NCT04116216

Brief Summary

In this study we wondered whether patients with different phenotypes of Parkinson's disease respond differently to the protocol of repetitive transcranial magnetic stimulation (rTMS) associated with physical therapy. Furthermore, the study aims to compare the effects of rTMS protocols (high and low frequency) associated with physical therapy in PD patients with different phenotypes regarding to motor performance; bradykinesia; functional mobility; balance; quality of life; perception of improvement.

Trial Health

43
At Risk

Trial Health Score

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

Trial has exceeded expected completion date
Enrollment
30

participants targeted

Target at P25-P50 for phase_2 parkinson-disease

Timeline
Completed

Started Oct 2019

Geographic Reach
1 country

1 active site

Status
unknown

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

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

September 23, 2019

Completed
11 days until next milestone

First Posted

Study publicly available on registry

October 4, 2019

Completed
11 days until next milestone

Study Start

First participant enrolled

October 15, 2019

Completed
1.2 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 30, 2020

Completed
4 months until next milestone

Study Completion

Last participant's last visit for all outcomes

April 30, 2021

Completed
Last Updated

October 4, 2019

Status Verified

October 1, 2019

Enrollment Period

1.2 years

First QC Date

September 23, 2019

Last Update Submit

October 2, 2019

Conditions

Keywords

Parkinson's disease

Outcome Measures

Primary Outcomes (1)

  • Change in Unified Parkinson's disease Rating Scale - Session III

    In the present study we will analyze the UPDRS session III which comprises 14 items with a score of 0-4 each, from best to worst motor performance (SHULMAN et al., 2010). According to UPDRS scores, patients will be classified as: (i) tremor-dominant (TD) or (ii) with postural instability and difficulty in walking (PIGD).

    baseline, after 7 days, after 15 days

Secondary Outcomes (3)

  • Changes on cortical excitability level

    baseline, after 7 days, after 15 days

  • Changes on quality of life

    baseline, after 15 days

  • Changes on Patient Global Impression of Change Scale

    after 15 days

Other Outcomes (6)

  • Changes on balance

    baseline, after 15 days

  • Changes on functional mobility to sit-to-stand

    baseline, baseline, after 7 days, after 15 days

  • Changes on functional mobility

    baseline, baseline, after 7 days, after 15 days

  • +3 more other outcomes

Study Arms (3)

High frequency rTMS + physical therapy

ACTIVE COMPARATOR

The sessions will be performed five times a week for two weeks. The individuals will be performed the following protocol: first the coil center will be positioned over Cz for the first 1000 pulses. Then the coil will be moved to C4 and C3, where 1000 pulses will be delivered to each hemisphere. The intensity will be set to 100% of the motor threshold. The high frequency stimulation will be delivered at 10 Hz, offered in 20 50-pulse trains, with 30-second train intervals. After rTMS, patients will be submitted to 40 minutes of physical therapy protocol.

Combination Product: High frequency repetitive transcranial magnetic stimulation

Low frequency rTMS + physical therapy

ACTIVE COMPARATOR

The sessions will be performed five times a week for two weeks. The individuals will be performed the following protocol: first the coil center will be positioned over Cz for the first 1000 pulses. Then the coil will be moved to C4 and C3, where 1000 pulses will be delivered to each hemisphere. The intensity will be set to 100% of the motor threshold. The low frequency will be performed at 1 Hz. After rTMS, patients will be submitted to 40 minutes of physical therapy protocol.

Combination Product: Low frequency repetitive transcranial magnetic stimulation

Sham rTMS + physical therapy

SHAM COMPARATOR

For sham stimulation, the stimulator positioned behind the patient will be turned off immediately after the determination of RMT, however, the coil will remain positioned over the patient's scalp (Cz, C3 and C4). A computer equipped with speakers will play an audio recording with the characteristic rTMS sound and no stimulation will be induced in the brain.

Combination Product: Sham repetitive transcranial magnetic stimulation

Interventions

The sessions will be performed five times a week for two weeks. The individuals will be performed the following protocol: first the coil center will be positioned over Cz for the first 1000 pulses. Then the coil will be moved to C4 and C3, where 1000 pulses will be delivered to each hemisphere. The intensity will be set to 100% of the motor threshold. The high frequency stimulation will be delivered at 10 Hz, offered in 20 50-pulse trains, with 30-second train intervals. The low frequency will be performed at 1 Hz. After rTMS, patients will be submitted to 40 minutes of physical therapy protocol.

High frequency rTMS + physical therapy

The sessions will be performed five times a week for two weeks. The individuals will be performed the following protocol: first the coil center will be positioned over Cz for the first 1000 pulses. Then the coil will be moved to C4 and C3, where 1000 pulses will be delivered to each hemisphere. The intensity will be set to 100% of the motor threshold. The high frequency stimulation will be delivered at 10 Hz, offered in 20 50-pulse trains, with 30-second train intervals. The low frequency will be performed at 1 Hz. After rTMS, patients will be submitted to 40 minutes of physical therapy protocol.

Low frequency rTMS + physical therapy

For sham stimulation, the stimulator positioned behind the patient will be turned off immediately after the determination of RMT, however, the coil will remain positioned over the patient's scalp (Cz, C3 and C4). A computer equipped with speakers will play an audio recording with the characteristic rTMS sound and no stimulation will be induced in the brain.

Sham rTMS + physical therapy

Eligibility Criteria

Age40 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Clinical diagnosis of PD provided by neurologist;
  • Aged 40 or over, of both gender;
  • Regular antiparkinsonian pharmacological treatment;
  • With staging from I to IV on the modified Hoehn \& Yahr scale.

You may not qualify if:

  • Prior neurological diseases
  • Metal implant in the skull and face
  • Pacemaker
  • History of seizures
  • Epilepsy
  • Pregnancy
  • Other disorders that affect the performance of the tests and proposed intervention
  • Other osteomioarticular diseases in the lower limbs that interfere with performance and locomotion
  • Submitted to previous surgical intervention for PD

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Applied Neuroscience Laboratory

Recife, Pernambuco, 50670-901, Brazil

Location

MeSH Terms

Conditions

Parkinson Disease

Condition Hierarchy (Ancestors)

Parkinsonian DisordersBasal Ganglia DiseasesBrain DiseasesCentral Nervous System DiseasesNervous System DiseasesMovement DisordersSynucleinopathiesNeurodegenerative Diseases

Study Officials

  • Kátia M Silva, PhD

    Universidade Federal de Pernambuco

    STUDY CHAIR

Central Study Contacts

Kátia M Silva, PhD

CONTACT

Lívia Shirahige, MSc

CONTACT

Study Design

Study Type
interventional
Phase
phase 2
Allocation
RANDOMIZED
Masking
TRIPLE
Who Masked
PARTICIPANT, INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Clinical professor

Study Record Dates

First Submitted

September 23, 2019

First Posted

October 4, 2019

Study Start

October 15, 2019

Primary Completion

December 30, 2020

Study Completion

April 30, 2021

Last Updated

October 4, 2019

Record last verified: 2019-10

Data Sharing

IPD Sharing
Will not share

Locations