Dopamine Turnover Rate as Surrogate Parameter for Diagnosis of Early Parkinson's Disease

NCT ID: NCT00153972

Last Updated: 2012-12-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

39 participants

Study Classification

INTERVENTIONAL

Study Start Date

2005-02-28

Study Completion Date

2009-01-31

Brief Summary

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The study is designed to measure the difference of dopamine turnover rate measured by Fluoro-Dopa-PET in the putamen between patients with Parkinson's disease treated with cabergoline and levodopa for 3 months.

The study protocol includes an initial Fluoro-Dopa-PET scan before treatment and after three months double-blind treatment with cabergoline or levodopa.

The hypothesis for this study is that the dopamine turnover rate is a more sensitive marker for the early diagnosis of Parkinson's disease compared to the standard Fluoro-Dopa-PET measuring only the Fluoro-Dopa uptake into the striatum.

For the interventional part of the study, the hypothesis is that levodopa has larger effects on striatal dopamine turnover compared to dopamine agonists by providing more dopamine precursor. Enhancement of compensatory mechanisms for dopamine loss in early PD such as increased dopamine turnover could have several beneficial implications such as improvement or prolongation of symptomatic treatment responses, but might also produce therapeutic problems such as the development of levodopa-induced motor complications.

Detailed Description

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The study is designed to measure the difference of dopamine turnover rate measured by Fluoro-Dopa-PET in the putamen between patients with Parkinson's disease treated with cabergoline and levodopa for 3 months.

The hypothesis for this study is that the dopamine turnover rate is a more sensitive marker for the early diagnosis of Parkinson's disease compared to the standard Fluoro-Dopa-PET measuring only the Fluoro-Dopa uptake into the striatum. The specific aim of the study was to estimate normal ranges and test-retest measures for various parameters characterising dopamine metabolism from a prolonged 18F-dopa positron emission tomography (PET) measurement using a reference tissue model and compare their value for the detection of early PD.

For the interventional part of the study, the hypothesis is that levodopa has larger effects on striatal dopamine turnover compared to dopamine agonists by providing more dopamine precursor. Enhancement of compensatory mechanisms for dopamine loss in early PD such as increased dopamine turnover could have several beneficial implications such as improvement or prolongation of symptomatic treatment responses, but might also produce therapeutic problems such as the development of levodopa-induced motor complications. The specific aim is to evaluate the effects of levodopa and the dopamine D2 agonist cabergoline on striatal dopamine turnover estimated as the inverse of the effective dopamine distribution volume ratio (EDVR) measured by 18F-dopa PET in de-novo PD.

The study protocol includes an initial Fluoro-Dopa-PET scan before treatment and after three months double-blind treatment with cabergoline or levodopa. This study is an investigator-blinded, randomized mono-center controlled phase IV study.

The main inclusion criteria are:

\- Early (de novo) Parkinson's disease (Hoen \& Yahr I and II), according to the UK brain bank criteria

The main exclusion criteria are:

* Current or past dopaminergic treatment
* Atypical parkinsonian syndromes
* Treatment with neuroleptics (present and past)

Methods:

* Fluoro-dopa-PET for measuring the dopamine turnover rate
* clinical investigations including parkinsonian rating scales (e.g. UPDRS, PDQ-39, etc.)
* olfactory tests

Study medication:

* Cabergoline (1 to 3 mg once per day)
* Levodopa/carbidopa (50 until 300 mg levodopa per day in one to three dosages)

Conditions

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Parkinson's Disease

Keywords

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Parkinson's disease Fluoro-Dopa-PET Dopamine agonists Cabergoline Surrogate marker Dopamine turnover

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Investigators

Study Groups

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Levodopa

Levodopa 300 mg per day orally.

Group Type ACTIVE_COMPARATOR

Cabergoline

Intervention Type DRUG

Levodopa

Intervention Type DRUG

Cabergoline

Cabergoline 3 mg per day orally.

Group Type ACTIVE_COMPARATOR

Cabergoline

Intervention Type DRUG

Levodopa

Intervention Type DRUG

Interventions

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Cabergoline

Intervention Type DRUG

Levodopa

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Early (de novo) Parkinson's disease (Hoen \& Yahr I and II), according to the UK brain bank criteria

Exclusion Criteria

* Current or past dopaminergic treatment
* Atypical parkinsonian syndromes
* Treatment with neuroleptics (present and past)
* Pregnancy
Minimum Eligible Age

40 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Pfizer

INDUSTRY

Sponsor Role collaborator

Technische Universität Dresden

OTHER

Sponsor Role lead

Responsible Party

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Alexander Storch

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Heinz Reichmann, MD

Role: PRINCIPAL_INVESTIGATOR

Technical University of Dresden

Locations

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Department of Neurology at the Technical University of Dresden

Dresden, Saxony, Germany

Site Status

Department of Nuclear Medicine at the Technical University of Dresden

Dresden, Saxony, Germany

Site Status

Countries

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Germany

References

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Oehme L, Perick M, Beuthien-Baumann B, Wolz M, Storch A, Lohle M, Herting B, Langner J, van den Hoff J, Reichmann H, Kotzerke J. Comparison of dopamine turnover, dopamine influx constant and activity ratio of striatum and occipital brain with (1)(8)F-dopa brain PET in normal controls and patients with Parkinson's disease. Eur J Nucl Med Mol Imaging. 2011 Aug;38(8):1550-9. doi: 10.1007/s00259-011-1819-8. Epub 2011 May 7.

Reference Type RESULT
PMID: 21553090 (View on PubMed)

Related Links

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http://www.neuro.med.tu-dresden.de

Homepage of principle location

Other Identifiers

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91052003

Identifier Type: -

Identifier Source: org_study_id