The Role of the Noradrenergic System in the Nonmotor Symptoms of Parkinson's Disease

• Status: Recruiting
• Trial end date: 2023-05-01
• Target enrollment: 0
• Participant gender: All

Summary

The purpose of the study is to learn about the role of noradrenergic system in the non-motor symptoms of Parkinson's disease. In particular, researchers hope to better understand what role the noradrenergic system may play in the regulation of blood pressure, cognition and mood symptoms in patients with Parkinson's disease. With this information, future research may explore treatments that target the noradrenergic system in order to better treat the non-motor symptoms of Parkinson's disease.

The experimental drug used in some of the study assessments, yohimbine hydrochloride, is not being tested as a potential treatment for Parkinson's disease. Yohimbine hydrochloride will be used to manipulate the noradrenergic system during some of the assessments. By measuring the amounts of hormones and neurotransmitters the body produces before and after yohimbine hydrochloride administration, researchers can assess how well the noradrenergic system is functioning.

• Phase: Early Phase 1
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Nathaniel M. Robbins
• Treatments: Yohimbine

Criteria

Inclusion Criteria:

1. Participant able to provide informed consent

2. Diagnosis of Parkinson's disease confirmed by a DH neurologist according to Movement Disorder Society criteria, with the exception that "Red flag" 5a will not be used (severe autonomic failure within five years of disease onset).

3. All subjects must have CMP and CBC drawn within 6 months of study visit 1, with results in the normal range or with abnormal results not considered to be clinically significant in the investigator's opinion.

4. Female patients must be post-menopausal (at least one year) or not planning to get pregnant and have negative pregnancy test.

Exclusion Criteria:

1. Diagnosis or previous history of diabetes of any kind

2. Known autonomic neuropathy unrelated to PD

3. History of or current cardiac, liver or renal disease that, in the opinion of the investigator, may put the patient at risk because of participation in the study

4. Known condition that in the investigator's opinion would be a contraindication to HUT testing or yohimbine challenge (e.g. decompensated cardiac disease, severe positional vertigo; severe anxiety, known panic disorder69)

5. Current use of catecholaminergic medications (e.g. stimulants, droxidopa, midodrine) that cannot be held for at least three half-lives

6. Inability to hold PD medications for at least 12 hours

7. History of major depressive or bipolar disorder preceding the diagnosis of PD,69 or diagnosis or previous history of psychiatric illness that in the investigator's opinion would affect the subject's ability to successfully participate in the study.

8. Any history (other than PD) that could significantly and adversely affect neurocognitive function, such as history of traumatic brain injury (head injury with loss of consciousness > 1 hour), known dementia unrelated to Parkinson's or related diseases; developmental delay, multiple sclerosis or epilepsy with cognitive impairment, intellectual deficit, diagnosed and untreated sleep apnea; untreated syphilis; HIV with HAND; or other conditions that, based on the investigators opinion, could interfere with neurocognitive evaluation.

9. Known ophthalmologic disease such as untreated cataract, glaucoma, optic neuritis, orbital trauma, or other neuroretinal disease that might impact pupillary function

10. Severe illness within 30 days prior to enrollment.

11. Use of opiate, procholinergic, or other medications influencing pupillary function that cannot be held for three half-lives

12. In the Investigator's opinion, subject would be unable to successfully participate in the study for any reason.