High-Altitude Neurodegeneration Cohort (HANC) Study

Chronic physiological hypoxia has been implicated in the pathogenesis of multiple system atrophy (MSA), a fatal neurodegenerative disorder of unknown etiology. This prospective, multicenter, observational cohort study (Phase II of the High-Altitude Neurodegeneration Cohort \[HANC\] study) aims to validate the association between chronic hypoxia exposure and incident MSA risk. A total of 20,000 Han Chinese participants aged 40-75 years will be enrolled from 23 sites across China spanning an altitude gradient from 4 m to 4,500 m. All participants will undergo standardized in-person assessment including questionnaires, physical examination, blood collection, and 3-night consecutive nocturnal pulse oximetry monitoring. Participants are to be followed for incident MSA over 12 months. The primary outcome is newly diagnosed MSA (probable or definite per Gilman consensus criteria), adjudicated by an independent panel of movement disorders specialists. Secondary outcomes include the association between altitude strata and MSA incidence, the association between mean nocturnal SpO₂ and MSA incidence, and incidence rates across MSA subtypes (MSA-P and MSA-C).

NCT Number	NCT07657520
Lead Sponsor	West China Hospital Collaborators: Affiliated Hospital of Qinghai University, Tibet Autonomous Region People's Hospital, Kunming Medical University, The First Affiliated Hospital of Guangzhou Medical University, First Affiliated Hospital of Suzhou Medical College, First People's Hospital of Hangzhou, The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School, Guiyang No.1 People's Hospital, Lanzhou University Second Hospital, The First People's Hospital of Yinchuan, Second Affiliated Hospital of Xi'an Jiaotong University, First Affiliated Hospital of Chongqing Medical University, The First People's Hospital of Xining City, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine
Conditions	Multiple System Atrophy
Enrollment	20,000 participants
Start Date	2026-06-13
Primary Completion	2027-07-30 (estimated)
Study Completion	2027-07-30 (estimated)
Updated on ClinicalTrials.gov	2026-07-09