Essential Amino Acids and Parkinsons Disease (EAAPD)
Stimulation of Muscle Protein Synthesis With Essential Amino Acids in Parkinsons Disease
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Parkinson's disease (PD) is characterized by the loss of dopaminergic neurons in the substantia nigra and is the second most common neurodegenerative disease in older individuals. PD may involve a variety of symptoms, but the predominant manifestation is impaired physical function, including muscle atrophy and weakness, bradykinesia, and reduced endurance. Older PD patients frequently present with, or develop, greater loss of muscle mass than expected from aging alone (sarcopenia). Sarcopenia results in inactivity, chronic inflammation, and neurodegeneration, all of which compound the loss of muscle function due to PD. L-DOPA/carbidopa is the most common drug therapy for PD and can mitigate some of the physical problems with PD, but progression of the disease usually ultimately results in severe reduction of quality of life.
The metabolic basis for loss of muscle mass with sarcopenia is anabolic resistance, defined as a diminished stimulation of muscle protein synthesis by dietary protein. Reduced muscle protein synthesis in response to dietary protein consumption not only contributes to the loss of muscle mass, but also to impaired single muscle fiber function, decreased mitochondrial biogenesis, and reduced neuromuscular junction stability, all of which contribute to impaired physical function. The consequences of anabolic resistance of muscle protein in PD is often compounded by the recommendation for reduced consumption of dietary protein due to the potential interference of absorbed dietary amino acids with the transport of L-DOPA from the intestine into the blood and from the blood into the brain.
We have developed an EAA-based nutritional supplement called AMS2434 designed to stimulate muscle protein synthesis in older individuals with PD and to promote dopamine production in the brain. AMS2434 is cleared rapidly from the blood after consumption, thereby minimally interfering with the transport of L-DOPA/carbidopa. In addition, AMS2434 contains tyrosine to enhance the brain production of dopamine. AMS2434 also decreases plasma tryptophan, which in turn reduces its degradation product kynurenine, which may be involved in the development of sarcopenia. We have previously shown that a 10g dose of EAAs maximally stimulates muscle protein synthesis in healthy elderly. In the current protocol we will determine if 10g of a mixture of a specifically designed mixture of EAAs (AMS2434) will robustly stimulate muscle protein synthesis in anabolic resistant individuals with Parkinson's disease. In addition, we will determine if AMS2434 stimulates brain dopamine synthesis from tyrosine.
Study Type
Study Type
Phase
Phase
- Phase 1
Contacts and Locations
Study Contact
Study Contact
- Name: Robert R Wolfe, Ph.D.
- Phone Number: 501-526-5708
- Email: RWolfe2@uams.edu
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age 55 years or older
- Clinical diagnosis of idiopathic Parkinson Disease
- Hoehn and Yahr stage 2-3
- Stable medication regimen with L-DOPA/carbidopa for at least 4 weeks prior to study entry
Exclusion Criteria:
- Findings suggestive of atypical or secondary Parkinsonism, including cerebellar sign
- Use of anticoagulation drugs (including aspirin and Plavix) within one week of the protocol
- Allergy to lidocaine
- Supranuclear gaze palsy, apraxia, prominent autonomic failure, or other cortical signs
- Multiple strokes with stepwise progression of symptoms
- Neuroleptic treatment at time of study entry or time of onset of Parkinsonism
- Inability to walk without a cane or walker
- Deep brain stimulation
- Montreal Cognitive Assessment (MoCA) score <18
- Use of investigational drugs
- Early Alzheimer's disease
- Frontotemporal dementia of dementia with Lewy bodies
- Major depression treated with SSRIs
- Individuals with auditory or visual hallucinations
- Individuals taking drugs that cause Parkinsonism like symptoms such as antipsychotics, anti-emetics, prokinectic and anti-seizure medications
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: AMS2434 (amino acids)
Product AMS2434. A single dose providing 10g of essential amino acids (EAAs). Study products will be in powder form and packaged in individual serving sizes and will be dissolved in 8 oz water for consumption. |
The proprietary composition includes leucine, valine, isoleucine, lysine, phenylalanine, threonine, tyrosine, histidine, and methionine.
Small amounts of non-caloric flavorings are also included.
Other Names:
|
|
Placebo Comparator: Placebo
Matched non-caloric placebo. Study products will be in powder form and packaged in individual serving sizes and will be dissolved in 8 oz water for consumption. |
Matched non-caloric placebo.
Study products will be in powder form and packaged in individual serving sizes and will be dissolved in 8 oz water for consumption.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Muscle Protein Synthesis
Time Frame: 4 hours
|
Mixed muscle protein synthesis expressed as the fractional synthetic rate.
|
4 hours
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Whole body protein breakdown
Time Frame: 6 hours
|
Amount of protein broken down per unit of time
|
6 hours
|
|
Whole body protein synthesis
Time Frame: 6 hours
|
Amount of protein gained per unit of time
|
6 hours
|
|
Plasma concentrations of amino acids
Time Frame: 8 hours
|
Measured via liquid chromatography mass spectrometry.
|
8 hours
|
|
Plasma concentrations of kynurenine
Time Frame: 6 hours
|
Measured via enzyme-linked immunosorbent assay
|
6 hours
|
|
Plasma concentrations of homovanillic acid (HVA)
Time Frame: 6 hours
|
Measured via enzyme-linked immunosorbent assay
|
6 hours
|
|
Homovanillic acid (HVA) production from tyrosine
Time Frame: 6 hours
|
Calculated from the isotopic enrichments of plasma HVA and tyrosine
|
6 hours
|
|
D-KEFS color-word interference test
Time Frame: 6 hours
|
Assessment of cognitive function
|
6 hours
|
|
WAIS-IV symbol search
Time Frame: 6 hours
|
Assessment of cognitive function
|
6 hours
|
|
Trail making test
Time Frame: 6 hours
|
Assessment of cognitive function
|
6 hours
|
|
Profile of mood states (POMS) questionnaire
Time Frame: 6 hours
|
Assessment of mood
|
6 hours
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Robert R Wolfe, Ph.D., University of Arkansas
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- EAAPD1
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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