Parkinson Disease Clinical Trial
Official title:
Expanding the Phenotype of the LRRK-2 Mutation in Individuals With History of Parkinson s Disease and Their Relatives: a Prospective Study
This study will identify symptoms and other characteristics of Parkinson s disease that may
be associated with changes in a gene called leucine-rich repeat kinase 2 (LRRK2). Changes in
this gene have been found in patients with and without a family history of Parkinson s
disease. This study will examine people with Parkinson s disease to try to identify how
symptoms develop over time. First-degree relatives of patients will also be studied.
People 18 years of age or older with Parkinson s disease or people who have a first-degree
relative with Parkinson s disease may be eligible for this study.
Participants visit the NIH Clinical Center every other year for 10 years for some or all of
the procedures listed below. Each visit requires 3-4 days of testing, which may be done on an
inpatient or outpatient basis. Telephone interviews are conducted during the alternate years.
- History and physical examination.
- Smell testing: Subjects are asked to identify 40 different scents.
- Sensory testing: Objects with grooves and ridges are touched to subjects fingertips.
With their eyes closed, the subjects are asked to say which way the grooves and ridges
run on the objects.
- Neuropsychological evaluation: Subjects are asked about their memory and thinking and
may be asked to complete some pen and paper tests.
- Psychiatric evaluation: Subjects are asked about psychiatric symptoms, including anxiety
and depression.
- Blood drawing: Blood is drawn through a needle in the arm.
- Magnetic imaging resonance (MRI) scans of the brain: MRI uses a strong magnetic field
and radio waves to obtain images of body organs and tissues. During the test, subjects
lie on a table that can slide in and out of the MRI scanner (a metal cylinder surrounded
by a strong magnetic field). The procedure lasts about 30 minutes, during which the
subjects may be asked to lie still for up to 5 minutes at a time.
- Transcranial sonography (TCS): TCS uses sound waves to obtain images of the brain.
Subjects lie on their back and an ultrasound device is moved around the scalp.
- Sleep study (1-2 night hospital admission): Subjects brain waves are recorded during
sleep using electroencephalography (EEG). Their breathing rate, pulse and oxygen level
are also monitored.
- Questionnaire: Subjects complete several questionnaires designed to obtain information
on symptoms or traits that have been reported to be associated with Parkinson s disease.
Parkinson s disease is a common neurological condition that was originally thought to develop
from environmental factors. More recently, genetic factors have been implicated. In this
study, we are interested in studying the phenotypic presentation of patients with Parkinson s
disease due to a specific defect in a gene called the Leucine rich repeat kinase 2 gene
(LRRK2) found in some patients with Parkinson s disease. In addition, we plan to study family
members whose genetic status is unknown to develop a pre-clinical description of Parkinson s
disease progression.
OBJECTIVE:
1. To develop a pre-clinical description in first-degree family members of patients with
Parkinson s disease who have the LRRK2 mutation. The first-degree relative may or may
not carry the LRRK2 mutation.
2. To phenotypically characterize Parkinson s disease patients who have the LRRK2 mutation.
STUDY POPULATION:
200 adult subjects including:
1. Patients with a diagnosis of PD due to LRRK2 mutation
2. First degree family members of patients with PD who have the LRRK2 mutation.
DESIGN:
This will be a longitudinal prospective natural history study.
OUTCOME MEASURES:
1. Pre-clinical signs of disease in first degree relatives of Parkinson s disease patients
who have the LRRK2 mutation.
2. Characterization of a pre-clinical phenotype in first degree relatives of LRRK2 positive
Parkinson s disease patients.
3. Progression of Parkinson s disease patients who have the LRRK2 mutation.
4. Genotypic characterization of first-degree relatives
5. RNA expression profile determination comparing mutation carriers to non-mutation
carriers in search for early biomarkers
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