Attentional Performance in Parkinson Disease

Sponsor
National Institute of Neurological Disorders and Stroke (NINDS) (NIH)
Overall Status
Withdrawn
CT.gov ID
NCT04428931
Collaborator
(none)
0
1

Study Details

Study Description

Brief Summary

Background:

Parkinson Disease (PD) is a nervous system disorder that affects movement. Dopamine is an important neurotransmitter in the brain. As PD progresses, there is less and less dopamine in the brain. Researchers think there may be a relationship between differences in attention and dopamine in people with PD.

Objective:

To learn if people with PD that is worse on one side also have differences in how much attention they pay to the two sides of space on their left and right.

Eligibility:

English-speaking, right-handed people age 35-80 with PD.

Design:

Participants will be screened with medical and neurological history and exam, and medicine review.

Participants will have 1 study visit. It will last 7-8 hours. They will stop taking their Parkinson medicine 12 hours before the visit.

Participants will complete questionnaires.

Participants will do tasks on a computer screen. They will judge the middle of lines, react to stimuli, and search and identify items that appear on the screen.

Participants may have functional and structural magnetic resonance imaging (MRI). MRI uses a strong magnetic field and radio waves to take pictures of the brain. During the MRI, participants will lie on a table that slides in and out of the MRI scanner. While inside the scanner, they will look at a cross on a screen, relax, and think about nothing.

Participants will undergo prism adaptation. They will sit in front of a board while their chin rests on a support. They will point to 1 of 2 dots on the board while they wear prism glasses that shift their vision to the left or right....

Condition or Disease Intervention/Treatment Phase

    Detailed Description

    Study Description:

    We will investigate the relationship between Dopamine (DA) function and attention in patients with asymmetric Parkinson Disease (PD). We hypothesize that the direction of asymmetry in dopamine (DA) depletion predicts the asymmetry in visual attention.

    Objectives:
    Primary Objective:
    • to study attentional asymmetry in patients with PD. We hypothesize that visual attention in Parkinson will be biased to the visual field contralateral to the least affected hemisphere (i.e. contralateral to the most affected side).
    Secondary Objectives:
    • to investigate the correlation between feedback learning and visuospatial attention performance in PD. We hypothesize that feedback learning will also be affected according to the most compromised hemisphere. Right hemisphere-predominant PD patients (left-motor predominant), compared to left hemisphere-predominant patients, will exhibit a rightward visuospatial bias and a relative preference for learning from reward, compared to punishment.

    • to investigate the effect of prism adaptation on feedback learning and visuospatial attention in PD. This objective is exploratory.

    Endpoints:

    Primary Endpoint: visuospatial performance on the Landmark Task

    Secondary Endpoints: performance on:
    • Posner Task

    • Visual Search Task

    • Attentional blink Task

    • Visuospatial performance on the Manual Line Bisection Task

    • Reward and Punishment Implicit Feedback Learning Task

    • The Attentional Scaling Task

    Functional connectivity measured with resting state fMRI.

    Study Population:

    Sixty patients with asymmetric PD. Any gender, aged 35-80 (inclusive), able to give consent and without a diagnosis of significant illness affecting the central nervous system other than PD.

    Study Design

    Study Type:
    Observational
    Actual Enrollment :
    0 participants
    Observational Model:
    Cohort
    Time Perspective:
    Prospective
    Official Title:
    Evaluation of Attentional Performance in Parkinson Disease
    Actual Study Start Date :
    Dec 6, 2021
    Actual Primary Completion Date :
    Dec 6, 2021
    Actual Study Completion Date :
    Dec 6, 2021

    Arms and Interventions

    Arm Intervention/Treatment
    PD patients

    Patients with Asymmetric Parkinson's disease

    Outcome Measures

    Primary Outcome Measures

    1. Attentional asymmetry [2 months]

      Direction and degree of visuospatial bias on the Landmark task

    Secondary Outcome Measures

    1. Feedback learning and visuospatial attention performance [2 months]

      Direction and degree of visuospatial bias on the Manual Line Bisection, Visual Search Posner, Attentional Blink, Reward and Punishment Implicit Feedback Learning, and the Attentional Scaling Tasks

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    35 Years to 80 Years
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    No
    • INCLUSION CRITERIA:
    1. Provision of signed and dated informed consent form

    2. Stated willingness to comply with all study procedures and availability for the duration of the study

    3. Male or female aged 35 - 80 (inclusive)

    4. Fluent in English

    5. Right-handed per the Edinburgh Handedness scale

    6. Able to provide consent

    7. Diagnosis of idiopathic Parkinson s disease according to UK Brain Bank criteria

    8. On dopaminergic therapy to treat Parkinsonian symptoms

    9. MOCA Score greater than or equal to 24 determined by a NIH neurologist

    10. Hoehn and Yahr Score less than or equal to 3 determined by a NIH neurologist

    11. Asymmetric motor symptoms

    EXCLUSION CRITERIA:
    1. Any current major neurological or psychiatric disorder other than Parkinson s disease, such as, (but not limited to) stroke, dementia, Alzheimer disease, Schizophrenia or Major Depression Disorder

    2. Inability to provide consent

    3. Members of the Behavioral Neurology Unit, NINDS

    4. Left-handed per the Edinburgh Handedness scale

    5. Primarily axial motor symptoms or symmetrical limb involvement

    6. Pregnancy

    7. Exclusion criteria for MRI

    • Presence of metal which would make having an MRI scan unsafe, such as pacemakers, stimulators, pumps, aneurysm clips, metallic prostheses, artificial heart valves, cochlear implants or shrapnel fragments, or if subject was a welder or metal worker, since small metal fragments may be present in the eye.

    • Claustrophobia

    • Inability to lie supine comfortably for 1 hour

    • Pregnancy

    INCLUSION OF VULNERABLE PARTICIPANTS:

    Because the goals of the study can be accomplished without involving vulnerable population, we will not include individuals without consent capacity.

    Since the goal is to characterize visuospatial attention deficits in idiopathic PD which is a disease of late adulthood, we will not include children.

    The effects of MRI on fetal development and the health of pregnant women is unknown.

    Therefore, women who are pregnant and breast-feeding will be excluded and women who can become pregnant will be excluded following a positive pregnancy test, if the optional MRI is under consideration.

    The study requires fluency in English in order to completely understand tasks instructions, thus non-English speakers/readers will be excluded.

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 National Institutes of Health Clinical Center Bethesda Maryland United States 20892

    Sponsors and Collaborators

    • National Institute of Neurological Disorders and Stroke (NINDS)

    Investigators

    • Principal Investigator: Eric M Wassermann, M.D., National Institute of Neurological Disorders and Stroke (NINDS)

    Study Documents (Full-Text)

    None provided.

    More Information

    Additional Information:

    Publications

    None provided.
    Responsible Party:
    National Institute of Neurological Disorders and Stroke (NINDS)
    ClinicalTrials.gov Identifier:
    NCT04428931
    Other Study ID Numbers:
    • 200102
    • 20-N-0102
    First Posted:
    Jun 11, 2020
    Last Update Posted:
    Dec 10, 2021
    Last Verified:
    Dec 1, 2021
    Keywords provided by National Institute of Neurological Disorders and Stroke (NINDS)
    Additional relevant MeSH terms:

    Study Results

    No Results Posted as of Dec 10, 2021