific exclusions (applicable only to patients participating in this arm of the study):

  • History of post-ictal psychosis or post-ictal aggression
  • Planning to get pregnant in the next 2 months
  • History of clinically significant liver or kidney disease that could potentially increase the risk of CNS damage due to manganese exposure
  • A history of drug or alcohol abuse/dependence (subjects scoring 8 or higher on the AUDIT scale)
  • Screening lab abnormalities demonstrating values more than 2 times the upper limit of normal for AST, ALT, bilirubin, alkaline phosphatase, BUN, creatinine
  • Previous presumed occupational exposure to manganese (i.e., having worked in a mine, foundry, smelter, dry cell battery manufacturing facility, or agriculture)
  • Allergy to manganese
  • On-going treatment with calcium-channel blocker
  • Iron-deficiency anemia
  • Personal history of Parkinson s Disease or Parkinsonism or presence of this disease in a 1st degree relative

Gadolinium enhanced MRI component specific exclusions (applicable only to patients participating in this arm of the study):

  • Estimated GFR <60, tested within 1 week of scan
  • Allergy to gadolinium

Of note, patients who are ineligible for one arm of the study may still be eligible for and participate in the other arm of the study.

Study Design

Enrollment

40 participants

Anticipated

Allocation

Non randomized

Intervention Model

Single group

Primary purpose

Diagnostic

Interventions and Outcome Measures

Arms

experimental: 1

Patients will be given the manganese contrast before 3T MRI.

experimental: 2

Patients will be given gadolinium contrast before 7T MRI.

Interventions

Mangafodipir

Patients will be imaged interictally with the administration of mangafodipir as an inpatient during long-term video EEG recording, to ensure administration in the peri-ictal period.

Gadolinium

Patients will be imaged with a gadolinium enhanced MRI session.

Primary outcome measure

  • description of the safety profile of mangafodipir administration in patients with epilepsy [ Time Frame: after mangafodipir adminstration ]
  • evaluation of the utility of MEMRI and/or DCE-MRI in identifying focal BBBD in the seizure onset zone identified by standard clinical, EEG, and imaging studies, and the homologous contralateral region. [ Time Frame: after mangafodipir and/or gadolinium administration ]

Central Contacts and Locations

Central contacts

Aaliyah M HamidullahThiam

(301) 435-2952aaliyah.hamidullahthiam@nih.gov

Sara K Inati, M.D.

(301) 435-6269inatisk@mail.nih.gov

Locations

National Institutes of Health Clinical Center

Recruiting

Bethesda, Maryland, United States, 20892

Contacts

For more information at the NIH Clinical Center contact Office of Patient Recruitment (OPR)

800-411-1222ccopr@nih.gov

More Information

Sponsor

National Institute of Neurological Disorders and Stroke (NINDS)

Last update posted

Oct 16, 2026

Last verified

Jun 4, 2026

Keywords

  • MRI
  • Manganese Enhanced MRI
  • Seizure Disorder
  • Seizures
  • Epileptic Focus

Trial information was received from ClinicalTrials.gov and was last updated on 2026-10-23. This information was provided to ClinicalTrials.gov by National Institute of Neurological Disorders and Stroke (NINDS) on 2026-10-16. Recruitment status is synced daily from ClinicalTrials.gov and may not reflect the sponsor's current status. Confirm during your call.