Role of Mesocorticolimbic Pathway in Apathy of Patients With Parkinson's Disease. - Study Using Diffusion Tensor Imaging and Fibres Tracking

NCT01794195 | Completed

• 2 other identifiers: CHU-01452012-A01293-40
• Study Type: interventional
• Target: 63
• Locations: 1 country
• Sites: 1

Brief Summary

Use lay language. Apathy is one of the most under recognised, underdiagnosed and poorly managed aspects of Parkinson's disease. Depending on methodological approach of the study, its prevalence is estimated to be between 16 and 51%. Apathy derives from a dysfunction of the dopaminergic meso cortico limbic systems, which seems to play a central role in the control of mood and motivation. The subcortical components of this system are the ventral tegmental area (VTA), the nucleus accumbens, and the constituents of the limbic system (particularly the hippocampus and amygdala), all of which are located deep inside the brain (18). The hypothesis is that depletion of striatal dopamine from regulators located in the midbrain (VTA and SNpc) in striato-thalamo-cortical circuits results in hypofunction of these circuits and the loss of frontal cortical activity, particularly within in the frontal orbital cortex, the anterior cingulate cortex and the prefrontal cortex The objective of this study is to explore, using diffusion weighted MRI, the regions of the brain which are proposed to play a role in motivation in apathetic Parkinson's disease patients and to define more precisely the relation between dopaminergic fibres and the meso-cortico-limbic system with the help of tractography methods

Conditions

Parkinson's Disease; Apathy

Keywords

Parkinson's disease; Apathy; diffusion tensor imaging; tractography

Outcome Measures

Primary Outcomes (1)

• Fractional anisotropy coefficient (the fractional anisotropy coefficient is computed from the eigenvalues of the diffusion tensor)

  at day 1

Secondary Outcomes (3)

• Fibres density (number of fibres / voxel)

  at day 1

• Bulk diffusivity index

  at day 1

• Apparent diffusion coefficient

  at day 1

Study Arms (3)

apathetic patients with Parkinson's disease

EXPERIMENTAL

The objective of this study is to explore, using diffusion weighted MRI, the regions of the brain which are proposed to play a role in motivation in apathetic Parkinson's disease patients and to define more precisely the relation between dopaminergic fibres and the meso-cortico-limbic system with the help of tractography methods

Behavioral: Diffusion tensor imaging and fibres tracking

non apathetic paired patients

EXPERIMENTAL

The objective of this study is to explore, using diffusion weighted MRI, the regions of the brain which are proposed to play a role in motivation in apathetic Parkinson's disease patients and to define more precisely the relation between dopaminergic fibres and the meso-cortico-limbic system with the help of tractography methods

Behavioral: Diffusion tensor imaging and fibres tracking

healthy paired control

EXPERIMENTAL

The objective of this study is to explore, using diffusion weighted MRI, the regions of the brain which are proposed to play a role in motivation in apathetic Parkinson's disease patients and to define more precisely the relation between dopaminergic fibres and the meso-cortico-limbic system with the help of tractography methods

Behavioral: Diffusion tensor imaging and fibres tracking

Interventions

Diffusion tensor imaging and fibres tracking BEHAVIORAL

apathetic patients with Parkinson's disease; healthy paired control; non apathetic paired patients

Eligibility Criteria

• Age: 18 Years - 85 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients :
• Men or women aged between 18 -85 years
• Patients with an idiopathic Parkinson's disease according to UKPDSBB criterias
• Non dement (MMS ≥ 26 ; MATTIS ≥ 130)
• Affiliated to National Health system
• Having given their informed consent
• Healthy controls
• Men or women aged between 18 -85 years
• Affiliated to National Health system
• Having given their informed consent

You may not qualify if:

• Patients :
• Patients suffering of an atypical Parkinson syndrome
• Psychiatric pathology
• Severe tremor form of PD
• Depression (MADRS \>16)., dementia (MMS \< 26, MATTIS \< 130).
• Pregnant
• Under guardianship
• In excluding period for another study
• Any contra-indication to MRI
• Healthy subject
• Subject with neurological, psychiatric diseases
• Depression, dementia, apathy
• Pregnant
• Under guardianship
• In excluding period for another study

Sponsors & Collaborators

• University Hospital, Clermont-Ferrand: lead

Study Sites (1)

CHU Clermont-Ferrand

Clermont-Ferrand, 63003, France

Location

MeSH Terms

Conditions

Parkinson Disease; Lethargy

Interventions

Diffusion Tensor Imaging

Condition Hierarchy (Ancestors)

Parkinsonian Disorders; Basal Ganglia Diseases; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Movement Disorders; Synucleinopathies; Neurodegenerative Diseases; Neurobehavioral Manifestations; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Neuroimaging; Diagnostic Imaging; Diagnostic Techniques and Procedures; Diagnosis; Diffusion Magnetic Resonance Imaging; Magnetic Resonance Imaging; Tomography; Diagnostic Techniques, Neurological; Investigative Techniques

Study Officials

• Franck DURIF

  University Hospital, Clermont-Ferrand

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: February 12, 2013
• First Posted: February 18, 2013
• Study Start: February 1, 2013
• Primary Completion: December 1, 2013
• Study Completion: December 1, 2013
• Last Updated: July 1, 2014

Record last verified: 2014-06

Locations

FR (1)