- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01521117
The Effect of Donepezil on Gait and Balance in Parkinson's Disease
A Randomized, Double-blind, Placebo Controlled, Crossover Study to Evaluate the Effect of Donepezil on Gait and Balance in Parkinson's Disease
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Parkinson's disease (PD) is a common neuro-degenerative disease affecting about 2% of the adult population in the United States over the age of 65. Some of the most disabling symptoms of Parkinson's disease are balance and gait dysfunction, leading to falls. These symptoms do not respond to current dopamine directed therapies. Evidence from both pathologic studies and advanced imaging has demonstrated that a cholinergic deficiency in the thalamus and basal ganglia is found in individuals with PD who fall compared to non-fallers. The central acting acetylcholine esterase inhibitor, donepezil, has been demonstrated to decrease falls in individuals with PD. The mechanism by which falls decreased is unknown. Our open label pilot data indicates that donepezil can improve quantitative measures of balance in individuals with PD. Suggesting that improvements in balance in the mechanism by which donepezil reduces falls. Our goal is to determine whether donepezil will:
- Improve quantitative measures of balance in subjects with Parkinson's disease compared to placebo.
- Improve quantitative measures of gait in subjects with Parkinson's disease compared to placebo.
- Improve cognitive measures in non-demented subjects with Parkinson's disease.
Study Type
Enrollment (Actual)
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
Oregon
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Portland, Oregon, United States, 97239
- Parkinson's Center of Oregon - Oregon Health and Science University
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Idiopathic Parkinson's disease, defined by the UK Brain Bank criteria, with a Hoehn and Yahr score of 2 to 4
- Treated with levodopa for at least a year and on a stable antiparkinsonian regimen for at least one month
- Abnormal computerized dynamic posturography (CDP) on screening defined as a composite score below 65 (range 1-100)
Exclusion Criteria:
- Dementia defined by MMSE less than 27
- Other medical conditions other than PD affecting balance or gait as determined by the investigators
- Unable to stand unassisted for 30 minutes
- Current use of an acetylcholinesterase inhibitors or drugs with known anticholinergic properties
- Medical or psychiatric co-morbidities that may interfere with compliance or might place subject in danger as determined by the investigators
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: Triple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Donepezil, Then Placebo
Donepezil 5 mg a day for weeks 1 - 3, if tolerated increased to 10 mg a day for weeks 4 - 6.
After a washout period of 4 weeks, placebo 5 mg a day for weeks 1 - 3, if tolerated increased to 10 mg a day for weeks 4 - 6.
|
Use 1 capsule (5 mg) of donepezil once per day for first 21 days than donepezil 10mg qday for 21 days.
Other Names:
Use 1 capsule (5 mg) once per day for first 21 days than 10mg qday for 21 days.
Other Names:
|
Experimental: Placebo, Then Donepezil
Placebo 5 mg a day for weeks 1 - 3, if tolerated increased to 10 mg a day for weeks 4 - 6. After a washout period of 4 weeks, donepezil 5 mg a day for weeks 1 - 3, if tolerated increased to 10 mg a day for weeks 4 - 6. |
Use 1 capsule (5 mg) of donepezil once per day for first 21 days than donepezil 10mg qday for 21 days.
Other Names:
Use 1 capsule (5 mg) once per day for first 21 days than 10mg qday for 21 days.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Sensory Organization Test - Composite Score
Time Frame: Change from Day 1 of each treatment phase to Day 42 of each treatment phase
|
Balance was measured using the Sensory Organization test (SOT) on the NeuroCom Balance Master Clinical Research System platform (Neurocom International, Inc), which tests sway in 6 conditions, eyes open, eyes closed, and a moving visual surround first with a stable platform then with a moving platform.
Center of Pressure (CoP) was calculated from the recordings.
Forces and moments were recorded at 100Hz sampling frequency.
A change score from the beginning of each treatment phase (placebo or active drug) to the end of the treatment phase.
The SOT is scored on an interval scale with the highest possible score of 100 indicating no sway at all.
The lowest possible score of 0 indicates the trial was stopped due to an impending fall.
Higher scores are indicative of better balance (greater stability).
|
Change from Day 1 of each treatment phase to Day 42 of each treatment phase
|
Sensory Organization Test (SOT) - Condition 4 (Eyes Open, Moving Surround, Stable Platform).
Time Frame: Change from Day 1 of each treatment phase to Day 42 of each treatment phase
|
Condition 4 of the Sensory Organization Test.
The participants eyes are open as the surround moves and the platform remains stable.
A change score from the beginning of each treatment phase (placebo or active drug) to the end of the treatment phase.
The SOT is scored on an interval scale with the highest possible score of 100 indicating no sway at all.
The lowest possible score of 0 indicates the trial was stopped due to an impending fall.
Higher scores are indicative of better balance (greater stability).
|
Change from Day 1 of each treatment phase to Day 42 of each treatment phase
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Trails B - A
Time Frame: Change from Day 1 of each treatment phase to Day 42 of each treatment phase
|
The Trail Making Test (TMT) consists of two parts (A & B) in which the subject is instructed to connect a set of 25 dots as quickly as possible while still maintaining accuracy.
The test provides information about visual search speed, scanning, speed of processing, and executive functioning.
Part A measures processing speed and part B measures executive functioning.
The TMT is time to complete each part of the test in seconds.
Higher scores indicate greater impairment.
Subtracting part A from part B (Trails B-A) is theorized to reduce the influence of the working memory and visuo-spatial demands and, therefore, provides a relatively pure indicator of executive function.
A change score from the beginning of each treatment phase (placebo or active drug) to the end of the treatment phase.
|
Change from Day 1 of each treatment phase to Day 42 of each treatment phase
|
Collaborators and Investigators
Investigators
- Principal Investigator: Seth Kareus, MD, Movement Disorders Program - Parkinson's Center of Oregon - Oregon Health and Science University
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
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
- Cholinergic Agents
- Enzyme Inhibitors
- Nootropic Agents
- Cholinesterase Inhibitors
- Donepezil
Other Study ID Numbers
- OHSU-7363
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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