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The Effect of Rasagiline on Cognition in Parkinson's Disease

Primary Purpose

Parkinson's Disease

Status
Completed
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Rasagiline
Placebo
Sponsored by
Brown University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Parkinson's Disease focused on measuring Parkinson's disease, cognition, executive function, rasagiline

Eligibility Criteria

40 Years - undefined (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • age 40 or older
  • able to speak and read English, at least 6 years of formal education
  • a diagnosis of PD
  • have a family member or caregiver willing to fill out study questionnaires
  • Participants will have been on stable medication regimens (no new PD medications and no changes to existing PD medication dosages) for the 4 weeks prior to study enrollment.
  • If participants are already taking other Parkinson's medications at time of study enrollment, the dosages of these medications must remain stable throughout study participation.
  • Changes to existing Parkinson's disease medications dosages or addition of other medications to treat Parkinson's disease after study enrollment will result in removal from study.
  • Participants are allowed to begin non-PD medications or to have changes to their existing non-PD medications if these additions and changes are deemed medically necessary.

Exclusion Criteria:

  • currently taking any MAO inhibitor
  • currently taking a cognition-enhancing medication such as a cholinesterase inhibitor medication or memantine
  • dementia (Mini-Mental Status Exam score below 21/30), significant depression (Beck Depression Inventory- Short Form score >7)
  • presence of a another neurodegenerative disorder besides PD
  • unstable cardiac disorder, clinically significant hepatic
  • lung or renal disease
  • In addition, changes to dosages of PD-related medications or the addition of other PD medications during the 6 month study enrollment will result in dismissal from the study.

Sites / Locations

  • Butler Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

rasagiline

Placebo

Arm Description

Participants in this arm will receive 1 mg of rasagiline daily for the six month duration of the study.

Participants in this group will receive 1 mg of placebo daily for the six month duration of the study.

Outcomes

Primary Outcome Measures

Rey Auditory Verbal Learning Test
This is a 15 item supraspan verbal memory test. This measure assesses immediate memory span, new learning, susceptibility to interference, retention, and recognition memory.

Secondary Outcome Measures

Controlled Oral Word Association Test
This test evaluates the spontaneous production of words beginning with a given letter of the alphabet under timed conditions. It is used to assess executive functioning.
Animal Fluency
Participants are asked to produce as many animal names as they can in one minute. This measure assesses executive functioning.
Judgement of Line Orientation from the Repeat Battery for the Assessment of Neuropsychological Status
This measure assesses spatial perception and orientation without requiring a motor output.
Digit Span from the Wechsler Adult Intelligence Scale- Fourth Edition
This is a measure of attention and working memory which requires participants to repeat a series of digits forward, in reverse, and to sequence a series of digits.
Trail Making Test
These are tests of speed for attention, sequencing, mental flexibility, and visual search.
Digit Symbol Modalities Test
This test assesses cognitive processing speed, and visuomotor coordination and is one of the most sensitive measures of cognitive dysfunction available.
Parkinson's Disease Quality of Life Questionnaire
The 39-item Parkinson's disease questionnaire (PDQ-39) is one of the most often used instruments to measure treat¬ment effect on quality of life in PD.

Full Information

First Posted
June 23, 2011
Last Updated
February 3, 2015
Sponsor
Brown University
Collaborators
Teva Pharmaceuticals USA
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1. Study Identification

Unique Protocol Identification Number
NCT01382342
Brief Title
The Effect of Rasagiline on Cognition in Parkinson's Disease
Study Type
Interventional

2. Study Status

Record Verification Date
February 2015
Overall Recruitment Status
Completed
Study Start Date
June 2011 (undefined)
Primary Completion Date
February 2014 (Actual)
Study Completion Date
February 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Brown University
Collaborators
Teva Pharmaceuticals USA

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
While Parkinson's disease has historically been defined in terms of its motor symptomatology, studies have shown that non-motor deficits form an important part of the syndrome. Cognitive deficits can occur even in the early stages of Parkinson's disease. These deficits are often subtle and do not rise to the level of impairment necessary for a diagnosis of dementia; however these deficits are discernable with neuropsychological testing and may produce subjective complaints of cognitive decline and mild functional difficulties in some patients. The traditional pharmacological interventions for Parkinson's disease have focused on controlling and alleviating motor symptoms with levodopa and dopamine agonists. However, these medications treat the symptoms of PD, but do not alter the course or progression of the underlying disorder. In contrast, rasagiline, an MAO-B inhibitor, has recently shown benefits consistent with a possible disease-modifying effect. Given the positive and intriguing findings seen with treatment with rasagiline, the investigators propose to study the effects of this medication on cognition in patients with mild to moderate stage Parkinson's disease. Hypotheses: Rasagiline will improve cognitive function, as measured by performance on neuropsychological tests in PD patients who do not suffer from dementia. Rasagiline will not negatively affect neuropsychiatric functioning.
Detailed Description
The results of our study found that while participants receiving rasagiline showed some improvements in their motor symptoms, as measured by the UPDRS, no significant changes were found on any of the neuropsychological measures after six months of treatment with rasagiline. Further, the participant group who received placebo also did not show significant change on any of the neuropsychological measures over the six month course of our study. Finally, the cognitive performance of our treatment and placebo groups did not differ significantly from one another at baseline or after six months of study participation.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Parkinson's Disease
Keywords
Parkinson's disease, cognition, executive function, rasagiline

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
50 (Actual)

8. Arms, Groups, and Interventions

Arm Title
rasagiline
Arm Type
Experimental
Arm Description
Participants in this arm will receive 1 mg of rasagiline daily for the six month duration of the study.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Participants in this group will receive 1 mg of placebo daily for the six month duration of the study.
Intervention Type
Drug
Intervention Name(s)
Rasagiline
Other Intervention Name(s)
Azilect
Intervention Description
1 mg daily
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
1 mg daily
Primary Outcome Measure Information:
Title
Rey Auditory Verbal Learning Test
Description
This is a 15 item supraspan verbal memory test. This measure assesses immediate memory span, new learning, susceptibility to interference, retention, and recognition memory.
Time Frame
Change in score from day 1 of study enrollment and score after 6 months of treatment
Secondary Outcome Measure Information:
Title
Controlled Oral Word Association Test
Description
This test evaluates the spontaneous production of words beginning with a given letter of the alphabet under timed conditions. It is used to assess executive functioning.
Time Frame
day 1 of study enrollment and after 6 months of treatment
Title
Animal Fluency
Description
Participants are asked to produce as many animal names as they can in one minute. This measure assesses executive functioning.
Time Frame
day 1 of study enrollment and after 6 months of treatment
Title
Judgement of Line Orientation from the Repeat Battery for the Assessment of Neuropsychological Status
Description
This measure assesses spatial perception and orientation without requiring a motor output.
Time Frame
day 1 of study enrollment and after 6 months of treatment
Title
Digit Span from the Wechsler Adult Intelligence Scale- Fourth Edition
Description
This is a measure of attention and working memory which requires participants to repeat a series of digits forward, in reverse, and to sequence a series of digits.
Time Frame
day 1 of study enrollment and after 6 months of treatment
Title
Trail Making Test
Description
These are tests of speed for attention, sequencing, mental flexibility, and visual search.
Time Frame
day 1 of study enrollment and after 6 months of treatment
Title
Digit Symbol Modalities Test
Description
This test assesses cognitive processing speed, and visuomotor coordination and is one of the most sensitive measures of cognitive dysfunction available.
Time Frame
day 1 of study enrollment and after 6 months of treatment
Title
Parkinson's Disease Quality of Life Questionnaire
Description
The 39-item Parkinson's disease questionnaire (PDQ-39) is one of the most often used instruments to measure treat¬ment effect on quality of life in PD.
Time Frame
day 1 of study enrollment and after 6 months of treatment

10. Eligibility

Sex
All
Minimum Age & Unit of Time
40 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: age 40 or older able to speak and read English, at least 6 years of formal education a diagnosis of PD have a family member or caregiver willing to fill out study questionnaires Participants will have been on stable medication regimens (no new PD medications and no changes to existing PD medication dosages) for the 4 weeks prior to study enrollment. If participants are already taking other Parkinson's medications at time of study enrollment, the dosages of these medications must remain stable throughout study participation. Changes to existing Parkinson's disease medications dosages or addition of other medications to treat Parkinson's disease after study enrollment will result in removal from study. Participants are allowed to begin non-PD medications or to have changes to their existing non-PD medications if these additions and changes are deemed medically necessary. Exclusion Criteria: currently taking any MAO inhibitor currently taking a cognition-enhancing medication such as a cholinesterase inhibitor medication or memantine dementia (Mini-Mental Status Exam score below 21/30), significant depression (Beck Depression Inventory- Short Form score >7) presence of a another neurodegenerative disorder besides PD unstable cardiac disorder, clinically significant hepatic lung or renal disease In addition, changes to dosages of PD-related medications or the addition of other PD medications during the 6 month study enrollment will result in dismissal from the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Laura L. Frakey, Ph.D.
Organizational Affiliation
Brown University
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Joseph Friedman, MD
Organizational Affiliation
Brown University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Butler Hospital
City
Providence
State/Province
Rhode Island
ZIP/Postal Code
02906
Country
United States

12. IPD Sharing Statement

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The Effect of Rasagiline on Cognition in Parkinson's Disease

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