Orthostatic Dysregulation and Associated Gastrointestinal Dysfunction in Parkinson's Disease - Evolution

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01518751
Recruitment Status : Completed
First Posted : January 26, 2012
Last Update Posted : September 30, 2015
Information provided by (Responsible Party):
University of Zurich

Brief Summary:

Symptoms of blood pressure dysregulation, impaired swallowing and digestion are common amongst parkinson patients. The overall aim of this study is to examine blood pressure regulation and esophageal motility and gastric emptying in Parkinson`s disease (PD) patients.

The investigators hypothesize that - compared to age-matched controls - PD patients display an altered regulation of blood pressure, altered gastroesophageal motility, and delayed gastric emptying. These symptoms occur already early in the disease process, but aggravate with progression of the disease.

The investigators will perform a 7-day blood pressure measurement, measurement of central blood pressure and pulse wave velocity, assessment of pulse variability, Schellong tests to assess orthostatic function, high resolution manometry assessments during swallowing acts, and a 13C-sodium octanoate breath test to assess gastric emptying, in 18 PD patients (9 each Hoehn&Yahr stages 1,2) and 12 age- and gender-matched healthy controls. Results will be interpreted in relation to the severity of PD motor symptoms.

The investigators anticipate that blood pressure dysregulation and gastroesophageal motility disturbances will be present only in PD subjects, but not in matched controls without neurological disorders and without any extrapyramidal motor signs. Furthermore, the investigators expect to find an association between motor impairment and the severity of these autonomic symptoms, however, that according to the Braak staging, subtle disturbances must already be present in the early stages of PD.

Condition or disease
Parkinson`s Disease - Autonomic Dysregulation

Study Type : Observational
Actual Enrollment : 27 participants
Observational Model: Case Control
Time Perspective: Prospective
Official Title: Orthostatic Dysregulation and Associated Gastrointestinal Dysfunction in Parkinson's Disease - Evolution A Monocentric Study to Investigate the Development of Symptoms of Autonomic Dysregulation in Parkinson`s Disease
Study Start Date : December 2011
Actual Primary Completion Date : December 2013
Actual Study Completion Date : December 2014

Resource links provided by the National Library of Medicine

Primary Outcome Measures :
  1. orthostatic hypotension [ Time Frame: during study visit ]
    drop of systolic (≥20mmHg) or diastolic (≥10mmHg) blood pressure upon Schellong test

Secondary Outcome Measures :
  1. delayed gastric emptying [ Time Frame: during study visit ]
    statistical difference in mean gastric emptying assessed via octanoate breath test

  2. long term blood pressure [ Time Frame: during 7d after study visit at home ]
    mean 7d systolic, diastolic, mean arterial blood pressure and heart rate recordings

  3. heart rate variability [ Time Frame: during study visit ]
    difference in heart rate variability or spectral analysis of heart rate variability?

  4. arterial stiffening [ Time Frame: during study visit ]
    difference in pulse wave velocity and augmentation index calculation from applanation tonometry recordings?

  5. oesophageal motility [ Time Frame: during study visit ]
    high-density manometry to measure aspects of oesophageal motility

  6. subjective symptoms of gastrointestinal and cardiovascular dysfunction [ Time Frame: during study visit ]
    validated questionnaires: Fraser, 2007, p14133; Stanghellini, 1996, p14183; Revicki, 2003, p13823; Kaufmann, 2012, p13817; }

  7. Clinical assessment [ Time Frame: during study visit ]
    UPDRS part III and MoCA score (Nasreddine, 2005, p14186)

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Ages Eligible for Study:   50 Years to 70 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Sampling Method:   Non-Probability Sample
Study Population

Subjects included in this trial must fulfil the he following criteria:

  • informed, written & formal consent for participation
  • male / female subjects, aged 50-70 years

    18 PD patients

  • 9 subjects Hoehn & Yahr stage 1, disease duration <4 years
  • 9 subjects Hoehn & Yahr stage 2; disease duration 4-8 years

    12 healthy control subjects

  • age- and gender-matched
  • without signs or history of neurological disorders
  • without significant systemic comorbidities (malignant / cardiovascular)

Inclusion criteria: - informed, written & formal consent for participation

  • male/female subjects, aged 50-70 years
  • PD patients (9 subjects each in Hoehn & Yahr stage 1 & 2)

Exclusion criteria: - Antihypertensive treatment

  • medication influencing gastrointestinal motility for at least the elimination half life of the drug
  • medication interfering with blood-pressure regulation for at least the elimination half life of the drug
  • significant systemic illness
  • BMI < 18 or > 30kg/m2
  • symptoms or a history of GI disease or surgery
  • with any evidence of infectious disease
  • evidence or history of drug or alcohol abuse
  • diabetes mellitus

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01518751

University Hospital Zurich, Neurology
Zurich, ZH, Switzerland, 8091
Sponsors and Collaborators
University of Zurich
Principal Investigator: Christian Baumann, Ass. Prof., MD University Hospital Zurich, Neurology

Publications of Results:
Responsible Party: University of Zurich Identifier: NCT01518751     History of Changes
Other Study ID Numbers: KEK-ZH-NR. 2011-0077
First Posted: January 26, 2012    Key Record Dates
Last Update Posted: September 30, 2015
Last Verified: September 2015

Additional relevant MeSH terms:
Parkinson Disease
Parkinsonian Disorders
Basal Ganglia Diseases
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases
Movement Disorders
Neurodegenerative Diseases