- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03462641
Modulation of GABA-A Receptors in Parkinson Disease-Flumazenil Arm
September 15, 2022 updated by: Nicolaas Bohnen, MD, PhD, University of Michigan
Modulation of GABA-A Receptors and Axial Motor Impairments in Parkinson Disease-Flumazenil Arm
This arm is a positron emission tomography (PET) biomechanistic GABA-A receptor target engagement study that includes detailed clinical and motor assessments before and after the i.v.
administration of 1 mg flumazenil or placebo in Parkinson disease subjects.
Each subject will receive 1mg flumazenil or placebo at two visits.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
This biomechanistic GABA-A receptor target engagement study includes clinical and motor assessments before and at various time points up to approximately 90 minutes after the i.v.
administration of 1 mg flumazenil and placebo in Parkinson disease subjects.
Thirty Parkinson disease subjects with disease severity (Hoehn and Yahr) stages 2-4 will be recruited.
Baseline [11C]FMZ and vesicular monoamine transporter type 2 (VMAT2) [11C]DTBZ brain PET imaging will be performed prior to drug administration to assess for GABA-A receptor availability and the integrity of nigrostriatal dopaminergic nerve terminals, respectively.
Study Type
Interventional
Enrollment (Actual)
36
Phase
- Phase 2
- Phase 1
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
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Michigan
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Ann Arbor, Michigan, United States, 48106
- University of Michigan Functional Neuroimaging, Cognitive and Mobility Laboratory
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Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
48 years to 97 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Parkinson's disease (PD): PD diagnosis will follow the UK Parkinson's Disease Society Brain Bank Research Center (UKPDSBRC) clinical diagnostic criteria for PD.
- Hoehn and Yahr stages 2-4
- Absence of dementia confirmed by cognitive testing.
- Abnormal 11C-Dihydrotetrabenazine ([11C]-DTBZ) PET study to demonstrate nigrostriatal dopaminergic denervation.
Exclusion Criteria:
- PD with Dementia (PDD) or dementia with Lewy bodies (DLB).
- Other disorders which may resemble PD, such as vascular dementia, normal pressure hydrocephalus, multiple system atrophy, corticobasal ganglionic degeneration, or toxic causes of parkinsonism. Prototypical cases have distinctive clinical profiles, like early and severe dysautonomia or appendicular apraxia, which may differentiate them from idiopathic PD. The use of the UKPDSBRC clinical diagnostic criteria for PD will mitigate the inclusion of subjects with atypical parkinsonism.
- Subjects on benzodiazepine, GABA-ergic medications (baclofen, tizanidine), neuroleptic, anticholinergic (trihexyphenidyl, benztropine), or cholinesterase inhibitor drugs.
- Evidence of a mass lesion on structural brain imaging (MRI).
- Participants in whom MRI is contraindicated including, but not limited to, those with a pacemaker, presence of metallic fragments near the eyes or spinal cord, chest, or cochlear implant.
- Severe claustrophobia precluding MR or PET imaging.
- Subjects limited by participation in research procedures involving ionizing radiation.
- Pregnancy (urine or serum pregnancy test within 48 hours of each PET session) or breastfeeding.
- History of seizures
- Significant anxiety or history of panic disorder.
- History of recent suicide attempt or overdose of tricyclic antidepressants or other medications
- Any other medical history determined by investigators to preclude safe participation.
- Allergy to flumazenil
- Significant liver disease
- History of alcohol or other substance abuse within past two years.
- History of regular benzodiazepine use within past year
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: Triple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Sequence A - (Flumazenil at Visit 1)
A detailed 90 minute clinical assessment was conducted before and after treatment administration for each visit.
Flumazenil 1mg in 10cc normal saline was given intravenously (iv) over 5-10 minutes on the first visit as treatment.
10 cc of normal saline placebo was given intravenously (iv) over 5-10 minutes on the second visit as treatment.
|
1mg in 10cc normal saline
10 cc normal saline
|
Experimental: Sequence B - (Placebo at Visit 1)
A detailed 90 minute clinical assessment was conducted before and after treatment administration for each visit.
10 cc of normal saline placebo was given intravenously (iv) over 5-10 minutes on the first visit as treatment.
Flumazenil 1mg in 10cc normal saline was given intravenously (iv) over 5-10 minutes on the second visit as treatment.
|
1mg in 10cc normal saline
10 cc normal saline
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Postural Instability and Gait Disorder (PIGD) Score
Time Frame: up to 3 hours (including pre and post infusion motor evaluation)
|
Postural Instability and Gait Disorder (PIGD) score is a subscale score of MDS-UPDRS scale. It is computed as a sum of following MDS-UPDRS items: 3.10 Gait 3.11 Freezing of gait 3.12 Postural stability 3.13 Posture Minimal possible score is 0, maximal possible score is 16. Higher scores indicate greater severity of PIGD symptoms (worse outcome). |
up to 3 hours (including pre and post infusion motor evaluation)
|
PIGD Score Change
Time Frame: up to 3 hours (including pre and post infusion motor evaluation)
|
Difference in PIGD score from pre-infusion to post-infusion.
Only observations where PIGD score change is less than 0 (decrease) are retained, as the hypothesis we are interested is whether the effect magnitude of flumazenil on PIGD score depends on baseline GABA-A receptor binding as assesed by FMZ PET.
|
up to 3 hours (including pre and post infusion motor evaluation)
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Nicolaas I Bohnen, MD, PhD, University of Michigan
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
March 9, 2018
Primary Completion (Actual)
June 4, 2021
Study Completion (Actual)
June 4, 2021
Study Registration Dates
First Submitted
March 6, 2018
First Submitted That Met QC Criteria
March 6, 2018
First Posted (Actual)
March 12, 2018
Study Record Updates
Last Update Posted (Actual)
September 27, 2022
Last Update Submitted That Met QC Criteria
September 15, 2022
Last Verified
September 1, 2022
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Brain Diseases
- Central Nervous System Diseases
- Nervous System Diseases
- Parkinsonian Disorders
- Basal Ganglia Diseases
- Movement Disorders
- Synucleinopathies
- Neurodegenerative Diseases
- Parkinson Disease
- Physiological Effects of Drugs
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Protective Agents
- GABA Modulators
- GABA Agents
- Antidotes
- Flumazenil
Other Study ID Numbers
- HUM00130361
- R01NS099535 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
No
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Yes
Studies a U.S. FDA-regulated device product
No
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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