NMT for Parkinson's Disease

NCT03049033 | Unknown DMC

• 2 other identifiers: 16-2308K01AT009894
• Study Type: interventional
• Target: 100
• Locations: 1 country
• Sites: 1

Brief Summary

Parkinson's Disease (PD) is defined by characteristic motor symptoms including slow movements, small movements, difficulty with movement initiation and disruptions in timing. Besides gross motor symptoms, fine motor impairments in PD cause difficulties with everyday tasks such as writing, self-care, and fine object manipulation. These activity limitations can lead to disability, social isolation, and a reduced quality of life. In a series of breakthrough studies Michael Thaut and colleagues developed Neurologic Music Therapy (NMT) and found it can address many gross motor impairments and improve gait and balance. Other music therapies such as Music-supported Therapy (MST) have proven motor benefits in stroke patients through movement exercises with musical instruments. However, the pathological basal ganglia (BG) in PD brains leads to a reduced supply of those internally generated movements. In contrast, externally cued movements (eg. via a beat or a rhythm) during NMT sessions are instantaneously entrained to the period of a rhythmic stimulus possibly without involvement of the BG. The underlying idea is that rhythm is the essential component relating music specifically to motor behavior. The mechanism of action is called "rhythmic entrainment" where one system's motion or signal frequency entrains the frequency of another system. The effect of NMT on fine motor function has not been investigated yet. Music activities are important in the lives of many older adults. Notably, the use of music has been associated with increased well-being for older adults, as it fosters social connection and mood regulation. Furthermore, many musical activities have limited physical demands, making them attainable for individuals who are living with mobility impairments or other physical restrictions. Based on the literature and the investigators preliminary studies, the investigators propose to test the efficacy of Neurologic Music Therapy in comparison to Music Supported Therapy and Occupational Therapy (OT) as standard of care on adults in the Parkinson's spectrum. The investigators have defined a working plan using different musical instruments and growing tempo to specifically improve fine motor movements.

Conditions

Parkinson Disease

Outcome Measures

Primary Outcomes (4)

• Clinical Outcome: Motor 1 (change in the Grooved Pegboard Test)

  First motor outcome will be a change in the Grooved Pegboard Test.

  Baseline and 5 weeks

• Quality of Life (QOL) Outcome: QOL 1 (change in the 39-Item Parkinson's Disease)

  First QOL outcome will be a change in the 39-Item Parkinson's Disease Questionnaire.

  Baseline and 5 weeks

• Mechanistic Outcome: Neurophysiology 1 (change in motor beta and gamma power using Magnetoencephalography)

  Our first mechanistic outcome will be a change in cortical motor beta and gamma power using Magnetoencephalography.

  Baseline and 5 weeks

• Mechanistic Outcome: Neurophysiology 2 (change in auditory-motor functional connectivity using Magnetoencephalography)

  Our second neurophysiology outcome will be a change in auditory-motor functional connectivity using Magnetoencephalography

  Baseline and 5 weeks

Secondary Outcomes (4)

• Clinical Outcome: Motor 2 (change in the Unified Parkinson Disease Rating Scale Part III)

  Baseline and 5 weeks

• Clinical Outcome: Motor 3 (change in the Finger-Thumb opposition from the Neurological Evaluation Scale)

  Baseline and 5 weeks

• Quality of Life (QOL) Outcome: QOL 2 (change in the Clinical Global Impression - Improvement Scale)

  Baseline and 5 weeks

• Quality of Life (QOL) Outcome: QOL 3 (change in the Hospital Anxiety and Depression Scale)

  Baseline and 5 weeks

Study Arms (4)

Neurologic Music Therapy (NMT)

EXPERIMENTAL

Neurologic Music Therapy is a 5-week intervention using different musical instruments and auditory cues to specifically improve fine motor movements.

Other: Neurologic Music Therapy

Occupational Therapy (OT)

ACTIVE COMPARATOR

Standard of care occupational therapy uses traditional motor training.

Other: Occupational Therapy

Waitlist Control

NO INTERVENTION

Participants assigned to the waitlist-control condition will not immediately receive services. The no-treatment duration for these participants is yoked to the amount of time their respective NMT- and OT-condition participants receive services (5 weeks). After the wait period, these participants will then be randomized to receive either NMT, MST or OT sessions.

Music Supported Therapy (MST)

ACTIVE COMPARATOR

Music Supported Therapy uses musical instruments to train fine motor movements.

Other: Music Supported Therapy

Interventions

Neurologic Music Therapy OTHER

Neurologic Music Therapy uses rhythms to change brain activity and function.

Neurologic Music Therapy (NMT)

Occupational Therapy OTHER

Occupational Therapy uses traditional motor training.

Occupational Therapy (OT)

Music Supported Therapy OTHER

Music Supported Therapy uses musical instruments to train fine motor movements.

Music Supported Therapy (MST)

Eligibility Criteria

• Age: 45 Years - 85 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age 45 to 85
• Diagnosis of Parkinson's Disease using the UK Brain Bank Criteria
• Fine motor impairments (if available, scores 2 and higher on the UPDRS motor examination part III.23 and 24)
• Medication stable for at least 30 days.

You may not qualify if:

• Features suggestive of other causes of parkinsonism, including cerebrovascular disease or history of major head trauma
• Inability to move fingers or hands
• Hoehn and Yahr stage 4 and higher
• Ferrous metal implants which may interfere with the MEG data acquisition and/or be an MRI safety concern
• Dementia
• Participants engaged in other research studies involving music therapies
• Participants whose insurance does not cover Occupational Therapy costs or who have no insurance.

Sponsors & Collaborators

• University of Colorado, Denver: lead
• National Center for Complementary and Integrative Health (NCCIH): collaborator

Study Sites (1)

University of Colorado Denver

Aurora, Colorado, 80045, United States

RECRUITING

Related Publications (1)

• Buard I, Lattanzio L, Stewart R, Thompson S, Sjoberg K, Hookstadt K, Morrow M, Holden SK, Sillau S, Thaut M, Kluger B. Randomized controlled trial of neurologic music therapy in Parkinson's disease: research rehabilitation protocols for mechanistic and clinical investigations. Trials. 2021 Aug 28;22(1):577. doi: 10.1186/s13063-021-05560-7.

  PMID: 34454592 DERIVED

MeSH Terms

Conditions

Parkinson Disease

Interventions

Occupational Therapy

Condition Hierarchy (Ancestors)

Parkinsonian Disorders; Basal Ganglia Diseases; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Movement Disorders; Synucleinopathies; Neurodegenerative Diseases

Intervention Hierarchy (Ancestors)

Rehabilitation; Aftercare; Continuity of Patient Care; Patient Care; Therapeutics

Study Officials

• Isabelle Buard, PhD

  University of Colorado, Denver

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Lucas Lattanzio, BA

CONTACT

303.724.2205; Lucas.Lattanzio@CUAnschutz.edu

Isabelle Buard, PhD

CONTACT

303.724.5973; Isabelle.Buard@CUAnschutz.edu

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: February 2, 2017
• First Posted: February 9, 2017
• Study Start: April 26, 2017
• Primary Completion: December 31, 2024
• Study Completion: December 31, 2025
• Last Updated: January 3, 2024

Record last verified: 2024-01

Data Sharing

• IPD Sharing: Will share

Locations

US (1)