NCT02390089

Brief Summary

Aspiration pneumonia (APn) occurs at a higher rate in patients with Parkinson's disease (PD) versus healthy adults. This is of particular public health concern given that death secondary to aspiration pneumonia and lung infection is a leading cause of death in persons with PD. Swallowing and cough function are affected in PD, putting people with PD at significant risk for uncompensated aspiration (aspiration without adequate cough response). One challenge in the management of airway protective deficits related to PD is the chronic and progressive nature of the disease, where swallowing dysfunction appears subtly in the form of microaspiration, reducing the perceived urgency of the swallowing disorder by both clinicians and patients. The long-term goal of this research is to advance the management of airway protection deficits in patients with neurodegenerative disease in order to decrease morbidity and mortality due to aspiration related lung infection. The objective here is to further specify deficits leading to uncompensated airway compromise in PD in order to advance the clinical management of these patients, leading to an immediate positive impact.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
158

participants targeted

Target at P75+ for phase_1

Timeline
Completed

Started Apr 2015

Longer than P75 for phase_1

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

February 19, 2015

Completed
26 days until next milestone

First Posted

Study publicly available on registry

March 17, 2015

Completed
15 days until next milestone

Study Start

First participant enrolled

April 1, 2015

Completed
1.9 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

February 10, 2017

Completed
2 years until next milestone

Study Completion

Last participant's last visit for all outcomes

February 13, 2019

Completed
Last Updated

February 15, 2019

Status Verified

February 1, 2019

Enrollment Period

1.9 years

First QC Date

February 19, 2015

Last Update Submit

February 13, 2019

Conditions

Keywords

DysphagiaCoughAspiration pneumonia

Outcome Measures

Primary Outcomes (2)

  • Urge-to-cough sensitivity

    Slope of the line created by plotting urge-to-cough (scale of 1-11) with capsaicin concentration (5 doses of increasing intensity).

    30 minute

  • Positive/negative cough response

    A positive response is 2 coughs produced to 2/3 trials of the stimulus

    10 minutes

Secondary Outcomes (3)

  • Latency

    10 minutes

  • Cough sensitivity threshold

    30 minutes

  • Cough motor threshold

    30 minutes

Other Outcomes (1)

  • Swallowing group

    20 minutes

Study Arms (3)

Healthy control

ACTIVE COMPARATOR

Healthy age-matched adult participants with no history of Parkinson's disease Participants in this group will receive capsaicin vapor cough provocation test. The vapor will be delivered using a small hand-held nebulizer.

Drug: Capsaicin vaporDevice: Nebulizer

Parkinson's disease - no PA

EXPERIMENTAL

People with Parkinson's disease without penetration or aspiration during swallowing; based on results of videofluoroscopic swallow evaluation. Participants in this group will receive capsaicin vapor and fog cough provocation test using a small, hand-held nebulizer.Participants in the group will also receive a fluoroscopic swallow evaluation.

Drug: Capsaicin vaporOther: fogRadiation: Videofluoroscopic swallow evaluationDevice: Nebulizer

Parkinson's disease - PA

EXPERIMENTAL

People with Parkinson's disease with penetration or aspiration during swallowing;based on results of videofluoroscopic swallow evaluation.Participants in this group will receive capsaicin vapor and fog cough provocation test using a small, hand-held nebulizer. Participants in the group will also receive a fluoroscopic swallow evaluation.

Drug: Capsaicin vaporOther: fogRadiation: Videofluoroscopic swallow evaluationDevice: Nebulizer

Interventions

Single-breath and continuous inhalation paradigm to induce cough.

Also known as: hot pepper vapor
Healthy controlParkinson's disease - PAParkinson's disease - no PA
fogOTHER

Continuous inhalation of fog until a cough is produced, or up to 60 seconds (whichever is shortest)

Also known as: aerosolized water
Parkinson's disease - PAParkinson's disease - no PA

Fluoroscopic evaluation of oropharyngeal swallowing function.

Also known as: Swallow study, Modified barium swallow study
Parkinson's disease - PAParkinson's disease - no PA
NebulizerDEVICE

A hand-held nebulizer will be used to aerosolize the capsaicin and water solutions. Participants will inhale through the device's mouthpiece, and cough if they need to.

Healthy controlParkinson's disease - PAParkinson's disease - no PA

Eligibility Criteria

Age50 Years - 80 Years
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Within age limits
  • For PD group: confirmed diagnosis of idiopathic parkinson's disease

You may not qualify if:

  • Uncontrolled hypertension
  • Difficulty complying due to neuropsychological dysfunction (i.e., severe depression)
  • Allergy to capsaicin or hot peppers
  • History of head or neck cancer
  • Neurological disorders other than PD (i.e., stroke, etc.)
  • \. control participants only: any history of neurologic disorders including PD
  • History of smoking in the last 5 years
  • Breathing disorders or diseases

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

University of Florida Center for Movement Disorders and Neurorestoration

Gainesville, Florida, 32611, United States

Location

MeSH Terms

Conditions

Parkinson DiseaseDeglutition DisordersCoughPneumonia, Aspiration

Interventions

WeatherNebulizers and Vaporizers

Condition Hierarchy (Ancestors)

Parkinsonian DisordersBasal Ganglia DiseasesBrain DiseasesCentral Nervous System DiseasesNervous System DiseasesMovement DisordersSynucleinopathiesNeurodegenerative DiseasesEsophageal DiseasesGastrointestinal DiseasesDigestive System DiseasesPharyngeal DiseasesOtorhinolaryngologic DiseasesRespiration DisordersRespiratory Tract DiseasesSigns and Symptoms, RespiratorySigns and SymptomsPathological Conditions, Signs and SymptomsPneumoniaRespiratory Tract InfectionsInfectionsLung Diseases

Intervention Hierarchy (Ancestors)

AtmosphereEnvironmentEcological and Environmental PhenomenaBiological PhenomenaMeteorological ConceptsEnvironment and Public HealthEquipment and Supplies

Study Officials

  • Karen W Hegland, PHD

    University of Florida

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
phase 1
Allocation
NON RANDOMIZED
Masking
SINGLE
Who Masked
PARTICIPANT
Purpose
DIAGNOSTIC
Intervention Model
SINGLE GROUP
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

February 19, 2015

First Posted

March 17, 2015

Study Start

April 1, 2015

Primary Completion

February 10, 2017

Study Completion

February 13, 2019

Last Updated

February 15, 2019

Record last verified: 2019-02

Locations