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Parkinson DiseaseMMCINCT06640673

Electrophysiological Signature of Mild Cognitive Impairment and Its Relationship with Parkinson's Disease: a High-density EEG Investigation

An observational study of Parkinson Disease and Parkinson Disease, Mild Cognitive Impairment, run by IRCCS San Camillo, Venezia, Italy at 1 site in Italy.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

The study aims to investigate neural correlate of Mild Cognitive Impairment (MCI) in Parkinson's disease (PD) and to identify a link between functional impairment (in both cognitive and motor domains) and electrophysiological cortical sing of MCI in PD. Read more about this study

Who is it for?
Ages 50 to 90 yearsHealthy volunteers can take part
What is being tested?
Hd-EEG
How many people
42 participants
Where
1 siteItaly
Study dates
18 Jun 2023to May 2025
Phase
Observational
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 50 to 90 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Study population: Parkinson's patients will be recruited in the IRCCS San Camillo Hospital or through collaborators of the responsible researchers. Healty controls will be enrolled voluntarily.

Who may be able to join

  • Upper score >24 MMSE or >15.5 Moca
  • If taking medications, taking stable doses for at least 4 weeks prior to the inclusion visit - of anticholinesterase drugs (donepezil, memantine, rivastigmine, ...) or antidepressants (SSRIs, tricyclics, SNARI, ...) or Levodopa.
  • Having signed the informed consent

Who cannot join

  • Subjects with severe dementia ( MMSE < 24 )
  • Lower score <15.5 Moca
  • Subjects on antipsychotic treatment for less than 3 months
  • Subjects with uncontrolled comorbidities
  • Subjects with metal prostheses or dentures and in general conditions for which MRI examinations are prevented.
  • Subjects with an inability to walk independently.

Trial locations and contacts

1 site in 1 country.

Italy1 site, 1 recruiting
  • IRCCS San Camillo S.R.L

    Lido, Italy

    Francesca Burgio, +39 0412207536 ext. +39, francesca.burgio@hsancamillo.it

    Giovanni Lazzaro, 04122079598, giovanni.lazzaro@hsancamillo.it

    Recruiting

Other trials in Italy

About this study

The study aims to investigate neural correlate of Mild Cognitive Impairment (MCI) in Parkinson's disease (PD) and to identify a link between functional impairment (in both cognitive and motor domains) and electrophysiological cortical sing of MCI in PD. A sample of 42 subjects will be divide into three subgroup: healthy control, PD with MCI (PD-MCI) and PD without MCI (PD-ctrl). Those subjects will undergo a specific neuropsychological evaluation and, to measure the electro-cortical activity, high-density electroencephalography (hdEEG) will be record during both resting state and cognitive tasks. Furthermore, hdEEG data will be combine with structural magnetic resonance to obtain information about network connectivity.

Read the detailed description

Parkinson's disease (PD) is a neurodegenerative disorder, characterized by a degeneration of dopaminergic neurons at the level of the pars compacta of the substantia nigra, which results in impaired control of the nigrostriatal pathway. This degeneration is manifested by both motor and non-motor symptoms such bradykinesia, tremor, rigidity, and cognitive disorders. Particularly, patients with PD might be affected by Mild Cognitive Impairment (MCI), dementia, and related behavioral disorders including apathy and depressive syndromes. However, while motor disturbances are more evident, it is difficult to evaluate the onset of cognitive symptoms, especially in the prodromal phases of the disease. Indeed, it seems that the onset of cognitive deficits in PD occurs in a high prevalence in the earlier stages of the disease. PD patients can often be associated with MCI, a preclinical condition characterized by the presence of deficits in memory and executive functions as well as, to a lesser extent, in language- and visuospatial- related functions.

Dual-syndrome hypothesis posit the existence of two subtypes of MCI one fronto-striatal, characterised by executive and attentional deficits, and a posterior cortical one, characterised by deficits in memory visuo-spatial and language deficits. Recent studies described alterations in brain rhythm, measured with high-density EEG (HDEEG) in terms of frequency domain analysis, at the level of fronto-striatal regions only in patients with the fronto-striatal subtype. Moreover, fMRI studies have shown that the presence of MCI in PD causes a reduction in activity at the level of the cognitive cortico-striatal loop, which includes the caudate nucleus (CN) and prefrontal cortex (PFC).

Although the use of neurophysiological and neuroimaging techniques have substantially grown, the available data highlight the lack of detailed descriptions of functional connectivity in relation whit the onset and extent of the cognitive deficit itself. Therefore, the aim of the present study is to characterise MCI in PD from a neurophysiological and clinical point of view. First, all patients undergo a neuropsychological assessment to identify PD patients with MCI (PD-MCI) and those without MCI (PD-nMCI). Then, to investigate the functional connectivity of cortical areas underpinning cognitive decline, HDEEG will be record, during both resting state and cognitive tasks. Furthermore, for each participant will be collect MRI (Magnetic resonance imaging), to combine structural data with electrodes position over the scalp. This would allow obtaining a realistic model of the head for source analysis.

Identification of alterations in functional connectivity between specific cortical areas in MCI-PD patients, and a possible direct relationship between these and clinical impairment, could lead to improve therapeutic interventions and prevent cognitive disorders in PD patients.

Being tested
Hd-EEG
Keywords
MCI in PD, Mild Cognitive Impairment, Parkinson's disease, Hd-EEG
Medical subject headings
Parkinson Disease, Cognitive Dysfunction

What participants receive

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

  • Hd-EEGDiagnostic test

    Also called MRI

    Subjects undergo a clinical and neuropsychological assesment, then a Hd-EEG both during resting state and execution of tasks, and structural Magnetic Resonance Imaging

Study groups in NCT06640673
Study groupRoleWhat they receive
PD-MCIParkinson's disease with Mild Cognitive Impairment
Receives: Diagnostic Test: Hd-EEG
PD-nMCIParkinson's disease without Mild Cognitive Impairment
Receives: Diagnostic Test: Hd-EEG
Healthy controlHealthy participants matched for age and gender with the experimental groups
Receives: Diagnostic Test: Hd-EEG

What is being measured

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

  1. Power Spectrum Density Analysis profile for hdEEG resting state data

    For all the groups, starting from the hdEEG data, brain oscillation will be studied by performing the Power Spectral Analysis (PSD). The PSD aims to investigate the spectral properties in the delta (1-4 Hz), theta (4-8 Hz), alpha (8-13 Hz), beta (13-30 Hz), and gamma (>30Hz) frequencies bands. PSD will be performed for each electrode, for each subject, and then averaged across subjects, obtaining a value of PSD for each electrode, separately for each group (PD-ctrl vs PD-MCI). Then the PSD value will be displayed over the scalp with a topological representation.

    Measured: at baseline

  2. Power Spectrum Density Analysis profile for hdEEG during cognitive task data

    For all the groups, starting from the hdEEG data, brain oscillation will be studied by performing the Power Spectral Analysis (PSD). The PSD aims to investigate the spectral properties in the delta (1-4 Hz), theta (4-8 Hz), alpha (8-13 Hz), beta (13-30 Hz), and gamma (>30 Hz) frequencies bands. PSD will be performed for each electrode, for each subject, and then averaged across subject obtaining value of PSD for each electrode, separately for each group (PD-ctrl vs PD-MCI). Then the PSD value will be displayed over the scalp with a topological representation.

    Measured: at baseline

  3. Functional connectivity - seed based analysis for hdEEG resting state data

    To study the temporal correlation of cortical signals generated in spatially distributed regions of interest (ROI), the collected hdEEG data will be analyzed using the seed-based functional connectivity analysis (FC-SBA). FC-SBA will measures the time course activation of specific resting state networks (RSNs). Specifically, the DMN (default mode network), SN (Salience Network), FPN1 and FNP2 (Fronto-parietal Network). This approach allows to obtain the functional connectivity matrices that will show the activation pattern of different RSNs and frequency bands (delta 1-4Hz; theta 4-8Hz; alpha 8-13 Hz, beta 13-30Hz; gamma >30Hz).

    Measured: at baseline

  4. Functional connectivity - seed based analysis for hdEEG during cognitive task data

    To study the temporal correlation of cortical signals generated in spatially distributed regions of interest (ROI), the collected hdEEG data will be analyzed using the seed-based functional connectivity analysis (FC-SBA). FC-SBA will measures the time course activation of specific resting state networks (RSNs). Specifically, the DMN (default mode network), SN (Salience Network), FPN1 and FNP2 (Fronto-parietal Network). This approach allows to obtain the functional connectivity matrices that will show the activation pattern of different RSNs and frequency bands (delta 1-4Hz; theta 4-8Hz; alpha 8-13 Hz, beta 13-30Hz; gamma >30Hz).

    Measured: at baseline

Secondary outcomes (3)
  1. Performances at neuropsychological evaluation

    Cognitive performances will be assessed before hdEEG by a neuropsychological battery encompassing the main cognitive domains. Specific neuropsychological tests will be administered according to the specific guideline for the cognitive evaluation in Parkinson's Disease, defined by the MDS Task Force.

    Raw scores at each test will be converted in z-scores based on each test normative data. Z-scores will be averaged to calculate composite scores for each cognitive domain. The composite scores will be the following: general cognitive functioning, attention, executive function, short-term memory, long-term memory, visuospatial abilities, language.

    Measured: at baseline

  2. Fraility assessment

    FRIED PHENOTYPE (PASE) analyzes 5 dimensions: presence of fatigue, grip strength, walking speed, unintentional weight loss, and level of activity. If at least 3 of these dimensions are deficient, then the patient is classified as frail; if 2 are deficient, the patient is pre-frail; if none are deficient, the patient is robust.

    Measured: at baseline

  3. Accuracy during cognitive task

    Accuracy during cognitive task will be extracted from the behavioral responses of each participant as the percentage of the correct responses. The accuracy at the task will be used as an additional parameter for analysis of the primary outcomes.

    Measured: at baseline

Timeline

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

  1. First posted15 Oct 2024
  2. Study start18 Jun 2023
  3. Primary completion1 Dec 2024 (estimated)
  4. Study completionMay 2025 (estimated)

Resources

More details

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

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Other
Enrolment
42 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06640673
Sponsor's protocol ID
2023.06
Acronym
MMCI
Status last verified
Oct 2024
First submitted
8 Feb 2024
Last updated
15 Oct 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Nagano-Saito A, Habak C, Mejia-Constain B, Degroot C, Monetta L, Jubault T, Bedetti C, Lafontaine AL, Chouinard S, Soland V, Ptito A, Strafella AP, Monchi O. Effect of mild cognitive impairment on the patterns of neural activity in early Parkinson's disease. Neurobiol Aging. 2014 Jan;35(1):223-31. doi: 10.1016/j.neurobiolaging.2013.06.025. Epub 2013 Aug 7.

    PubMed 23932879
  • Betrouni N, Devignes Q, Bayot M, Derambure P, Defebvre L, Leentjens AF, Delval A, Dujardin K. The frontostriatal subtype of mild cognitive impairment in Parkinson's disease, but not the posterior cortical one, is associated with specific EEG alterations. Cortex. 2022 Aug;153:166-177. doi: 10.1016/j.cortex.2022.04.015. Epub 2022 May 11.

    PubMed 35667287
  • Monchi O, Petrides M, Doyon J, Postuma RB, Worsley K, Dagher A. Neural bases of set-shifting deficits in Parkinson's disease. J Neurosci. 2004 Jan 21;24(3):702-10. doi: 10.1523/JNEUROSCI.4860-03.2004.

    PubMed 14736856
  • Samogin J, Marino M, Porcaro C, Wenderoth N, Dupont P, Swinnen SP, Mantini D. Frequency-dependent functional connectivity in resting state networks. Hum Brain Mapp. 2020 Dec 15;41(18):5187-5198. doi: 10.1002/hbm.25184. Epub 2020 Aug 25.

    PubMed 32840936
  • Cai M, Dang G, Su X, Zhu L, Shi X, Che S, Lan X, Luo X, Guo Y. Identifying Mild Cognitive Impairment in Parkinson's Disease With Electroencephalogram Functional Connectivity. Front Aging Neurosci. 2021 Jul 1;13:701499. doi: 10.3389/fnagi.2021.701499. eCollection 2021.

    PubMed 34276350
  • Cera N, Esposito R, Cieri F, Tartaro A. Altered Cingulate Cortex Functional Connectivity in Normal Aging and Mild Cognitive Impairment. Front Neurosci. 2019 Sep 13;13:857. doi: 10.3389/fnins.2019.00857. eCollection 2019.

    PubMed 31572106
  • Gorges M, Muller HP, Lule D; LANDSCAPE Consortium; Pinkhardt EH, Ludolph AC, Kassubek J. To rise and to fall: functional connectivity in cognitively normal and cognitively impaired patients with Parkinson's disease. Neurobiol Aging. 2015 Apr;36(4):1727-1735. doi: 10.1016/j.neurobiolaging.2014.12.026. Epub 2014 Dec 31.

    PubMed 25623332
  • Litvan I, Goldman JG, Troster AI, Schmand BA, Weintraub D, Petersen RC, Mollenhauer B, Adler CH, Marder K, Williams-Gray CH, Aarsland D, Kulisevsky J, Rodriguez-Oroz MC, Burn DJ, Barker RA, Emre M. Diagnostic criteria for mild cognitive impairment in Parkinson's disease: Movement Disorder Society Task Force guidelines. Mov Disord. 2012 Mar;27(3):349-56. doi: 10.1002/mds.24893. Epub 2012 Jan 24.

    PubMed 22275317

Questions about this trial

What is this clinical trial studying?

An observational study of Parkinson Disease and Parkinson Disease, Mild Cognitive Impairment, run by IRCCS San Camillo, Venezia, Italy at 1 site in Italy.

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 6 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: status not confirmed, as of the sponsor's last update on 15 Oct 2024. 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 Italy. 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?

Results are not available in the source record.

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

Contact Francesca Burgio, PhD (+390412207536, francesca.burgio@hsancamillo.it), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Power Spectrum Density Analysis profile for hdEEG resting state data (time frame: at baseline). 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 NCT06640673, which also lists 8 linked publications.

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 15 Oct 2024.

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