Clinical trial NCT01244269: The Effect of Methylphenidate on Non-motor Symptoms and Postural Control in Parkinson's Disease.
Official title: Two-phase Randomized Controlled Trial of Low and Moderate Dose Methylphenidate for Non-motor and Postural Symptoms in Parkinson's Disease.
Study type: INTERVENTIONAL
Overall status: TERMINATED
Phase: PHASE4
Conditions: Parkinson's Disease
Keywords: Parkinson's disease
Methylphenidate
Non motor symptoms
Postural control
Lead sponsor: Laval University
Sponsor class: OTHER
Collaborators: name: Fonds de la Recherche en Santé du Québec
name: Quebec Memory and Motor Skills Disorders Research Center
First posted: 2010-11-19
Enrollment: 6
Sex: ALL
Maximum age (years): 75
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: CROSSOVER
Primary purpose: TREATMENT

Brief summary: This project aims to determine if methylphenidate can improve deficits in attention and symptoms of orthostatic hypotension, two common non-motor symptoms, in patients with Parkinson's Disease. This project also seeks to evaluate the effect of methylphenidate on postural control in these patients, a debilitating motor symptom that places patients at an increased risk of falling. This study will build on existing data to support a new indication for the use of methylphenidate in Parkinson's Disease. Using standard and objective evaluations, this study will quantify the effect of methylphenidate at two doses on attention levels, orthostatic hypotension, and measures of postural control. Phase I of the study will compare methylphenidate 10mg three times daily to placebo and Phase II of the study, for those tolerating the lower dose in Phase I, will compare methylphenidate 20mg three times daily to placebo. By incorporating two different doses, the study also seeks to determine if any improvements are dose-related. Secondary endpoints will include safety assessments (adverse event monitoring and vital signs) performed every 30 minutes following supervised drug administration. Visual analog scales will be presented to each participant before treatment and following the final dose of each treatment to assess changes in fatigue. A secondary task will be added to postural tests to assess the influence of cognitive processes. It is hypothesized that methylphenidate will demonstrate a significant beneficial effect on all outcomes. It is projected that objective improvements will be observed following treatment with methylphenidate at both doses (10 and 20mg three time daily) when compared to placebo. It is further hypothesized that the effects will be dose-related and therefore more profound with higher doses.


Eligibility criteria: Inclusion Criteria:

* Patients with stages 2-3 Parkinson's disease as defined by the Hoehn \&Yahr staging system (Hoehn \&Yahr, 1967).
* Age less than or equal to 75 years.
* Subjects who are willing and able to provide, in writing, informed consent.
* Subjects who are willing and able to be confined to the clinical research unit as required by the protocol and to complete all procedures required on an outpatient basis.

Exclusion Criteria:

* Subjects with evidence or history of clinically significant hematological, renal, endocrine, pulmonary, gastrointestinal, cardiovascular, hepatic, psychiatric, neurological, or allergic disease (including drug allergies and excluding seasonal allergies).
* Subjects with a history of substance abuse or dependence or a positive urine screen for drugs of abuse.
* A history of regular alcohol consumption exceeding 7 drinks/week for women or 14 drinks/week for men (1 drink = 5 ounces of wine or 12 ounces of beer or 1.5 ounces of hard liquor) within 6 months of screening.
* Subjects with a documented allergy to methylphenidate or one of the product excipients.
* Subjects with any medical condition affecting drug absorption (e.g. gastrectomy).
* Treatment with an investigational drug within 30 days or 5 half-lives (whichever is longer) preceding the first dose of study medication.
* Use of a monoamine oxidase inhibitor or other interacting medication within the preceding 14 days or 5 half-lives (whichever is longer).
* History of sensitivity to heparin or heparin-induced thrombocytopenia.

Primary outcomes:
measure: Conners' Continuous Performance Test-II score
timeFrame: Baseline, 2 hours following first dose, 2 hours following last dose
measure: Orthostatic drop - blood pressure in mmHg
timeFrame: Baseline, 2 hours following first dose, 2 hours following last dose
measure: Average speed of center of pressure oscillations
timeFrame: Baseline, 2 hours following first dose, 2 hours following last dose
measure: Total area of center of pressure oscillations
timeFrame: Baseline, 2 hours following first dose, 2 hours following last dose
Secondary outcomes:
measure: Visual analog fatigue scale scores
timeFrame: Baseline, 2 hours following last dose
measure: Blood pressure (mmHg)
timeFrame: Baseline, 30, 60, and 90 minutes following first and final dose of study medication
measure: Heart rate
timeFrame: Basesline, 30, 60, and 90 minutes following first and final dose of study medication
measure: Number of errors recorded for 'Backward Digit Span' task
timeFrame: Baseline, 2 hours following first dose, 2 hours following final dose
Other outcomes:
Locations:
city: Québec
country: Canada
facility: Québec Memory and Motor Skills Disorders Research Center
state: Quebec
city: Québec
country: Canada
facility: Laval University
state: Quebec
Study officials:
affiliation: Laval University
name: Philippe Corbeil, PhD
role: STUDY_DIRECTOR
affiliation: Laval University
name: Jaime McDonald, BScPhm
role: STUDY_DIRECTOR
affiliation: Québec Memory and Motor Skills Disorders Research Center
name: Emmanuelle Pourcher, MD
role: PRINCIPAL_INVESTIGATOR
References: