From the March 2010 PDtrials Newsletter.To learn more, visit www.PDtrials.org

The QE3 Study: Finding Ways to Slow the Progression of PD

By Flint Beal, M.D.

Although tremendous advances have been made in the treatment of Parkinson's Disease (PD), they have mostly been focused on symptomatic improvement.  Currently, available treatments address tremor, rigidity and slowness of movement experienced by people living with Parkinson's. However, they do not have any effect on slowing the progression of the illness and treating the underlying disease process.  This is a major area of therapies development for people living with Parkinson's.  If one could slow the disease progression, one could avoid many of the long range complications of PD such as dyskinesias and eventually perhaps cognitive impairment.

New Clinical Trials

Study of Rasagiline as Add-on to Dopamine Agonists in the Treatment of Parkinson's Disease
Dopamine agonists are increasingly used as first-line therapy for those who are newly diagnosed with PD. As the disease progresses, dopamine agonists alone do not fully control the symptoms of PD and additional dopaminergic therapy is needed. Three hundred sixty participants at many sites around the U.S. will be enrolled in this study based on need for additional PD symptom control despite dopamine agonist treatment, and will be dispensed rasagiline or matching placebo in order to assess the efficacy of rasagiline as add-on treatment to dopamine agonist therapy in people with early PD not optimally treated on dopamine agonists.

Singing in Groups for Parkinson's Disease (SING-PD)
The main purpose of this study is to find out if singing in groups helps the voice and speech problems related to PD more than speech therapy without singing. The investigators are using standard measures of symptoms before and after therapy to look for improvement. This study will involve weekly treatment sessions where 32 participants will receive training in vocal exercises from a speech-language pathologist with expertise in PD, as well as instructions for structured home practice.

A Study to Evaluate the Safety and Efficacy of IPX066 in Advanced Parkinson's Disease
This is a study to evaluate the safety and efficacy of an experimental drug, IPX066 in advanced PD. Four hundred twenty participants will be randomly selected to orally take either IPX066 or regular carbidopa-levodopa (CD-LD) treatment. The duration of this study is approximately 22 weeks.

A Study of Rating Scales for Dyskinesia in Parkinson's Disease
Dyskinesias, or involuntary jerking movements, are troublesome problems for many people with PD, and because dyskinesias cause various degrees of difficulty for people with PD, the rating of dyskinesias remains a scientific challenge.  This study will examine a wide gamut of available rating scales to determine which one(s) detect change during dyskinesia treatment. Establishing excellent measurement tools of dyskinesias will allow future treatments to be evaluated in a maximally effective manner. This will be a double-blind, randomized trial of 60 participants administered with amantadine or placebo for 8 weeks.

Study of Naltrexone for Impulse Control Disorders in Parkinson's Disease
Impulse control disorders (ICDs), including compulsive gambling, sexual behavior, buying, and eating, are increasingly recognized as a significant clinical problem in PD. Dopamine agonist (DA) treatment is thought to be the primary risk factor for the development of ICDs in PD. People with PD may be reluctant to discontinue DA treatment due to the motor benefits derived from treatment, so they often have chronic symptoms. Forty-eight PD participants with an ICD will be treated either with naltrexone or placebo for a period of eight weeks. The study will assess if naltrexone improves ICD symptoms in PD and is well tolerated.

Colonoscopic Screening for Autonomic Pathology in Parkinson's Disease
The purpose of this study is to determine whether the abnormal protein build-up seen in the brains of people with PD and dementia with Lewy bodies (DLB) is also present in the nerves that line the intestine. This information would guide future research designed to diagnose people at the earliest stage of these diseases. Such information could help with research on new therapies designed to slow progression of (or even prevent) PD and DLB. This study will recruit 70 participants in Utah with PD or DLB, as well as people (over age 50) who do not have a neurologic condition.

Study of Rasagiline Mesylate in People with Multiple System Atrophy of the Parkinsonian Subtype (MSA-P)
Multiple system atrophy (MSA) is a neurodegenerative disease marked by a combination of symptoms affecting movement, blood pressure, and other body functions; hence the label "multiple system" atrophy. The purpose of this study is to test the clinical effect of rasagiline on people with MSA of the parkinsonian subtype (initials symptoms are similar to PD). Forty study participants around the country will receive either rasagiline mesylate or matching placebo for 48 weeks.

Smoking Years Key Factor in Lower Parkinson's Risk

Several studies have shown that smokers have a lower risk of developing PD. A new study shows that it's how many years of smoking a person has under their belt -- rather than how much they smoke every day -- that matters. "Smoking is bad for you and no one should advocate smoking just for prevention of Parkinson's," Dr. Honglei Chen of the National Institute of Environmental Health Sciences in Research Triangle Park, North Carolina, one of the study's authors, emphasized in comments to Reuters Health. But the findings could help researchers who are trying to figure out the underlying cause of the disease.

Melanoma Risk Higher in Parkinson's Patients

Exams of more than 2,000 people with PD found that about one percent currently had melanoma, Dr. John M. Bertoni of the University of Nebraska Medical Center in Omaha and his colleagues found. Based on the findings, they say, people with the degenerative nerve disease should receive regular skin cancer screening.

Parkinson's Patients Have Trouble Recognizing Emotions

Scientists are beginning to find out why people with PD often feel socially awkward. Parkinson's patients find it harder to recognize expressions of emotion in other people's faces and voices, report two studies published by the American Psychological Association.