PPMI 2.0 Clinical -Establishing a Deeply Phenotyped PD Cohort (PPMI)
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ClinicalTrials.gov Identifier: NCT04477785 |
Recruitment Status :
Recruiting
First Posted : July 20, 2020
Last Update Posted : February 23, 2023
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The Parkinson Progression Marker Initiative 2.0 (PPMI 2.0) is a longitudinal, observational, multi-center natural history study to assess progression of clinical features, digital outcomes, and imaging, biologic and genetic markers of Parkinson's disease (PD) progression in study participants with manifest PD, prodromal PD, and healthy controls
The overall goal of PPMI 2.0 is to identify markers of disease progression for use in clinical trials of therapies to reduce progression of PD disability.
Condition or disease |
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Parkinson Disease |
Study Type : | Observational |
Estimated Enrollment : | 4500 participants |
Observational Model: | Case-Control |
Time Perspective: | Other |
Official Title: | The Parkinson's Progression Markers Initiative (PPMI) 2.0 Clinical -Establishing a Deeply Phenotyped PD Cohort |
Actual Study Start Date : | July 1, 2020 |
Estimated Primary Completion Date : | December 2033 |
Estimated Study Completion Date : | December 2033 |

Group/Cohort |
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Clinical Observation
Up to 4500 participants will be followed clinically once identified, over the course of 5-8 years.
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- Establish standardized protocols for acquisition, transfer & analysis of clinical, digital, imaging, biologic and genetic data that can be used in the PD research community. [ Time Frame: Baseline to 156 months ]This protocol will build on the existing PPMI infrastructure
- Comprehensive and uniformly acquired dataset [ Time Frame: Baseline to 156 months ]Develop a comprehensive and uniformly acquired clinical, digital and imaging dataset and repository of biological and genetic samples that would be available to the PD research community to test hypotheses of the underlying molecular pathobiology of PD, enable modeling of PD progression to identify clinical and/or data driven PD progression sub-sets, and inform studies testing PD therapeutics (for examples, clinical trials targeting synuclein, LRRK2, GBA as well as other targets)
- Comparison between Rates of Change [ Time Frame: Study intervals ranging from 3 months to 156 months ]Use clinical and biological data to estimate the mean rates of change and the variability around the mean of clinical, digital, imaging, biological and genetic outcomes in study participants with PD diagnosis (including patients with a LRRK2, GBA, SNCA or rare genetic mutations (such as Parkin or Pink1) and individuals with prodromal Parkinson disease (including individuals with RBD, olfactory loss, LRRK2, GBA, SNCA or rare genetic mutations (such as Parkin or Pink1) and/or other risk factors for PD with and without DAT deficit and in healthy participants.
- Prevalence of measures of clinical, imaging and biomic outcomes in various subsets [ Time Frame: study intervals ranging from baseline to 156 months. ]Confirm existing and identify novel clinical, digital, imaging, biologic and genetic PD progression markers to identify quantitative individual measures or combinations of measures that demonstrate optimum interval change in study participants with PD diagnosis (including patients with a LRRK2, GBA, SNCA or rare genetic mutations (such as Parkin or Pink1)) and individuals with prodromal Parkinson disease (including individuals with RBD, olfactory loss, a LRRK2, GBA, SNCA or rare genetic mutations (such as Parkin or Pink1) and/or other risk factors for PD with and without DAT deficit in comparison to healthy controls or in sub-sets of study participants with PD diagnosis or prodromal PD defined by baseline assessments, progression milestones and/or rate of clinical, digital, imaging, biologic and genetic change, or other measures.
- Establish the probability of phenoconversion to PD [ Time Frame: study intervals ranging from baseline to 156 months. ]Evaluate the probability of phenoconversion to PD for individuals with prodromal PD enrolled in the prodromal cohorts (including individuals with RBD, olfactory loss, a LRRK2, GBA, SNCA or rare genetic mutations (such as Parkin or Pink1) and/ or other risk factors for PD with and without DAT deficit).
Biospecimen Retention: Samples With DNA

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Ages Eligible for Study: | 30 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | Yes |
Sampling Method: | Non-Probability Sample |
Inclusion Criteria:
Parkinson Disease (PD) Subjects:
- Male or female age 30 years or older at Screening Visit.
- A diagnosis of Parkinson disease for 2 years or less at Screening Visit.
- Not expected to require PD medication with at least 6 months from Baseline.
- Patients must have at least two of the following: resting tremor, bradykinesia, rigidity (must have either resting tremor or bradykinesia); OR either asymmetric resting tremor or asymmetric bradykinesia.
- Hoehn and Yahr stage I or II at Baseline.
- Individuals taking any of the following drugs: alpha methyldopa, methylphenidate, amphetamine derivatives or modafinil, must be willing and medically able to hold the medication for at least 5 half-lives before DaTscan imaging.
- Confirmation that participant is eligible based on Screening DaTscan imaging.
- Able to provide informed consent
- Woman may not be pregnant, lactating or planning pregnancy during the study. ~Including a negative pregnancy test on day of Screening DaTscan imaging test prior to injection of DaTscan.
Healthy Control (HC) Subjects:
- Male or female age 30 years or older at Screening visit.
- Individuals taking any of the following drugs: alpha methyldopa, methylphenidate, amphetamine derivatives or modafinil, must be willing and medically able to hold the medication for at least 5 half-lives before DaTscan imaging.
- Confirmation that participant is eligible based on Screening DaTscan imaging.
- Able to provide informed consent
- Women may not be pregnant, lactating or planning pregnancy during the study. ~ Includes a negative pregnancy test on day of Screening DaTscan imaging test prior to injection of DaTscan™.
Exclusion Criteria:
Parkinson Disease (PD) Subjects:
- Currently taking levodopa, dopamine agonists, MAO-B inhibitors (e.g., selegiline, rasagiline), amantadine or other PD medication.
- Has taken levodopa, dopamine agonists, MAO-B inhibitors or amantadine within 60 days of Baseline.
- Has taken levodopa or dopamine agonists prior to Baseline for more than a total of 90 days.
- Atypical PD syndromes due to either drugs (e.g., metoclopramide, flunarizine, neuroleptics) or metabolic disorders (e.g., Wilson's disease), encephalitis, or degenerative diseases (e.g., progressive supranuclear palsy)
- A clinical diagnosis of dementia as determined by the investigator.
- Previously obtained MRI scan with evidence of clinically significant neurological disorder (in the opinion of the Investigator)
- Received any of the following drugs: dopamine receptor blockers (neuroleptics), metoclopramide and reserpine within 6 months of Screening visit.
- Current treatment with anticoagulants (e.g. coumadin, heparin, oral thrombin inhibitors) that might preclude safe completion of lumbar puncture.
- Condition that precludes the safe performance of routine lumbar puncture, such as prohibitive lumbar spinal disease, bleeding diathesis, or clinically significant coagulopathy or thrombocytopenia.
- Any other medical or psychiatric condition or lab abnormality, which in the opinion of the investigator might preclude participation.
Healthy Control (HC) Subjects:
- Current or active clinically significant neurological disorder (in the opinion of the Investigator).
- First degree relative with PD (parent, sibling, child).
- Previously obtained MRI scan with evidence of clinically significant neurological disorder (in the opinion of the Investigator)
- Received any of the follow drugs: dopamine receptor blockers (neuroleptics), metoclopramide and reserpine within 6 months of Screening visit.
- Current treatment with anticoagulants (e.g., coumadin, heparin, oral thrombin inhibitors) that might preclude safe completion of the lumbar puncture.
- Condition that precludes the safe performance of routine lumbar puncture, such as prohibitive lumbar spinal disease, bleeding diathesis, or clinically significant coagulopathy or thrombocytopenia.
- Any other medical or psychiatric condition or lab abnormality, which in the opinion of the investigator might preclude participation.
Inclusion Criteria:
(PD-LRRK2 or GBA) Participants:
- Male or female age 30 years or older at Screening visit.
- A diagnosis of Parkinson disease for 2 years or less at Screening Visit.
- Patients must have a least two of the following: resting tremor, bradykinesia, rigidity (must have either resting tremor or bradykinesia); OR either asymmetric resting tremor or asymmetric bradykinesia.
- Hoehn and Yahr stage I or II at Baseline.
- Confirmation of causative LRRK2 or GBA (willingness to undergo genetic testing as part of genetic screening and be informed of genetic testing results, or documentation of prior genetic testing results).
- Individuals taking any of the following drugs: alpha methyldopa, methylphenidate, amphetamine derivatives or modafinil, must be willing and medically able to hold the medication for at least 5 half-lives before DaTscan imaging.
- Confirmation that participant is eligible based on Screening DaTscan imaging.
- Able to provide informed consent
- Woman may not be pregnant, lactating or planning pregnancy during the study. ~Including a negative pregnancy test on day of Screening DaTscan imaging test prior to injection of DaTscan™.
Exclusion Criteria:
PD-LRRK2 or GBA
- Received any of the following drugs: dopamine receptor blockers (neuroleptics), metoclopramide and reserpine within 6 months of Screening visit.
- Current treatment with anticoagulants (e.g., coumadin, heparin) that might preclude safe completion of the lumbar puncture
- Condition that precludes the safe performance of routine lumbar puncture, such as prohibitive lumbar spinal disease, bleeding diathesis, or clinically significant coagulopathy or thrombocytopenia.
- Any other medical or psychiatric condition or lab abnormality, which in the opinion of the investigator might preclude participation.
Inclusion Criteria:
PD-SNCA or rate genetic mutation (such as Parkin or Pink 1))
- Male or female age 30 years or older at Screening Visit.
- Parkinson disease diagnosis at Screening Visit.
- Patients must have at least two of the following: resting tremor, bradykinesia, rigidity (must have either resting tremor or bradykinesia); OR either asymmetric resting tremor or asymmetric bradykinesia.
- Hoehn and Yahr stage I, II or III at Baseline.
- Confirmation of causative SNCA or rare genetic mutation (such as Parkin or Pink 1) (willingness to undergo genetic testing as part of genetic screening and be informed of genetic testing results, or documentation of prior genetic testing results).
- Individuals taking any of the following drugs: alpha methyldopa, methylphenidate, amphetamine derivatives or modafinil, must be willing and medically able to hold the medication for at least 5 half-lives before DaTscan imaging.
- Confirmation that participant is eligible based on Screening DaTscan imaging.
- Able to provide informed consent
- Woman may not be pregnant, lactating or planning pregnancy during the study. ~Including a negative pregnancy test on day of Screening DaTscan imaging test prior to injection DaTscan™.
Exclusion Criteria:
PD-SNCA or rate genetic mutation (such as Parkin or Pink 1))
- Received any of the following drugs: dopamine receptor blockers (neuroleptics), metoclopramide and reserpine within 6 months of Screening visit.
- Current treatment with anticoagulants (e.g., coumadin, heparin) that might preclude safe completion of the lumbar puncture
- Condition that precludes the safe performance of routine lumbar puncture, such as prohibitive lumbar spinal disease, bleeding diathesis, or clinically significant coagulopathy or thrombocytopenia.
- Any other medical or psychiatric condition or lab abnormality, which in the opinion of the investigator might preclude participation.
Prodromal Subjects:
Inclusion Criteria For Screening:
- Enrolled in PPMI 2.0 Remote and based on risk criteria, or olfaction, and/or other assessments in the PPMI 2.0 Online protocol are eligible for PPMI 2.0 Clinical.
- Male or female age 60 years or older (except age 30 years or older for SNCA, or rate genetic mutations (such as Parkin or Pink1) participants).
- Individuals taking any of the following drugs: alpha methyldopa, methylphenidate, amphetamine derivatives or modafinil, must be willing and medically able to hold the medication for at least 5 half-lives before DaTscan imaging.
- Able to provide informed consent
- Woman may not be pregnant, lactating or planning pregnancy during the study. ~Including a negative pregnancy test on day of Screening DaTscan imaging test prior to injection of DaTscan™.
Exclusion Criteria : Prodromal
- Clinical diagnosis of PD, other parkinsonism, or dementia
- Received any of the following drugs: dopamine receptor blockers (neuroleptics), metoclopramide and reserpine within 6 months of Screening visit.
- Current treatment with anticoagulants (e.g. coumadin, heparin) that might preclude safe completion of the lumbar puncture.
- Condition that precludes the safe performance of routine lumbar puncture, such as prohibitive lumbar spinal disease, bleeding diathesis, or clinically significant coagulopathy or thrombocytopenia.
- Any other medical or psychiatric condition or lab abnormality, which in the opinion of the investigator might preclude participation.

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): NCT04477785
Contact: Cari Rainville, BS | 877-525-7764 | crainville@indd.org |

Principal Investigator: | Kenneth L Marek, MD | Institute for Neurodegenerative Disorders | |
Principal Investigator: | Caroline Tanner, MD, PhD | University of California, San Francisco |
Responsible Party: | Ken Marek, MD, Protocol Co- Principal Investigator, Institute for Neurodegenerative Disorders |
ClinicalTrials.gov Identifier: | NCT04477785 |
Other Study ID Numbers: |
PPMI-002 |
First Posted: | July 20, 2020 Key Record Dates |
Last Update Posted: | February 23, 2023 |
Last Verified: | February 2023 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | Undecided |
Studies a U.S. FDA-regulated Drug Product: | No |
Studies a U.S. FDA-regulated Device Product: | No |
Parkinson Bio-markers Neurodegenerative disorder Imaging |
Prodromal Genetics At Risk Loss of Smell |
Parkinson Disease Parkinsonian Disorders Basal Ganglia Diseases Brain Diseases Central Nervous System Diseases |
Nervous System Diseases Movement Disorders Synucleinopathies Neurodegenerative Diseases |