Emotion, Mood and Executive Function in Parkinson's Disease (PD)

NCT ID: NCT01385735

Last Updated: 2011-06-30

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

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

70 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-10-31

Study Completion Date

2013-04-30

Brief Summary

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The current study aims to assess the effect of an 8 week Azilect treatment (as adjunct therapy to levodopa) on affect perception and emotional expressiveness in a double-blind placebo-controlled study.

Detailed Description

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Parkinson's disease (PD) is associated with a range of cognitive impairments, most notably deficits of higher order cognitive control mechanisms referred to as "executive dysfunction". These problems have consistently been related to dysfunction of fronto-striatal circuitry (summary see Stocchi \& Brusa, 2000). Executive function impairments may already be present in early stages of PD (Uekermann et al., 2004) and their severity may be exacerbated by affective changes such as depression (Uekermann et al., 2003). In addition to cognitive problems, PD patients frequently suffer from mood changes, in particular apathy (Kirsch-Darrow et al., 2006) and from affect processing impairments, relating to both the ability to decode the affective state of other people on the basis of facial expressions or prosody and to the ability to adequately express the patients' own emotions (e.g. Breitenstein et al., 1998; Zgaljardic et al., 2003, Pell \& Leonard, 2005). The capacity for emotion perception was found to be linked to the severity of executive dysfunction; affective and cognitive changes are thus not independent, at least in patients with moderate PD (Breitenstein et al., 2001).

In a recent drug monitoring study by Lundbeck GmbH/TEVA Pharma GmbH based on a small group of PD patients (n=29), introduction of Azilect (Rasagiline) therapy was associated with a significant improvement of PD patients' emotional expressiveness (e.g. facial expression, gestures, voice intonation) over an 8 week observation period. Significant improvements were observed for self-ratings of emotional expressiveness as well as ratings by physicians and relatives. The lack of a placebo-control group, however, does not allow any firm conclusions with regard to the specificity of these effects.

Intact affect recognition and an adequate ability to express emotions are of critical importance for social interaction. The therapeutic efficacy of drug treatment on non-motor symptoms in PD has so far only rarely been addressed. The documentation of a beneficial effect of Azilect on emotional processing would be of great relevance for the quality of life of PD patients and greatly enhance their ability to participate in social life.

The addition of a placebo control group is critical for the assessment of the specificity of the expected beneficial effects of Azilect.

Conditions

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Parkinson Disease

Keywords

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Parkinson Disease Emotion mood executive function

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Placebo

Placebo 1 Tbl per day, 12 week (84 days) duration

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

Placebo 1 Tbl per day, 12 week (84 days) duration

Rasagiline

Azilect Group: Dose: 1 mg per day, 12 week (84 days) duration

Group Type ACTIVE_COMPARATOR

Rasagiline

Intervention Type DRUG

Azilect Group: Dose: 1 mg per day, 12 week (84 days) duration

Interventions

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Rasagiline

Azilect Group: Dose: 1 mg per day, 12 week (84 days) duration

Intervention Type DRUG

Placebo

Placebo 1 Tbl per day, 12 week (84 days) duration

Intervention Type DRUG

Other Intervention Names

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Azilect EU/1/04/304/001-007

Eligibility Criteria

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Inclusion Criteria

* idiopathic PD
* age range 30-75 yrs, HY I-III
* stable medication for at least 4 weeks prior to baseline
* Native speakers (German)
* signing of informed consent form

Exclusion Criteria

* clinically significant depression (BDI\>13)
* freezing, pronounced fluctuations
* other neurological or psychiatric disorders
* dementia (MMSE\<25)
* treatment with the MAO-B-inhibitor Selegiline, antidepressants
* any contraindication according to SmPC
* participation in another interventional study
Minimum Eligible Age

30 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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St. Josef Hospital Bochum

OTHER

Sponsor Role lead

Responsible Party

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Neurologische Universitätsklinik der Ruhr-Universität Bochum

Locations

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St. Josef Hospital

Bochum, North Rhine-Westphalia, Germany

Site Status

Countries

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Germany

Central Contacts

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Dirk Woitalla, MD

Role: CONTACT

Phone: 0049234509

Email: [email protected]

Anke Hartung

Role: CONTACT

Phone: 0049234509

Email: [email protected]

References

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Roca M, Torralva T, Gleichgerrcht E, Chade A, Arevalo GG, Gershanik O, Manes F. Impairments in social cognition in early medicated and unmedicated Parkinson disease. Cogn Behav Neurol. 2010 Sep;23(3):152-8. doi: 10.1097/WNN.0b013e3181e078de.

Reference Type BACKGROUND
PMID: 20829664 (View on PubMed)

Rosenthal E, Brennan L, Xie S, Hurtig H, Milber J, Weintraub D, Karlawish J, Siderowf A. Association between cognition and function in patients with Parkinson disease with and without dementia. Mov Disord. 2010 Jul 15;25(9):1170-6. doi: 10.1002/mds.23073.

Reference Type BACKGROUND
PMID: 20310053 (View on PubMed)

Scholtissen B, Verhey FR, Adam JJ, Weber W, Leentjens AF. Challenging the serotonergic system in Parkinson disease patients: effects on cognition, mood, and motor performance. Clin Neuropharmacol. 2006 Sep-Oct;29(5):276-85. doi: 10.1097/01.WNF.0000229013.95927.C7.

Reference Type BACKGROUND
PMID: 16960473 (View on PubMed)

Growdon JH, Kieburtz K, McDermott MP, Panisset M, Friedman JH. Levodopa improves motor function without impairing cognition in mild non-demented Parkinson's disease patients. Parkinson Study Group. Neurology. 1998 May;50(5):1327-31. doi: 10.1212/wnl.50.5.1327.

Reference Type BACKGROUND
PMID: 9595982 (View on PubMed)

Timmann D, Daum I. How consistent are cognitive impairments in patients with cerebellar disorders? Behav Neurol. 2010;23(1-2):81-100. doi: 10.3233/BEN-2010-0271.

Reference Type BACKGROUND
PMID: 20714063 (View on PubMed)

Other Identifiers

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2011-TevAzi

Identifier Type: -

Identifier Source: org_study_id