Parkinson DiseaseNCT04512599
Prebiotics in the Parkinson's Disease Microbiome
A study testing Prebiotic Bar in people with Parkinson Disease, run by Rush University Medical Center at 1 site in United States.
Trial summary
There are about one million Parkinson's disease (PD) patients in America. The risks associated with whether or not an individual may develop PD include environment and genetic (biologic, hereditary) factors. Read more about this study
- Who is it for?
- Any age
- Conditions the study is for
- Parkinson Disease
- What is being tested?
- Prebiotic Bar
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 20 participants
- Where
- 1 siteUnited States
- Study dates
- 31 Aug 2020to 31 Mar 2022
- Phase
- Interventional
- Are there results?
- None posted in the registry
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 Any age
- All sexes
- No healthy volunteers
- Child, Adult, Older adult
Who may be able to join
- Clinical diagnosis of Parkinson's disease,
- >age 30,
- Must be able to consent
Who cannot join
- prior intestinal resection,
- patient history of GI diseases except for hiatal hernia, gastroesophageal reflux disease, hemorrhoids,
- severe renal disease defined by creatinine more than 2 ½ times normal,
- markedly abnormal liver function defined by liver function tests over 4 times normal levels or elevated bilirubin,
- antibiotic use within the last 12 weeks prior to enrollment,
- a plan to have a major change in dietary habit during the study,
- consumption of probiotics, prebiotics or synbiotics without an appropriate 2 week washout period
Trial locations and contacts
1 site in 1 country.
United States1 site
Rush University Medical Cener
Chicago, Illinois, 60612
About this study
Official title: Short Chain Fatty Acid Enhancing Prebiotics and Normalization of Parkinson's Disease Microbiome: A Pilot Tolerability Study
There are about one million Parkinson's disease (PD) patients in America. The risks associated with whether or not an individual may develop PD include environment and genetic (biologic, hereditary) factors. Studies have show that certain things may be triggers, for example cells in the brain that are made active and associated inflammation in the brain. The gut is the largest interface between the PD patient and the environment, and it is highly thought to be pathway to the environment trigger. Research studies have looked at how information is passed back and forth between the brain and the gut.
The goal of this study (pilot) is to gather information to conduct a larger clinical trial. For this pilot study is to determine if a microbiota-directed (bacteria in the gut) intervention (dietary bar) is capable of correcting the bacteria gut balance in PD. This is based on the thought that an imbalance of bacteria in the gut of PD patients may lead to the gut and intestines working correctly. The long term goal is to see if the intervention has the potential to modify the disease or protect the brain in PD. If the intervention successfully improves the bacterial imbalance in PD, it will be the first attempt to modify the Gut-Brain communication in PD, which can lead to additional studies aimed at improving the disease progression or prevention.
In this project, the investigators will test how well Parkinson's disease patients tolerate changes in the gut and intestines by providing the participants a dietary bar to eat for 10 days. The investigators intend to conduct this pilot clinical trial in which the investigators believe that daily oral intake of a "prebiotic" mixture will be safe and well tolerated in a small number Parkinson's disease participants prior to a larger clinical trial looking at efficacy.
Read the detailed description
Intestinal microbiota, are a dynamic community of commensal bacteria that modulate gut homeostasis and systemic biological processes including brain development and function through a bidirectional "Gut-Brain axis". Recent studies in both rodent models of disease and human have shown disrupted intestinal microbiota community in multiple systemic metabolic and inflammatory disorders including neurological disease. More specifically emerging evidence shows that stool and intestinal mucosal associated microbiota composition and function are abnormal in PD patients. Divergence of commensal bacteria composition from the microbial communities found in healthy persons (so called "dysbiosis"), has been associated with PD in early and late stages, as well as in patients with Rapid Eye Movement (REM) sleep behavior disorder (RBD), a group that are at high risk of progression to PD.
In this project, the investigators will test the tolerability of Parkinson's disease patients in modulating the gut microbiota through dietary means. The investigators intend to conduct a pilot clinical trial in which the investigators hypothesize that daily oral intake of a prebiotic mixture will be safe and well tolerated in a small number Parkinson's disease participants prior to a larger clinical trial looking at efficacy.
Research design and protocol:
The study is an open-label, non-randomized study in 20 Parkinson's disease participants at Rush University Medical Center (RUMC) under the supervision of Drs. Hall and Keshavarzian. The trial will include 10 PD patients who are de novo (not yet on medication) or moderate stage (on medications). Participants will take the prebiotics in a form of a bar (Table 1) for 10 days- one bar (10 gram fiber) a day for 3 days and then one bar twice a day for additional one week.
Each participant will have a baseline visit and a follow up visit after 10 days of the intervention (consumption of prebiotic dietary bar). At each visit, participants will complete questionnaires regarding adverse events including a questionnaire that rates bowel movement, stool consistency, discomfort, flatulence, abdominal pain, and bloating on a scale from 1 (best) to 10 (worst). Participants will also complete a Perceived Stress Questionnaire (Appendix D) and GI Symptom and Severity Checklist (Appendix A). Participants will be asked to fill out a diet record (24ASA diet questionnaire) (Appendix E) during the last 3 days on the intervention. Participant will also are asked to self-collect stool at home before consuming (eating) the first probiotic bar in the study and during the last day of the study at home. Supplies for stool collection (2 stool collection kit) and instructions for specimen handling and for completing these tasks will be given at Visit 1 and refreshed before visit 2. At visit 1 participants will be provided with 2 stool collection kits. First stool will be collected at home about 1 day and participants are asked to mail the stool in a pre-paid Fed Ex right after collecting the stool. The second stool collection will be on the last day that participants consume the probiotic bars prior to coming to for study visit 2 when the participants bring the stool to the study visit. The kit includes supplies to preserve the sample with gas packs and collection bag so the sample can be brought with the participant to the visits within 24 hours. The self-collected stool samples will be saved by the study team and frozen for future use. Participants will be asked to complete several dietary questionnaires including a Mediterranean diet screener (Appendix F), food timing screener (Appendix B) and food frequency questionnaire (Appendix C). Before Visit 2, each participant will collect the stool and complete the 3-day food record; these will be returned at Visit 2. At Visit 2, participants will complete a Perceived Stress Questionnaire (Appendix D) and GI Symptom and Severity Checklist and associated instructions (Appendix A). Each participant will also have blood draw (1 red top to collect serum and 1 EDTA tube to collect plasma) at visit 1 (baseline) and at visit 2 (completion of the study) to check for serum short chain fatty acids, lipopolysaccharides, interleukins and cytosine monophosphate(check for safety).
Participants will provide written informed consent (Visit 1) before any study procedures, data or sample collection are performed.
- Conditions
- Parkinson Disease
- Being tested
- Prebiotic Bar
- Keywords
- microbiome, prebiotic
- Medical subject headings
- Parkinson Disease
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Prebiotic BarOther
The prebiotic bar is a proprietary formula created by the study co-investigators, who will not be involved in participant recruitment, selection or outcome measures.The prebiotic bars will be shipped and stored at room temperature prior to consumption.
| Study group | Role | What they receive |
|---|---|---|
| Single Arm | Experimental | Open-label consumption of prebiotic bar(s); 1 bar for 3 days; followed by 2 bars for 7 days Receives: Other: Prebiotic Bar |
What is being measured
The primary outcome is the main question the study is designed to answer.
Tolerability of prebiotic bar after 10 days in PD participants
Tolerability of the prebiotic bar will be assessed for change in the GI Symptoms and Severity Checklist at 10 days from baseline
Measured: 10 days
Secondary outcomes (1)
Safety of prebiotic bar during 10 days in Parkinson's disease participants
Measurement of safety will be assessed using the frequency of adverse events over the 10 day trial period
Measured: 10 days
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted13 Aug 2020
- Study start31 Aug 2020
- Primary completion31 Dec 2021
- Study completion31 Mar 2022
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Parkinson DiseaseStudies of the same condition, open and under way.
- More trials run by Rush University Medical CenterThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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 N/A
- Primary purpose
- Prevention
- Allocation
- Not applicable
- Intervention model
- Single group
- Model description
- The study is an open-label, non-randomized study in Parkinson's disease participants
- Masking
- None (open label)
- Enrolment
- 20 participants (actual)
Sponsor and investigators
- Lead sponsor
- Rush University Medical Center
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Deborah Hall, MD, Rush University Medical Center
- Investigators
- Deborah A Hall, MD PhD, Principal investigator, Rush University Medical Center
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04512599
- Sponsor's protocol ID
- ORA20072703
- Status last verified
- Nov 2022
- First submitted
- 31 Jul 2020
- Last updated
- 3 Nov 2022
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Hall DA, Voigt RM, Cantu-Jungles TM, Hamaker B, Engen PA, Shaikh M, Raeisi S, Green SJ, Naqib A, Forsyth CB, Chen T, Manfready R, Ouyang B, Rasmussen HE, Sedghi S, Goetz CG, Keshavarzian A. An open label, non-randomized study assessing a prebiotic fiber intervention in a small cohort of Parkinson's disease participants. Nat Commun. 2023 Feb 18;14(1):926. doi: 10.1038/s41467-023-36497-x.
PubMed 36801916
Study at a glance
From the registry record, last updated by the sponsor on 3 Nov 2022. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Short Chain Fatty Acid Enhancing Prebiotics and Normalization of Parkinson's Disease Microbiome: A Pilot Tolerability Study
- ClinicalTrials.gov ID
- NCT04512599
- Acronym / sponsor ID
- ORA20072703
- Conditions
- Parkinson Disease
- Keywords
- microbiome, prebiotic
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 20 participants (actual)
- Lead sponsor
- Rush University Medical CenterUniversity, hospital or other
- Study start
- 31 Aug 2020 (actual)
- Primary completion
- 31 Dec 2021 (actual)
- Study completion
- 31 Mar 2022 (actual)
- First posted
- 13 Aug 2020 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
There are about one million Parkinson's disease (PD) patients in America. The risks associated with whether or not an individual may develop PD include environment and genetic (biologic, hereditary) factors. Studies have show that certain things may be triggers, for example cells in the brain that are made active and associated inflammation in the brain. The gut is the largest interface between the PD patient and the environment, and it is highly thought to be pathway to the environment trigger. Research studies have looked at how information is passed back and forth between the brain and the gut.
The goal of this study (pilot) is to gather information to conduct a larger clinical trial. For this pilot study is to determine if a microbiota-directed (bacteria in the gut) intervention (dietary bar) is capable of correcting the bacteria gut balance in PD. This is based on the thought that an imbalance of bacteria in the gut of PD patients may lead to the gut and intestines working correctly. The long term goal is to see if the intervention has the potential to modify the disease or protect the brain in PD. If the intervention successfully improves the bacterial imbalance in PD, it will be the first attempt to modify the Gut-Brain communication in PD, which can lead to additional studies aimed at improving the disease progression or prevention.
In this project, the investigators will test how well Parkinson's disease patients tolerate changes in the gut and intestines by providing the participants a dietary bar to eat for 10 days. The investigators intend to conduct this pilot clinical trial in which the investigators believe that daily oral intake of a "prebiotic" mixture will be safe and well tolerated in a small number Parkinson's disease participants prior to a larger clinical trial looking at efficacy.
Detailed description
Intestinal microbiota, are a dynamic community of commensal bacteria that modulate gut homeostasis and systemic biological processes including brain development and function through a bidirectional "Gut-Brain axis". Recent studies in both rodent models of disease and human have shown disrupted intestinal microbiota community in multiple systemic metabolic and inflammatory disorders including neurological disease. More specifically emerging evidence shows that stool and intestinal mucosal associated microbiota composition and function are abnormal in PD patients. Divergence of commensal bacteria composition from the microbial communities found in healthy persons (so called "dysbiosis"), has been associated with PD in early and late stages, as well as in patients with Rapid Eye Movement (REM) sleep behavior disorder (RBD), a group that are at high risk of progression to PD.
In this project, the investigators will test the tolerability of Parkinson's disease patients in modulating the gut microbiota through dietary means. The investigators intend to conduct a pilot clinical trial in which the investigators hypothesize that daily oral intake of a prebiotic mixture will be safe and well tolerated in a small number Parkinson's disease participants prior to a larger clinical trial looking at efficacy.
Research design and protocol:
The study is an open-label, non-randomized study in 20 Parkinson's disease participants at Rush University Medical Center (RUMC) under the supervision of Drs. Hall and Keshavarzian. The trial will include 10 PD patients who are de novo (not yet on medication) or moderate stage (on medications). Participants will take the prebiotics in a form of a bar (Table 1) for 10 days- one bar (10 gram fiber) a day for 3 days and then one bar twice a day for additional one week.
Each participant will have a baseline visit and a follow up visit after 10 days of the intervention (consumption of prebiotic dietary bar). At each visit, participants will complete questionnaires regarding adverse events including a questionnaire that rates bowel movement, stool consistency, discomfort, flatulence, abdominal pain, and bloating on a scale from 1 (best) to 10 (worst). Participants will also complete a Perceived Stress Questionnaire (Appendix D) and GI Symptom and Severity Checklist (Appendix A). Participants will be asked to fill out a diet record (24ASA diet questionnaire) (Appendix E) during the last 3 days on the intervention. Participant will also are asked to self-collect stool at home before consuming (eating) the first probiotic bar in the study and during the last day of the study at home. Supplies for stool collection (2 stool collection kit) and instructions for specimen handling and for completing these tasks will be given at Visit 1 and refreshed before visit 2. At visit 1 participants will be provided with 2 stool collection kits. First stool will be collected at home about 1 day and participants are asked to mail the stool in a pre-paid Fed Ex right after collecting the stool. The second stool collection will be on the last day that participants consume the probiotic bars prior to coming to for study visit 2 when the participants bring the stool to the study visit. The kit includes supplies to preserve the sample with gas packs and collection bag so the sample can be brought with the participant to the visits within 24 hours. The self-collected stool samples will be saved by the study team and frozen for future use. Participants will be asked to complete several dietary questionnaires including a Mediterranean diet screener (Appendix F), food timing screener (Appendix B) and food frequency questionnaire (Appendix C). Before Visit 2, each participant will collect the stool and complete the 3-day food record; these will be returned at Visit 2. At Visit 2, participants will complete a Perceived Stress Questionnaire (Appendix D) and GI Symptom and Severity Checklist and associated instructions (Appendix A). Each participant will also have blood draw (1 red top to collect serum and 1 EDTA tube to collect plasma) at visit 1 (baseline) and at visit 2 (completion of the study) to check for serum short chain fatty acids, lipopolysaccharides, interleukins and cytosine monophosphate(check for safety).
Participants will provide written informed consent (Visit 1) before any study procedures, data or sample collection are performed.
Study design
- Primary purpose
- Prevention
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
- Model description
- The study is an open-label, non-randomized study in Parkinson's disease participants
| Arm | Type | Receives |
|---|---|---|
| Single Arm | Experimental | Other: Prebiotic BarOpen-label consumption of prebiotic bar(s); 1 bar for 3 days; followed by 2 bars for 7 days |
Who may qualify
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult, Older adult
Key inclusion criteria (3 listed)
- Clinical diagnosis of Parkinson's disease,
- >age 30,
- Must be able to consent
Key exclusion criteria (7 listed)
- prior intestinal resection,
- patient history of GI diseases except for hiatal hernia, gastroesophageal reflux disease, hemorrhoids,
- severe renal disease defined by creatinine more than 2 ½ times normal,
- markedly abnormal liver function defined by liver function tests over 4 times normal levels or elevated bilirubin,
- antibiotic use within the last 12 weeks prior to enrollment,
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Prebiotic BarThe prebiotic bar is a proprietary formula created by the study co-investigators, who will not be involved in participant recruitment, selection or outcome measures.The prebiotic bars will be shipped and stored at room temperature prior to consumption. | Other | Single Arm |
Primary outcome
Tolerability of prebiotic bar after 10 days in PD participants
Time frame: 10 days
Tolerability of the prebiotic bar will be assessed for change in the GI Symptoms and Severity Checklist at 10 days from baseline
1 secondary outcome
Safety of prebiotic bar during 10 days in Parkinson's disease participants
Time frame: 10 days
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 3 Nov 2022.
- Derived from this study: PubMed 36801916Hall DA, Voigt RM, Cantu-Jungles TM, Hamaker B, Engen PA, Shaikh M, Raeisi S, Green SJ, Naqib A, Forsyth CB, Chen T, Manfready R, Ouyang B, Rasmussen HE, Sedghi S, Goetz CG, Keshavarzian A. An open label, non-randomized study assessing a prebiotic fiber intervention in a small cohort of Parkinson's disease participants. Nat Commun. 2023 Feb 18;14(1):926. doi: 10.1038/s41467-023-36497-x.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Deborah A Hall, MD PhD principal investigator
Rush University Medical Center
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Prebiotic Bar in people with Parkinson Disease, run by Rush University Medical Center 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 3 inclusion and 7 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 3 Nov 2022. 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. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
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?
Tolerability of prebiotic bar after 10 days in PD participants (time frame: 10 days). 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 NCT04512599, 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 3 Nov 2022.