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Reducing Dyskinesia in Parkinson's Disease With Omega-3 Fatty Acids (RLID-PD)

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ClinicalTrials.gov Identifier: NCT01563913
Recruitment Status : Completed
First Posted : March 27, 2012
Results First Posted : May 29, 2018
Last Update Posted : June 29, 2018
Oregon Health and Science University
Information provided by (Responsible Party):
VA Office of Research and Development

Brief Summary:
The purpose of this research study is to measure the safety (side effects) of an Omega 3 Fatty acid called docosahexanoic acid (DHA) and measure the dyskinesia (involuntary movements) in Parkinson 's disease (PD).

Condition or disease Intervention/treatment Phase
Parkinson's Disease Drug: Docosahexaenoic Acid (DHA) Drug: Placebo Phase 1

Detailed Description:

Levodopa induced dyskinesias (LID) are involuntary, abnormal movements that occur in most patients with Parkinson disease(PD) as a consequence of chronic use of the most effective symptomatic drug, levodopa (LD). LID can range from subtle and unobtrusive to marked and disabling. There are surprisingly few treatments for LID, including amantadine and deep brain stimulation. In many instances, amantadine is either poorly tolerated, or provides inadequate benefit, and only a small minority are appropriate candidates for surgery. Given the finding that docosahexanoic acid (the most abundant omega-3 fatty acid in the brain), delays the onset and reduces the severity of dyskinesia in two different animal models of LID, a trial of docosahexanoic acid (DHA) in PD subjects about to start LD as part of their drug regimen, to prevent or slow the progression of LID is warranted.

Prior to embarking on a large trial, preliminary data about safety and tolerability of DHA in PD subjects is needed, and collection of this data is the primary outcome of this pilot project proposal. 40 subjects who have not yet used levodopa, but are about to begin it will be randomized to daily DHA or placebo. Safety laboratory testing, adverse event monitoring, DHA plasma and CSF levels as well as compliance/subject retention will be outcomes collected.

In addition, preliminary data about modification of incidence rates will be collected and compared between the two treatment groups. This information will aid in calculating an appropriate sample size and treatment period for a larger definitive future study.

Dyskinesia manifests overwhelmingly when plasma levodopa levels are high enough to cause anti-parkinsonian benefits, and lessens or stops when levodopa levels drop below a threshold. Thus, the subject's dyskinesia measurements must occur during a levodopa administration period. Dyskinesia measurement will occur during a two-hour levodopa cycle administered to subjects at weeks 0, 6, 24, 52, 76. It is expected that a good proportion of subjects will manifest dyskinesia within the two-year observation period, as previous studies using the most objective means to measure dyskinesia report incidence rates of 67% or greater within the first year of levodopa use. An instrument to measure dyskinesia developed by this center will be used as an additional outcome, and is expected to measure dyskinesia more accurately and with greater sensitivity than the gold standard methods of clinical rating scales.

By conclusion of this pilot project, the safety and tolerability, subject retention and compliance, plasma/CSF levels of DHA administration will be determined. Trends in dyskinesia development may be measured. This will provide the needed background information to proceed with a future larger trial of DHA to prevent dyskinesia in PD.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 33 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary Purpose: Other
Official Title: Reducing Dyskinesia in Parkinson Disease With Omega-3 Fatty Acids
Study Start Date : October 2012
Actual Primary Completion Date : June 2016
Actual Study Completion Date : June 2016

Resource links provided by the National Library of Medicine

Arm Intervention/treatment
Experimental: Arm 1
Docosahexaenoic Acid (DHA)
Drug: Docosahexaenoic Acid (DHA)
Docosahexaenoic Acid (DHA) 2 grams per day taken for 1.5 years
Other Name: DHA

Placebo Comparator: Arm 2
Drug: Placebo
Sugar Pill, taken for 1.5 years
Other Name: Sugar Pill

Primary Outcome Measures :
  1. Efficacy of DHA - Change in Blood ng/dL Levels [ Time Frame: baseline and 1.5 years ]
    Therapeutic level monitoring will be accomplished by analyzing blood levels for DHA.

  2. Efficacy of DHA - Number of Participants With An Abnormal Safety Lab (CBC) [ Time Frame: Year 1 ]
    This study is seeking to determine the safety/efficacy of DHA in Parkinson's disease patients. The safety/efficacy of DHA will be determined using periodic safety lab information. Safety labs for complete blood count (CBC) were performed at each inpatient visit, reviewed by the PI, and marked as normal or abnormal.

Secondary Outcome Measures :
  1. Forceplate Measured Dyskinesia [ Time Frame: baseline and 1.5 years ]
    Dyskinesia are abnormal movements caused by levodopa. These abnormal movements will be measured with a forceplate (a device that is similar to a door mat). Dyskinesia will be examined at all inpatient visits and area under the curves will be compared with a clinical rating scale to measure the development of dyskinesia after starting levodopa therapy.

Information from the National Library of Medicine

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Ages Eligible for Study:   21 Years to 99 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Diagnosed with Parkinsons disease
  • No levodopa (Sinemet) treatment or prior exposure to levodopa

Exclusion Criteria:

  • Prior exposure to levodopa
  • Unable to stand for 1 minute without aid
  • Sensory deficits on feet
  • Significant cognitive impairment
  • Current use of dopamine receptor blocking medications (depakote, lithium, amiodarone, tetrabenazine, metoclopramide, dronabinol)
  • Current fish oil or lutein supplementation
  • Allergy to soy

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 ClinicalTrials.gov identifier (NCT number): NCT01563913

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United States, Oregon
VA Portland Health Care System, Portland, OR
Portland, Oregon, United States, 97239
Sponsors and Collaborators
VA Office of Research and Development
Oregon Health and Science University
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Principal Investigator: Kathryn Anne Chung, MD VA Portland Health Care System, Portland, OR
Publications of Results:
Other Publications:
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Responsible Party: VA Office of Research and Development
ClinicalTrials.gov Identifier: NCT01563913    
Other Study ID Numbers: CLIN-006-11S
2907 ( Other Identifier: Portland VA Medical Center )
8012 ( Other Identifier: Oregon Health & Science University )
First Posted: March 27, 2012    Key Record Dates
Results First Posted: May 29, 2018
Last Update Posted: June 29, 2018
Last Verified: May 2018
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No
Keywords provided by VA Office of Research and Development:
Parkinsons disease
abnormal movements
Additional relevant MeSH terms:
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Parkinson Disease
Parkinsonian Disorders
Basal Ganglia Diseases
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases
Movement Disorders
Neurodegenerative Diseases
Neurologic Manifestations