Overview

A Multidisciplinary Approach to Manage Gait Difficulty in Parkinson Patients

Status:
Withdrawn
Trial end date:
2017-11-01
Target enrollment:
0
Participant gender:
All
Summary
The study team proposes to treat Parkinson's patients with gait difficulty with multidisciplinary approach of medications. Single medication treatment, such as the use of cholinergic-boosting anti-dementia medication targeting cholinergic deficiency to improve executive dysfunction and attention deficit, or the use of medication boosting the norepinephrine system, have not proven effective so far in treating the gait difficulty. Anti-anxiety medications, particularly the SNRI (serotonin and norepinephrine reuptake inhibitor) medications, which also ameliorate the norepinephrinergic deficiency, have not been studied except for one successful case report using duloxetine to treat primary progressive freezing of gait. Targeting multiple mechanisms at same time, such as the combination of a SNRI antianxiety medication (also boosting the norepinephrine system, such as duloxetine) with an anti-dementia medication correcting the cholinergic deficiency (such as donepezil), or targeting a new mechanism, such as the use of anti-GABAergic medication targeting the area responsible for gait and sleep cycle (pedunculopontine nucleus area, PPNa) should be tried. Therefore, a collaboration of multidisciplinary teams among the neurology movement disorder team and cognition and sleep team, and psychiatry team is essential, which has not been tried before in studying and treating the challenging gait difficulty in Parkinson patients.
Phase:
Phase 2
Accepts Healthy Volunteers?
No
Details
Lead Sponsor:
University of Chicago
Treatments:
Armodafinil
Donepezil
Duloxetine Hydrochloride
Modafinil
Criteria
Inclusion Criteria:

- Parkinsonian patient with Parkinson's disease per UK brain bank criteria 15,

- or PSP per SPSP-NINDS criteria 16,

- FOG at off or on dopaminergic medication or both.

Exclusion Criteria:

- Patients with psychosis,

- unable to walk without assistance,

- seizures,

- or allergy to any of these three medications on trial.