Clinical Trial Details
— Status: Completed
Administrative data
| NCT number |
NCT03103347 |
| Other study ID # |
Pro00051803 |
| Secondary ID |
|
| Status |
Completed |
| Phase |
|
| First received |
|
| Last updated |
|
| Start date |
March 17, 2014 |
| Est. completion date |
February 1, 2017 |
Study information
| Verified date |
March 2017 |
| Source |
Duke University |
| Contact |
n/a |
| Is FDA regulated |
No |
| Health authority |
|
| Study type |
Observational
|
Clinical Trial Summary
The investigators are studying the relationship between a certain oscillatory brain rhythm
(13-30 cycles/sec) that emerges prominently in patients with Parkinson's disease and symptoms
of slowness of movement. The investigators are recruiting patients with a range of severity
of Parkinson's disease symptoms to perform electroencephalography (EEG), in which the study
team records brain waves using electrodes placed on the scalp, while patients sit at rest or
perform certain hand tasks. The investigators will analyze the recorded brain waves to
extract the brain rhythm of interest and relate it to motor symptom severity as well as study
its behavior during rest and hand movement.
Description:
Parkinson's disease (PD) is a devastating, progressive neurodegenerative disease. The
hallmark of PD is loss of dopaminergic neurons in the substantia nigra pars compacta (SNc),
which disrupts motor circuit processing in the basal ganglia and results in motor dysfunction
including tremor, rigidity, and bradykinesia. This disruption of motor circuit processing is
reflected in abnormal oscillatory neural activity. For example, recordings of local field
potentials with electrodes implanted in the basal ganglia reveal a substantial elevation of
beta frequency (15-35 Hz) oscillatory activity in persons with PD, and this increased beta
frequency activity is suppressed following levodopa treatment and deep brain stimulation.
However, the link between the frequency and amplitude of abnormal oscillations and the degree
of Parkinsonian symptoms is unclear. For example, magneto-encephalography revealed that
beta-frequency oscillatory activity is elevated over the motor cortices even in persons with
early-stage PD, and there were not any clear differences in beta frequency oscillations
between newly diagnosed and under treatment PD. However, this study did not address any
changes in the frequency of oscillations or distribution of power across frequencies. For
example, a recent study has suggested that variability of ongoing beta-frequency oscillatory
activity, in this case recorded from the STN, may be more strongly correlated with symptoms
than the amplitude of beta frequency oscillations. Therefore, the objective of the
investigator's proposed study is to determine whether there are changes in the
characteristics of beta frequency oscillatory activity in the EEG over the motor cortex
across differing degrees of Parkinson's disease. Such information is critical to
understanding the (possible) link between abnormal oscillatory brain activity and symptom
severity, as these signals could be used as potential biomarkers of therapeutic efficacy and
to inform the design of new methods of intervention
This is an observational, prospective evaluation of the beta content in routine 20-40 minute
EEG recordings from patients with PD for varied periods of time. The investigators anticipate
running data collection for 4-6 months in an outpatient movement disorders clinic. Subjects
will be identified by their physician and then referred to the study team. Patients that
agree to participate will be screened and have all questions answered at the time of their
routine appointment. If the patient decides to participate and informed consent is obtained,
a clinic appointment will be made for study data collection at a later date. Patient will be
instructed not to take their normal dopamine replacement medications for 12 hours prior to
the EEG study visit as this can interfere with the brain wave activity being studied. At the
study clinic encounter, routine recordings will be made from a total of 33 PD patients; 11
with <3 years of PD diagnosis, 11 with >5 but <10 years of PD diagnosis, and 11 with advanced
>10 years of PD diagnosis. EEG will be recorded using an FDA template system to facilitate
EEG lead placement by research coordinators. Clinical description of PD severity and duration
will be collected from each subject through questionnaire and from review of clinical
evaluation. A UPDRS score may be determined for each participant. Following the data
collection period, the EEG recordings will be indexed, de-identified, and randomly ordered to
blind the subsequent analyses. These indexed EEG segments will be quantitatively analyzed to
determine the relative contribution of beta frequency to the recordings, and comparison
between the duration and severity of PD symptoms and beta content will also be made.