Cognitive Dysfunction in Parkinson's Disease
Parkinson's Disease
About this trial
This is an interventional treatment trial for Parkinson's Disease focused on measuring Parkinson's, TMS, Kluger
Eligibility Criteria
Inclusion Criteria:
- Diagnosis of probable PD (using United Kingdom Brain Bank criteria)
- Diagnosis of mild cognitive impairment
- No unstable medical condition
Exclusion Criteria:
- Features suggestive of other causes of Parkinsonism or other neurological disorders
- Prior deep brain stimulation (DBS) or ablation surgery
- Evidence for active depression or Hospital Anxiety and Depression Scale (HADS) score greater than or equal to 11
- Motor symptoms expected to interfere with scanning (e.g. sever tremor)
- Contraindications to TMS, MEG, or MRI such as pregnancy, pacemaker, unstable cardiac disease, skull lesion, claustrophobia, history of epilepsy, or on medications known to lower seizure threshold
- Implanted electronic devices or metal
Sites / Locations
- University of Colorado School of Medicine
Arms of the Study
Arm 1
Arm 2
Experimental
Sham Comparator
Real TMS
Sham TMS
TMS will be administered using a 70-mm diameter air-cooled figure-of-8 coil and SuperRapid2 Magstim Stimulator. Repetitive pulses will be delivered to the right and left pre-frontal cortex (Brodmann area 46) using a frameless stereotactic navigation system and the subject's magnetic resonance imaging (MRI) in Brainsight software. Stimuli will be delivered at 20 Hz at 90% resting motor threshold (rMT) for 25 trains of 30 pulses per train, inter-train interval of 30 seconds for a total of 750 pulses per hemisphere. This dose and duration of repetitive TMS (rTMS) is based on physiological studies of healthy adults and treatment studies of cognition in PD and Alzheimer's disease.52, 123 Side of first stimulation (left vs right hemisphere) will be counterbalanced across subjects.
Sham stimulation will be delivered using a sham coil fitted with electrodes to mimic both the auditory and somatic sensation of real TMS.