Parkinson Disease Before and After Medication and Rehabilitation Treatment
The Role of Noradrenergic Network, and Its Association With Autonomous Dysfunction,Cerebral Autoregulation and microRNA in Parkinson Disease Before and After Medication and Rehabilitation Treatment
調査の概要
詳細な説明
(1) 70 patients with PD. (2) 30 age and sex-match controls.
Methods:
-1st year To built up the biobank of 30 early PD patients (Hoehn and Yahr stage 1-3) and 30 health controls in all examination.
The PD patients will accept the MRI, autonomic dysfunction, and peripheral microRNA examination and their correlations among each other at least 12 hours after the least medication.
-2nd year Second year, the investigators will follow-up the 30 PD patients enrolled in the 1st years.
The PD patients will receive studies to evaluate the pharmacokinetics effect before medication, including MRI, autonomic dysfunction, and peripheral microRNA examination.
-3rd year the investigators will study the rehabilitation effect in PD (3 days per week, for 12 weeks).
30 PD with rehabilitation and 30 PD without rehabilitation will be enrolled and compared their difference in MRI study, autonomic dysfunction, and peripheral microRNA examination before and after 3 month follow-up.
Goals
- To define the effect of norepinephrine network to autonomic dysfunction in PD
- To define the effect of peripheral microRNA level to norepinephrine network in PD
- To associate drug/physical rehabilitation effect to alteration of norepinephrine network, autonomic dysfunction, and peripheral microRNA and their interactions to striatal dopaminergic network in PD.
- According to previous results, to verify the role of norepinephrine network and autonomic dysfunction in long-term PD evolution.
研究の種類
入学 (予想される)
段階
- 適用できない
参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- In this study, the patients should be 40-75 years of age and identified as PD. PD patients with an early clinical stage (Hoehn and Yahr stage 1-3) will be enrolled in this study. The informed written consent which is approved by Ethics Committee of our hospital will be obtained from the patient or their family.
Exclusion Criteria:
Patients with the following conditions are excluded:
- Atherosclerotic narrowing on intracranial and extracranial vessels (>50% stenosis) with or without evidence of old cerebral infarctions, coronary artery diseases status post percutaneous transluminal coronary angioplasty or bypass surgery and renal failure requiring hemodialysis or peritoneal dialysis
- Moderate to severe heart failure (NYHA class III and IV).
- Central or peripheral disorders known to affect autonomic nervous systems.
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:非ランダム化
- 介入モデル:並列代入
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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介入なし:Normal
30 normal volunteers with age, sex and BMI-match as control group
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アクティブコンパレータ:treatment group
The Rehabilitation treatment group will receive rehabilitation training once per day, 3 days per week, for 12 weeks.
The duration of each session is about 1 hour.
Participants will first receive relaxation exercises, positioning and self-stretch exercises (emphasizing on spinal mobility and flexor muscle groups of limbs and trunk) for 15 minutes.
Then they will have balance training for 20 minutes.
The investigators will use goal-directed tasks, such as different types of ball games, for balance training.
At the end, participants will receive walking exercise for 20 minutes, and cool down exercises for 5 minutes.
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The walking exercise will be aerobic with a Borg rating perceived exertion around 11-14 scales.
Before and after the 12 weeks rehabilitation training, should accept MRI and Clinical assessments.
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偽コンパレータ:non-treatment group
The group will not receive non-rehabilitation treatment, before and after the 12 weeks non-rehabilitation training, should accept MRI and Clinical assessments.
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The walking exercise will be aerobic with a Borg rating perceived exertion around 11-14 scales.
Before and after the 12 weeks non-rehabilitation training, should accept MRI and Clinical assessments.
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Neuroimage
時間枠:12 weeks
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Conventional MRI, Rest function MRI Image Data Preprocessing, Assessment of cerebral blood flow with Arterial Spin Labeling (ASL) MRI and Chemical Exchange Saturation Transfer
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12 weeks
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Physical Rehabilitation_1
時間枠:12 weeks
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Unified Parkinson's Disease Rating Scale
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12 weeks
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Physical Rehabilitation_2
時間枠:12 weeks
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Walking speed by self-selected gait speed over 10 m
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12 weeks
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Physical Rehabilitation_3
時間枠:12 weeks
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Walking endurance, by using the 6-minute walk test
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12 weeks
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Physical Rehabilitation_4
時間枠:12 weeks
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Static and dynamic balance control, by using Biodex Balance System and Timed Up and Go test
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12 weeks
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Biochemical Analysis
時間枠:18 months
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interval change of serum MicroRNA level (increase of decrease)
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18 months
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協力者と研究者
捜査官
- スタディディレクター:Cheng-Hsien Lu, M.D.、Chang Gung Memorial Hospital
- 主任研究者:Jen-Wen Hung, M.D.、Chang Gung Memorial Hospital
研究記録日
主要日程の研究
研究開始
一次修了 (予想される)
研究の完了 (予想される)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (見積もり)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
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