Progression of Striatal and Extrastriatal Degeneration in PD and PSP Patients

NCT ID: NCT03840252

Last Updated: 2024-04-10

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

NA

Total Enrollment

78 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-09-23

Study Completion Date

2019-07-31

Brief Summary

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This longitudinal study aims to research cognitive and gait phenotypes of Parkinson's disease and Supranuclear Palsy as well as to provide markers to track diseases progression using a multi-modality approach based on 3D-gait analysis and MR Imaging.

Specifically, this study want to identify cognitive pattern and gait-related cerebral diffusion/functional connectivity in PD and PSP patients and to verify their progression over a period of 18 months.

In summary, the current protocol proposed to investigate the following issues:

* to perform a multifactorial quantitative analysis of outcomes for PD and PSP compared to a control group in order to categorize cognitive and gait pattern in the group of patients and verify if the gait can be useful as discriminator for diagnosis.
* to analyze whether diffusion and resting-state functional connectivity indices are correlated with clinical disease severity scores and motor scores and how they change over time (18 months later).

Detailed Description

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Gait disorder is one of the key features of Parkinson's disease (PD), often leading to loss of mobility and severe disability. Yet in the early stages of disease, examination of gait may lead to inconclusive results for differential diagnosis between PD and other parkinsonism because slow and small stepped walking is often unspecific and can be related to age, depressive mood, or to a presence of neurodegenerative atypical parkinsonism (AP) such as Progressive Supranuclear Palsy (PSP).

At the same time, emerging evidence indicates that early disturbances in cognitive processes such as attention, executive function, and working memory are associated with slower gait and gait instability during single and dual-task testing.

It is therefore crucial to carefully investigate the multiple cognitive domains in order to identify possible mild cognitive deficits in PD and PSP patients and to correlate them with gait disorders.

The use of quantitative movement analysis with 3D-gait analysis allow an objective multifactorial evaluation of the functional limitation related to PD and PSP patients and can be used to analyze the gait in pathologies characterized by gait impairment compared to healthy control (HC).

This longitudinal clinical study aims to analyze cognitive profiles and gait pattern (with 3D-gait analysis) and their progression (18 months later) in a PD- and a PSP-group, respect to HC group.

Moreover, with the Magnetic Resonance Imaging (MRI), the study want to research for possible gait-related cerebral diffusion/functional connectivity alterations and their changes over time.

The specific aims of the project are:

* To perform a multifactorial quantitative analysis of outcomes for PD and PSP compared to a control group in order to categorize the gait in the group of patients and verify if the gait can be useful as discriminator for diagnosis.
* To detect possible cognitive deficits in Parkinson's Disease and PSP more corelated with gait disturbances.
* To analyze whether diffusion and resting-state functional connectivity indices are correlated with clinical disease severity scores and motor scores and how they change over time (18 months later).
* To identify gait-related cerebral diffusion/functional connectivity in PD and PSP patients and to verify their progression over a period of 18 months.

Conditions

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Parkinson Disease (PD) Paralysis; Supranuclear

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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PD patients: Parkinson's disease group

Diagnosis of idiopathic PD by United Kingdom Brain Bank criteria, exclusion of other significant neurological or orthopedic problems; ages of 21-90; able to walk 25 feet unassisted and without any assistive device.

Imaging: rsfMRI, diffusion tensor imaging; Motor evaluation: 3D gait analysis; Movement Disorder Society (MDS)-UPDRS Behavioral: PD-MCI-specific Level II battery (Mov Dis. 2015 Mar; 30(3): 402-406)

Group Type ACTIVE_COMPARATOR

3D gait analysis

Intervention Type DIAGNOSTIC_TEST

Computed analysis of posture and gait pattern and motor performance by kinematic and kinetics parameters analysis such as the step length, gait velocity, stride time variability, 3D joint kinematics, ground reaction forces, joint kinetics

rsfMRI

Intervention Type DIAGNOSTIC_TEST

MR scans acquired by 1.5 Tesla (Siemens Medical Systems, Erlangen, Germany).

Montreal Cognitive assesment (MoCA)

Intervention Type DIAGNOSTIC_TEST

Standard clinical questionnaire

PSP patients

Application of the National Institute of Neurological Disorders and Stroke and Society for Progressive Supranuclear Palsy (NINDS-SPSP) criteria for the clinical diagnosis of "probable" PSP, evaluation of PSP rating scale, exclusion of other significant neurological or orthopedic problems; ages of 21-90; able to walk 25 feet unassisted and without any assistive device.

Imaging: rsfMRI, diffusion tensor imaging; Motor evaluation: 3D gait analysis;MDS-UPDRS Behavioral: PD-MCI-specific Level II battery (Mov Dis. 2015 Mar; 30(3): 402-406)

Group Type ACTIVE_COMPARATOR

3D gait analysis

Intervention Type DIAGNOSTIC_TEST

Computed analysis of posture and gait pattern and motor performance by kinematic and kinetics parameters analysis such as the step length, gait velocity, stride time variability, 3D joint kinematics, ground reaction forces, joint kinetics

rsfMRI

Intervention Type DIAGNOSTIC_TEST

MR scans acquired by 1.5 Tesla (Siemens Medical Systems, Erlangen, Germany).

Montreal Cognitive assesment (MoCA)

Intervention Type DIAGNOSTIC_TEST

Standard clinical questionnaire

HC: healthy control group

Healthy adults ages 21-90 without movement disorders, psychiatric disorders, or dementia.

Imaging: rsfMRI, diffusion tensor imaging; Motor evaluation: 3D gait analysis; Behavioral: PD-Mild Cognitive Impairment (MCI)-specific Level II battery (Mov Dis. 2015 Mar; 30(3): 402-406)

Group Type ACTIVE_COMPARATOR

3D gait analysis

Intervention Type DIAGNOSTIC_TEST

Computed analysis of posture and gait pattern and motor performance by kinematic and kinetics parameters analysis such as the step length, gait velocity, stride time variability, 3D joint kinematics, ground reaction forces, joint kinetics

rsfMRI

Intervention Type DIAGNOSTIC_TEST

MR scans acquired by 1.5 Tesla (Siemens Medical Systems, Erlangen, Germany).

Montreal Cognitive assesment (MoCA)

Intervention Type DIAGNOSTIC_TEST

Standard clinical questionnaire

Interventions

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3D gait analysis

Computed analysis of posture and gait pattern and motor performance by kinematic and kinetics parameters analysis such as the step length, gait velocity, stride time variability, 3D joint kinematics, ground reaction forces, joint kinetics

Intervention Type DIAGNOSTIC_TEST

rsfMRI

MR scans acquired by 1.5 Tesla (Siemens Medical Systems, Erlangen, Germany).

Intervention Type DIAGNOSTIC_TEST

Montreal Cognitive assesment (MoCA)

Standard clinical questionnaire

Intervention Type DIAGNOSTIC_TEST

Other Intervention Names

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resting state functional magnetic resonance (rsfMRI)

Eligibility Criteria

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Inclusion Criteria

* Diagnosis of idiopathic PD by United Kingdom (UK) Brain Bank criteria and PSP according to NINDS-SPSP criteria, without other significant neurological or orthopedic problems;
* ages of 20-80;
* able to walk 25 feet unassisted and without any assistive device

Exclusion Criteria

* History of epileptic seizures, head injury, other neurological disorders.
* Cardiac pacemaker implantation
Minimum Eligible Age

20 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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IRCCS San Raffaele Roma

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Fabrizio Stocchi, MD, PhD

Role: STUDY_DIRECTOR

IRCCS San Raffaele Pisana

Locations

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Casa di cura San Raffaele Cassino

Cassino, Frosinone, Italy

Site Status

Countries

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Italy

Other Identifiers

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RP 06/15

Identifier Type: -

Identifier Source: org_study_id

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