The role of dopaminergic therapy in Parkinson’s disease

  • Research type

    Research Study

  • Full title

    The role of dopaminergic therapy in the restoration of neural activation and brain networks in patients with Parkinson’s disease

  • IRAS ID

    221459

  • Contact name

    Marios Politis

  • Contact email

    marios.politis@kcl.ac.uk

  • Sponsor organisation

    King's College London

  • Duration of Study in the UK

    3 years, 6 months, 0 days

  • Research summary

    Although oral levodopa and dopamine agonists are still the most effective symptomatic treatment for PD patients, after years of daily exposure, most PD patients develop troublesome involuntary movements known as levodopa-induced dyskinesias (LIDs). The mechanisms underlying LIDs are not fully understood and the changes in the brains of PD patients progressing from the stable levodopa response state into the development of LIDs remain unknown. State-of-the-art MRI techniques can give invaluable insight into the brain mechanisms underlying the effect of dopaminergic therapy in patients with PD and development of LIDs.

    In this longitudinal study, we aim to investigate changes in neural activation and functional and structural brain networks which may have a predictive significance in LID development by scanning PD patients who are at high risk of LID development.

    This study would be of great benefit in understanding the pathophysiology of LIDs in patients with PD. The successful application in incorporating multimodal fMRI and DTI data could also facilitate the development of potential new treatments, as well as diagnostic and/or prognostic markers of LIDs in PD patients.

    We aim to recruit 16 PD patients with disease onset below 40 years and 16 PD patients with disease onset between 40-59 years who have all been taking levodopa for a duration of 5-10 years. Each patient will undergo 2 MRI scans with the following sequences: T1-weighted MPRAGE, task-based fMRI (finger tapping), RS-fMRI, DTI, QSM, ASL and Neuromelanin. Patients will then attend two clinical visits: one after 6 months and one after a year. Imaging and clinical assessments will take place at the outstanding state-of-the-art research facility: the NIHR-Wellcome Trust KCL Clinical Research Facility. Patients will be asked to wear a PKG™ watch once every month for 7 days after their baseline visit. These watches will be posted directly to the patient’s home, so they will not need to attend King’s College Hospital. This study is funded by the Medical Research Council (MRC).

  • REC name

    London - Camden & Kings Cross Research Ethics Committee

  • REC reference

    17/LO/0689

  • Date of REC Opinion

    7 Jun 2017

  • REC opinion

    Further Information Favourable Opinion