Parkinson's Disease
Conditions
Brief summary
The objective of this protocol is to investigate the microstructural alterations and monoaminergic function in Parkinson's disease patients with impulse control disorders and cognitive impairment by multimodal MRI and 18F-DTBZ PET imaging.
Detailed description
Study duration is expected to be completed in a period of 4 year. This study will compare the microstructural integrity by multimodal MRI imaging and monoaminergic function by18F- DTBZ PET in 35 PD patients without dementia/ICD (PD group), 35 patients with mild cognitive impairment (PD-MCI), 35 PD patients with dementia (PDD group), and 35 patients with impulse control disorders (PD-ICD group).
Interventions
DRUG18-FDTBZ
During this study, participants will receive a single i.v. administration of approximately 370MBq (10 mCi) 18F- DTBZ immediately prior to imaging. The dosage of DTBZ is 10 nmole. The effective dose in human body is about 5.6 mSV. The proposed dose for this study is based on the investigators' phase I study. At the proposed human dose of 10 mCi, the whole body effective dose (ED) will be approximately 680 mrem. The estimated human ED is expected to be comparable to or below the range of other approved brain imaging agents, such as 18F-FDG (Lin 2010).
Sponsors
Chang Gung Memorial Hospital
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
20 Years to 80 Years
Healthy volunteers
Yes
Inclusion criteria
1. PD group: 35 subjects with a diagnosis of PD whom must: * Male or female patients, age range 20\ 80. * Patients should not have any clinical evidence of cognitive impairment or ICD. * Patients who provide a written informed consent prior to study entry. If the patient is incapable of informed consent, the caregiver may consent on behalf of the patient (the patient must still confirm assent). 2. PD-MCI group: 35 subjects with a diagnosis of PD with mild cognitive impairment whom must: * Male or female patients, age range 20\ 80. * Patients should be fulfilled theDiagnostic Criteria for Mild Cognitive Impairment in Parkinson's Disease: Movement Disorder Society Task Force Guidelines as PD-MCI. (Litvan, 2012; Appendix II). * Patients should not have any clinical evidence of ICD. * Patients who provide a written informed consent prior to study entry. If the patient is incapable of informed consent, the caregiver may consent on behalf of the patient (the patient must still confirm assent). 3. PDD group: 35 subjects with a diagnosis of PD with dementia whom must: * Male or female patients, age range 20\ 80. * Patients should be fulfilled the Movement Disorders Society diagnostic criteria of PDD as possible or probable PDD (Emre, 2006). (Appendix III) * Patients should not have any clinical evidence of ICD. iv.Patients who provide a written informed consent prior to study entry. If the patient is incapable of informed consent, the caregiver may consent on behalf of the patient (the patient must still confirm assent). 4. PD-ICD group: 35 subjects with a diagnosis of PD with ICD whom must: * Male or female patients, age range 20\ 80. * Patients should be fulfilled one of the diagnostic criteria or definition in these ICDs: pathological gambling, hypersexuality, compulsive shopping, compulsive eating, punding, and compulsive medication use (Voon, 2009). (Appendix IV). * Patients should not have any clinical evidence of dementia or cognitive impairment. * Patients who provide a written informed consent prior to study entry. If the patient is incapable of informed consent, the caregiver may consent on behalf of the patient (the patient must still confirm assent).
Exclusion criteria
1. Pregnant or becoming pregnant during the study (as documented by pregnancy testing at screening or at any date during the study according to the PI discretion) or current breast feeding. 2. Any subject who has a clinically significant abnormal laboratory values, and/or clinically significant or unstable medical or psychiatric illness. 3. History of drug or alcohol abuse within the last year, or prior prolonged history of abuse. 4. History of intracranial operation, including thalamotomy, pallidotomy, and/or deep brain stimulation. 5. Any documented abnormality in the brain by CT or MRI of brain, which might contribute to the motor function, such as hydrocephalus, multiple infarction and encephalomalacia, will be excluded. Mild cortical atrophy and non-specific white matter changes will be allowed. 6. Any evidence of secondary parkinsonism (multiple infarcts, intoxication, and hydrocephalus, etc) or other neurodegenerative diseases (multiple system atrophy, progressive supranuclear palsy). 7. History of allergy to radioligands that contain 18F isotope.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The difference of specific uptake ratio (SUR) of 18F- DTBZ between each diagnostic group | 4 years | The SUVRs of 18F-FP-(+)-DTBZ in ipsilateral caudate, anterior putamen, and bilateral nucleus accumbans were significantly lower in PDD group than those of PD group. |
Secondary
| Measure | Time frame |
|---|---|
| The difference of eigenvalues obtained from diffusion tensor imaging (DTI) between each diagnostic group. | 4 years |
Other
| Measure | Time frame |
|---|---|
| The correlation between SURs of 18F-DTBZ and eigenvalues of DTI in each brain regions and the severity of motor or nonmotor symptoms. | 4 years |
Countries
Taiwan
Outcome results
None listed