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Parkinson DiseasePhase 2INI-PDNCT04251585

Intranasal Insulin in Parkinson's Disease

A Phase 2 study testing Regular Novolin R in people with Parkinson Disease, run by HealthPartners Institute at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This project will investigate exploratory outcomes related to the effect of intranasal insulin on cognition, mood, apathy and motor performance of subjects with Parkinson's disease over a 3 week period. Read more about this study

Who is it for?
Ages 41 to 89 years
Conditions the study is for
Parkinson Disease
What is being tested?
Regular Novolin R
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
31 participants
Where
1 siteUnited States
Study dates
4 Feb 2020to 27 Aug 2024
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 41 to 89 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Subject has Idiopathic PD defined by the cardinal sign, bradykinesia, plus the presence of at least 1 of the following: resting tremor or rigidity and without any other known or suspected cause of Parkinsonism (according to Movement disorder society (MDS) clinical diagnostic criteria for Parkinson's disease confirmed by a fellowship trained movements disorder specialist
  • Subject is Hoehn \& Yahr stage less than or equal to 3
  • Subject has a MOCA score ≥10.
  • Subject is > 40 and <90 years of age.
  • Female subjects are post-menopausal or have a negative pregnancy test
  • The subject must be proficient in speaking, reading and understanding English in order to comply with procedural testing of cognitive function, memory and physiology.
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  • Subject has provided informed written consent prior to participation. In the event that subject is legally unable to provide informed written consent due to deterioration in cognitive abilities, fully informed written consent must be provided by a legally authorized representative.
  • Subject is on a stable dose (at least 1 month prior to baseline visit) of antiparkinsonian agents and is willing to remain on this dose for the duration of the study. If the subject is on a cholinesterase inhibitor, a stable dose without changes for 1 month is also required.
  • Subject has undergone a brain CT or MRI prior to the study as part of their previous diagnostic workup for PD to rule out underlying structural lesions, as determined clinically significant by the investigator

Who cannot join

  • Subject has atypical Parkinson's syndrome(s) due to drugs (e.g., metoclopramide, neuroleptics), metabolic neurogenetic disorders (e.g., Wilson's Disease), encephalitis, cerebrovascular disease, or degenerative disease (e.g., Progressive Supranuclear Palsy, Multiple System Atrophy, Corticobasal Degeneration, Lewy Body dementia)
  • Subject has medical history and/or clinically determined disorders: chronic sinusitis, untreated thyroid disease, or significant head trauma.
  • Subject has history of any of the following: moderate to severe pulmonary disease, poorly controlled congestive heart failure, significant cardiovascular and/or cerebrovascular events within previous 6 months, condition known to affect absorption, distribution, metabolism, or excretion of drugs such as any hepatic, renal or gastrointestinal disease or any other clinically relevant abnormality that inclusion would pose a safety risk to the subject as determined by investigator.
  • Subject has had previous nasal and/or oto-pharyngeal surgery and severe deviated septum and/or other anomalies.
  • Subject has history of any psychiatric illness that would pose a safety risk to the subject as determined by investigator.
  • Subject is currently taking sedative medications that are clinically contraindicated as determined by investigator.
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  • Subject has undergone a recent change (<1 month) in their anti-parkinsonian medication, cholinesterase inhibitor or anti-depressant medication.
  • Subject has current or recent drug or alcohol abuse or dependence as defined by Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV TR).
  • Screening laboratory results that are medically relevant, in which inclusion would pose a safety risk to the subject as determined by investigator.
  • Subject has participated in a clinical trial investigation within 3 months of this study.
  • Subject has an insulin allergy.
  • Subject has Insulin-dependent diabetes

Trial locations and contacts

1 site in 1 country.

United States1 site
  • HealthPartners Neuroscience Center

    Saint Paul, Minnesota, 55130

Other trials in United States

About this study

Official title: Single Center Safety and Tolerability Trial of Intranasal Insulin in Parkinson's Disease

This project will investigate exploratory outcomes related to the effect of intranasal insulin on cognition, mood, apathy and motor performance of subjects with Parkinson's disease over a 3 week period.

Read the detailed description

Parkinson's disease (PD) is the second most common neurodegenerative disease after Alzheimer's dementia and was originally described as a motor disease. The diagnosis of PD is still based on the core motor features of bradykinesia, resting tremor, and rigidity, primarily as a result of degeneration of nigrostriatal dopaminergic neurons. In addition to the classic motor symptoms, however, PD is increasingly recognized as a multisystem disorder. A variety of non-motor symptoms, including cognitive deficits and dementia, are commonly observed in patients with PD.

In this study, we aim to investigate which intranasal insulin dose out of three doses and placebo, administered at three different doses or placebo over a 21-day period, is the optimum dosage based on safety and tolerability in Parkinson's disease. A similar design was used in a trial investigating intranasal oxytocin in frontotemporal dementia. Dosing for the first two groups of this study is based on previously conducted intranasal insulin studies in Alzheimer's disease (AD) and mild cognitive impairment (MCI), using daily doses on 20 and 40 IU of intranasal insulin. Higher dose have been found to be safe in healthy adults. Prior studies performed have demonstrated favorable effects of this regimen in the MCI/AD population without peripheral hypoglycemia.

Being tested
Regular Novolin R, Placebo
Keywords
intranasal, insulin
Medical subject headings
Parkinson Disease, Insulin Resistance

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Regular Novolin RDrug

    Intranasal insulin

  • PlaceboDrug

    Intranasal placebo (0.9% saline)

Study groups in NCT04251585
Study groupRoleWhat they receive
Low InsulinExperimentalRegular insulin (Novolin-R) 20 international units (10 units) in one nostril twice daily for 21 days, 100 µl volume.
Receives: Drug: Regular Novolin R
Medium InsulinExperimentalRegular insulin (Novolin-R) 40 international units (10 units) in each nostril twice daily for 21 days, 100 µl volume.
Receives: Drug: Regular Novolin R
High InsulinExperimentalRegular insulin (Novolin-R) 80 international units (10 units) in each nostril twice daily for 21 days, 200 µl volume.
Receives: Drug: Regular Novolin R
PlaceboPlacebo comparator0.9% sodium chloride in each nostril twice daily for 21 days, 100 µl volume.
Receives: Drug: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Safety Measured by Count of Safety Events

    Composite safety event - this is a count of either a reduction of fasting glucose to <70 mg/dL or an unintended reduction of weight >5%. A larger composite event count indicates a less safe treatment.

    Measured: 3 weeks

  2. Safety Measured by Fasting Glucose

    Pre-post change in fasting glucose (mg/dL). A larger decrease in fasting glucose indicates a less safe treatment.

    Measured: baseline and 3 weeks

  3. Safety Measured by Body Weight

    Pre-post change in body weight (lbs). An unintended decrease in body weight indicates a less safe treatment.

    Measured: baseline and 3 weeks

  4. Safety Measured by the Number of Serious Adverse Events (SAE) and Adverse Events (AE)

    Total number of AEs/SAEs during the course of treatment. More AEs/SAEs indicates a less safe treatment.

    Measured: 3 weeks

Secondary outcomes (17)
  1. Cognitive Function Measured by the Montreal Cognitive Assessment (MoCA)

    Pre-post difference. Total sum of scores. Range: 0-30. Higher score indicates less memory loss

    Measured: 5 weeks

  2. Cognitive Function Measured by the Weschler Adult Intelligence Scale - Fourth Edition (WAIS-IV) Digit Span

    Pre-post difference. Scaled score. Range: 1-19. Forward and backward. Lower score indicates more impairment.

    Measured: 3 weeks

  3. Cognitive Function Measured by the Trailmaking Test Part A Time

    Pre-post difference. T-score. Mean: 50, Standard deviation: 10. A higher T-score indicates a better outcome/performance. Clinically, 1-1.5 standard deviations would be significant, 2 standard deviations would be considered abnormal/impaired.

    Measured: baseline and 3 weeks

  4. Cognitive Function Measured by the Trailmaking Test Part B Time

    Pre-post difference. T-score. Mean: 50, Standard deviation: 10. A higher T-score indicates a better outcome/performance. Clinically, 1-1.5 standard deviations would be significant, 2 standard deviations would be considered abnormal/impaired.

    Measured: baseline and 3 weeks

  5. Cognitive Function Measured by the Trailmaking Test Parts A & B Errors

    Pre-post difference. Total number of errors. No range. More errors indicate more impairment.

    Measured: 3 weeks

  6. Cognitive Function Measured by the Judgement of Line Orientation

    Judgement of Line Orientation is an assessment of visuospatial ability. A Z-score of 0 represents the population mean. Pre-post difference. A positive difference indicates an improvement.

    Measured: baseline and 3 weeks

  7. Cognitive Function Measured by the Logical Memory Scaled Scores

    Pre-post difference. Scaled score. Range: 1-19. Logical memory immediate and delayed. Lower score indicates more impairment.

    Measured: baseline and 3 weeks

  8. Cognitive Function Measured by the Logical Memory, Recognition

    Pre-post difference in median category from baseline to 3 weeks on the Logical memory, recognition subscale. Scoring of this and all outcomes were based on best practices conveyed by study neuropsychologist during study design, and scoring approaches were chosen completely a priori. The recognition outcome of the LM test is derived from a series of conversions, as follows. First, the raw "process" score is converted to cumulative percentage (0-100). Because the cumulative percentage distribution is known to be skewed, best practice is to report scores as the following ordinal categorizations of cumulative percentages: <1, 3-9, 10-16, 17-25, 26-50, 51-75, and >75. To analyze them using simple statistics, these ordinal categories are converted to integer values (1-7), and the change in median ordinal category is presented along with 95% confidence intervals, generated by the Wilcoxon signed rank test with continuity correction.

    Measured: baseline and 3 weeks

  9. Cognitive Function Measured by the Hopkins Verbal Learning Test - Revised (HVLT)

    Pre-post difference. T-score. Mean: 50, Standard deviation: 10. A higher T-score indicates a better outcome/performance. Clinically, 1-1.5 standard deviations would be significant, 2 standard deviations would be considered abnormal/impaired.

    Measured: baseline and 3 weeks

  10. Cognitive Function Measured by the Visuospatial Memory Test - Revised (BVMT)

    Pre-post difference. T-score. Mean: 50, Standard deviation: 10. A higher T-score indicates a better outcome/performance. Clinically, 1-1.5 standard deviations would be significant, 2 standard deviations would be considered abnormal/impaired.

    Measured: 3 weeks

  11. Cognitive Function Measured by the Stroop Color Word Test (CWT)

    Pre-post difference. T-score. Mean: 50, Standard deviation: 10. A higher T-score indicates a better outcome/performance. Clinically, 1-1.5 standard deviations would be significant, 2 standard deviations would be considered abnormal/impaired.

    Measured: baseline and 3 weeks

  12. Cognitive Function Measured by Fluency

    Pre-post difference. T-score. Mean: 50, Standard deviation: 10. A higher T-score indicates a better outcome/performance. Clinically, 1-1.5 standard deviations would be significant, 2 standard deviations would be considered abnormal/impaired.

    Measured: baseline and 3 weeks

  13. Mood Measured by the Beck Depression Inventory - Second Edition

    Pre-post difference. Raw score. Range: 0-63. Higher score indicates more symptomatic.

    Measured: baseline and 3 weeks

  14. Apathy Measured by the Apathy Scale

    Pre-post difference. Raw score. Range: 0-42. Higher score indicates more symptomatic.

    Measured: baseline and 3 weeks

  15. Mood Measured by the Columbia Suicide Severity Rating (C-SSRS)

    Pre-post difference. Raw score. Range:1 or 0. 1 score - more symptomatic, 0 score - no symptoms.

    Measured: baseline and 3 weeks

  16. Motor Function as Measured by the United Parkinson's Disease Rating Scale (UPDRS-III)

    Pre-post difference. Raw score. Range: 0-72. Higher score indicates more symptomatic.

    Measured: baseline and 3 weeks

  17. Cognitive Function Measured by Visuospatial Memory Test - Revised (BVMT Recognition)

    Pre-post difference in median category from baseline to 3 weeks on the Brief Visual Spatial Memory Test - Revised recognition. Scoring of this and all outcomes were based on best practices conveyed by study neuropsychologist during study design, and scoring approaches were chosen completely a priori. The recognition outcome of the BVMT test is derived from a series of conversions, as follows. First, the raw score is converted to cumulative percentage (0-100). Because the cumulative percentage distribution is known to be skewed, best practice is to report scores as the following ordinal categorizations of cumulative percentages: <2, 2-5, 6-10, 11-16, >16. To analyze them using simple statistics, these ordinal categories are converted to integer values (1-5), and the change in median ordinal category is presented along with 95% confidence intervals, generated by the Wilcoxon signed rank test with continuity correction.

    Measured: baseline and 3 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted5 Feb 2020
  2. Study start4 Feb 2020
  3. Primary completion27 Aug 2024
  4. Study completion27 Aug 2024

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Other
Allocation
Randomised
Intervention model
Parallel groups
Model description
Participants will be randomly assigned to one of 3 treatment groups or the placebo group. * 20 international units twice daily (n=7) * 40 international units twice daily (n=7) * 80 international units twice daily (n=9) * placebo (n=7)
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
31 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04251585
Sponsor's protocol ID
A19-214
Acronym
INI-PD
Status last verified
Feb 2026
First submitted
28 Jan 2020
Last updated
11 Feb 2026
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No

Publications

  • Johnson JC, Kashyap B, Gustafson SK, O'Brien M, Frey WH 2nd, Svitak AL, Hanson LR. Safety and tolerability of intranasal insulin in Parkinson's disease. Front Neurol. 2026 Sep 9;17:1875165. doi: 10.3389/fneur.2026.1875165. eCollection 2026.

    PubMed 42780868

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Regular Novolin R in people with Parkinson Disease, run by HealthPartners Institute at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 9 inclusion and 12 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 11 Feb 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 11 Feb 2026). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Safety Measured by Count of Safety Events (time frame: 3 weeks). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04251585, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 Feb 2026.

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