Effects of Chocolate on Motor Symptoms of Parkinson's Disease

Study Overview
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Brief Summary
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Chocolate consumption has long been associated with enjoyment and pleasure. Popular claims confer on chocolate the properties of being a stimulant, relaxant, euphoriant and antidepressant. These possible pharmacological actions might be related to various biogenic amines, such as serotonin, dopamine, tyramine, histamine, phenylethylamine and cannabinoid-like substances. Most amines are metabolized by monoamineoxidase-A (MAO-A) and are therefore unable to pass the blood-brain-barrier. In contrast, phenylethylamine is a direct dopamine releasing ingredient and as a substrate of MAO-B and due to its lipophilic structure even capable to pass the blood-brain-barrier. Within this line, own clinical observations suggested an increased chocolate consumption in patients with Parkinson's disease (PD) compared to healthy subjects and to their pre-disease state. In a previous study, we assessed the consumption of chocolate and non-chocolate sweets in PD patients and their partners (as household controls) using a self-questionnaire. Consumption of chocolate was significantly higher in PD patients compared to controls, while consumption of non-chocolate sweets was similar in both groups. Our study suggests that chocolate consumption is increased in PD independent of concomitant depressive symptoms measured by BDI-1. Although reasons for increased chocolate consumption in PD remain elusive, it may hypothetically be a consequence of the high content of various biogenic amines as a content of cocoa influencing dopamine metabolism. Therefore, in the present study we aim to study the effects of dark chocolate with high cocoa content (85%) compared to chocolate without any cocoa (white chocolate) on motor symptoms in PD patients as measured with UPDRS part III (motor score). The principle design of the intervention is similar to the standard pharmacological challenge test for studying effects on motor symptoms in PD (e.g. levodopa challenge test).

Official Title
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Effects of Chocolate on Motor Symptoms of Parkinson's Disease - A Monocenter, Prospective, Observer-blinded Interventional Trial

Conditions
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Parkinson's Disease

Intervention / Treatment
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* Dietary Supplement: Chocolate


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age of 18 Years or older Idiopathic Parkinson's disease, according to UKBB criteria Hoehn & Yahr Score II-III 16 Points or more in UPDRS part III scale Sufficient ability to follow the study procedure for at least 3 hours Ability to give informed consent Stable antiparkinsonian medication for at least 4 weeks prior to study inclusion Exclusion Criteria: Psychiatric conditions, severe enough to interfere with study procedures motor or affective fluctuations or dyskinesias treatment with COMT and/or MAO inhibitors Diabetes mellitus

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Dark Chocolate (85% cocoa)<br>Oral Intake of dark chocolate (85% cocoa) over 15 minutes. | Dietary Supplement: Chocolate<br>* A single oral application of 200 grams of chocolate (85% cocoa for arm #1; 0% cocoa for arm #2).<br>|
| Active Comparator: White chocolate (0% cocoa)<br>Oral intake of 200 grams of white chocolate (0% cocoa) over 15 Minutes. | Dietary Supplement: Chocolate<br>* A single oral application of 200 grams of chocolate (85% cocoa for arm #1; 0% cocoa for arm #2).<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| UPDRS part III |  | 1 h after intake of study intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Biogenic amines in blood |  | 1 to 3 h after study intervention | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Parkinson's disease, Neurodegenerative Disorders, Biogenic amines, Chocolate, Cocoa