Parkinson Disease
Conditions
Keywords
Dementia, Cerebral metabolism, PET scan
Brief summary
Parkinson's disease (PD) is a common disease. Dementia will affect 80% of these patients during their evolution. In addition, treatments of motor signs have a potential impact on these disorders and conversely. The purpose of this study is to show focal abnormalities in brain metabolism in the precuneus and posterior cingulate region are predictive of the onset of dementia within 2 years.
Detailed description
Cognitive impairment and dementia have become major factors of disability induced by Parkinson's disease. The prediction of dementia in any given patient may be useful for prognosis but also for discussion of setting up heavy therapeutic techniques, especially surgical. Currently, known predictors are disease severity, age and existence of pre-cognitive disorders; other assumptions are discussed. Among these, morphological imaging techniques (MRI) and functional techniques (MRI, PET) are proposed. Use increasingly early of heavy, expensive and potentially ineffective surgical treatment in dementia makes it necessary to find independent, early and reliable markers of the onset of dementia in Parkinson's Disease.
Interventions
OTHERExplorations
Imaging tests and neuropsychological assessment are carried out within 60 days following patient enrollment. Neuropsychological assessment lasts 1:30 to 2:00 hours and is conducted by a psychologist in an interview during which patient will pass several tests on memory, language, attention or orientation in space. These tests do not require discontinuation of Parkinson's disease treatment.
Sponsors
Assistance Publique - Hôpitaux de Paris
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
45 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Male or female with Parkinson's Disease * 45 \< Age ≥ 75 years * Parkinson's disease with clinical diagnosis made for at least 5 years (60 months) * Patient able to perform cognitive tests in French during 1 hour 30 minutes * Patient having provided a signed consent to participate in this trial * Be either affiliated to, or a beneficiary of, a social security category * Existence of caregiver at least contactable by phone
Exclusion criteria
* Parkinson's disease diagnosed before 40 years old * Clinical evidence for dementia or dementia criteria according to level 1 MDS-Task Force (Dubois et al. 2007) * Atypical form of parkinsonism * Other disease affecting the central nervous system * Poorly controlled diabetes with glucose \> 2.0 g/l or HbA1c\>7,5% based on results of less than 3 months * Taking a cholinesterase inhibitor treatment, memantine or long-term benzodiazepines other than referred hypnotic, neuroleptic * History of surgery for Parkinson's disease or planned surgery within 6 months. Surgery is possible beyond * Cons-indication to 3T MRI * Inability to lie down for 60 minutes * Legal protection * Patient living outside the Ile-de France region Secondary
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Onset of dementia authenticated by a neuropsychological assessment (MDS Task Force criteria) | Year 2 |
Secondary
| Measure | Time frame |
|---|---|
| Determination of cerebral blood flow (CBF) by arterial spin labelling (ASL) perfusion 3Tesla (3T) Magnetic Resonance Imaging (MRI) | Day 90 |
| Identifying different striatal functional connectivity patterns by resting state functional MRI at 3T | Day 90 |
| Cerebral cortex trophicity by VBM technique (Voxel-based morphometry) | Day 90 |
| Regional cerebral glucose consumption in the parietal lobes studied with fluorodeoxyglucose (FDG) Positron Emission Tomography (PET) and regional glucose consumption in the caudate nucleus and prefrontal areas studied with FDG PET | Day 90 |
| Concentration of iron in the mesencephalon measured with MRI | Day 90 |
| Degree of anosmia measured with the University of Pennsylvania Smell Identification Test (UPSIT) | Day 90 |
| Correlation between initial clinical, neuropsychological and biological parameters and risk of onset of dementia | Day 0 and year 2 |
| Number of hyperintensities in the FLAIR MR image | Day 90 |
Countries
France
Contacts
Primary ContactClaire THIRIEZ, MD
Backup ContactPhilippe REMY, MD, PhD
Outcome results
None listed