Epidemiology and Pathophysiology of Parkinsonism in the Caribbeans

NCT ID: NCT03368300

Last Updated: 2017-12-11

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

NA

Total Enrollment

550 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-08-03

Study Completion Date

2023-08-03

Brief Summary

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The primary aim of this study is to estimate the frequency and to characterize clinically atypical parkinsonism in the French West Indies and Guyana.

Detailed Description

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An atypical akineto-rigid parkinsonian syndrome, unresponsive to L-dopa has been evidenced in Guadeloupe. Abnormally frequent, this progressive supranuclear palsy (PSP)-like syndrome represents a new clinical entity. Unlike in classical PSP 70% of patients have myoclonus, 59% hallucinations, 78% REM sleep behavior disorders. Oculomotor pattern differs from classical PSP suggesting that cortical dysfunction predominates over brainstem impairments. Neuropathological examination in four patients has shown a widespread accumulation of the tau protein in the basal ganglia, the midbrain and cortical areas.

This syndrome has been associated to the regular consumption of food products derived from plants of the Annonaceae family, more specifically Annona Muricata (soursop), suggesting a toxic origin. We have already confirmed the neurotoxic potential of the lipophilic mitochondrial complex I inhibitor annonacin, the major acetogenin in Annona muricata. This class of compounds is specific to Annonaceae. Nanomolar concentrations of annonacin induce the death of dopaminergic neurons in culture, by impairment of energy production. Chronic systemic intoxication of rats with annonacin causes neuronal damage in the same brain regions that are damaged in patients with atypical parkinsonism. These results greatly suggest that the consumption of annonacea might contribute to the pathogenesis of the disease. The H1 subhaplotype in tau gene associated with PSP in Caucasians did not confer risk for PSP-like atypical parkinsonism in Guadeloupe.

Conditions

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Atypical Parkinsonism

Keywords

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progressive supranuclear palsy Caribbean atypical Parkinsonism Annona Muricata

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

The primary aim of this study is to estimate the frequency and to characterize clinically atypical parkinsonism in the French West Indies and Guyana.

This study has been designed as epidemiological, multicentric transversal descriptive and longitudinal prospective study with biological collection and post-mortem neuropathological sub-study of brain tissue.
Primary Study Purpose

OTHER

Blinding Strategy

NONE

Not masking, 2 groups parallel

Study Groups

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Patients

Parkinson's patient

Group Type OTHER

Clinical and biological exam

Intervention Type OTHER

The study will include a clinical, neuropsychological, oculomotor, food intake and environmental exposure assessment. Blood samples will be taken to constitute a library of plasma, DNA and serum. The harvesting of samples will be part of a subsequent study. Consent for possible post-mortem neuropathological analysis will be proposed.

All the patients accepting it will be followed by a 5-year longitudinal follow-up. The longitudinal follow-up bi-annual and then annual will include a clinical evaluation, a questionnaire of dependence and a questionnaire of monitoring of exposure to certain environmental factors

All controls must answer a questionnaire of environmental exposure factors, oculomotor test, and blood sample (3 collections: DNA, serum, plasma).

witnesses: without parkinson's disease

Subjects without parkinson's disease

Group Type OTHER

Clinical and biological exam

Intervention Type OTHER

The study will include a clinical, neuropsychological, oculomotor, food intake and environmental exposure assessment. Blood samples will be taken to constitute a library of plasma, DNA and serum. The harvesting of samples will be part of a subsequent study. Consent for possible post-mortem neuropathological analysis will be proposed.

All the patients accepting it will be followed by a 5-year longitudinal follow-up. The longitudinal follow-up bi-annual and then annual will include a clinical evaluation, a questionnaire of dependence and a questionnaire of monitoring of exposure to certain environmental factors

All controls must answer a questionnaire of environmental exposure factors, oculomotor test, and blood sample (3 collections: DNA, serum, plasma).

Interventions

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Clinical and biological exam

The study will include a clinical, neuropsychological, oculomotor, food intake and environmental exposure assessment. Blood samples will be taken to constitute a library of plasma, DNA and serum. The harvesting of samples will be part of a subsequent study. Consent for possible post-mortem neuropathological analysis will be proposed.

All the patients accepting it will be followed by a 5-year longitudinal follow-up. The longitudinal follow-up bi-annual and then annual will include a clinical evaluation, a questionnaire of dependence and a questionnaire of monitoring of exposure to certain environmental factors

All controls must answer a questionnaire of environmental exposure factors, oculomotor test, and blood sample (3 collections: DNA, serum, plasma).

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Pour les patients :

1. Patient ou tiers responsable ayant reçu une information sur l'étude et ayant signé le consentement éclairé
2. Patient âgé de plus de 18 ans
3. Patient consultant en neurologie ou en gériatrie pour symptomatologie parkinsonienne ou pour troubles cognitifs évocateurs d'une démence à corps de Lewy
4. Patient domicilié aux Antilles-Guyane

Pour les témoins :
5. Conjoint ou accompagnant ayant reçu une information sur l'étude et ayant signé le consentement éclairé
6. Personne âgée de plus de 18 ans
7. Personne ne présentant pas de pathologie d'allure neurodégénérative (Parkinson, démence notamment)
8. Personne domiciliée aux Antilles-Guyane

Exclusion Criteria

Pour les patients :

1. Syndrome parkinsonien secondaire (post-traumatique, vasculaire, iatrogène, post encéphalitique)
2. Patient non affilié au régime de sécurité sociale
3. En cas de difficulté de suivi le patient sera exclu de l'étude longitudinale

Pour les témoins :

1. Personnes présentant des troubles cognitifs ou un syndrome parkinsonien diagnostiqué.
2. Patient non affilié au régime de sécurité sociale -
Minimum Eligible Age

19 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Centre Hospitalier Universitaire de la Guadeloupe

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Annie LANNUZEL, PU-PH

Role: STUDY_DIRECTOR

University Hospital of Guadeloupe

Régine EDRAGAS, PH

Role: PRINCIPAL_INVESTIGATOR

University Hospital of Martinique

Dominique MARNET, PH

Role: PRINCIPAL_INVESTIGATOR

: University Hospital of Guyana

Locations

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University Hospital of Guyana

Cayenne, , French Guiana

Site Status RECRUITING

University Hospital of Martinique

Fort-de-France, , Martinique

Site Status RECRUITING

Countries

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French Guiana Martinique

Central Contacts

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Valérie HAMONY SOTER, Project leader

Role: CONTACT

Phone: 0590 93 46 86

Email: [email protected]

Mélanie PETAPERMAL, Monito manager

Role: CONTACT

Phone: 0590 93 46 86

Email: [email protected]

Facility Contacts

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Dominique MARNET, PH

Role: primary

Régine EDRAGAS, PH

Role: primary

Other Identifiers

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RBM-PAP-2011/86

Identifier Type: -

Identifier Source: org_study_id