Cardiac Changes in Early Parkinson's Disease: a Follow Up Study

Launched by CEDARS-SINAI MEDICAL CENTER · Jan 2, 2020

Keywords

ClinConnect Summary

Primary procedures in this study are MIBG scan, DAT scan, Neuromelanin Magnetic Resonance Imaging (NM-MRI), and carvedilol treatment. Subjects will return for research visits and imaging tests every six months for three years. We hypothesize that the rate of decline in DAT scan123I-Ioflupane uptake will be slower in subjects who have received the adrenergic blocker carvedilol, resulting in a decreased clinical phenoconversion rate to parkinsonism. If this is true, it might create a considerable window of opportunity for treatment with adrenergic blockers - or similar compounds able to reduc...

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Eligibility criteria

• Inclusion Criteria:
• • Enrolled in the study "The Effect of Adrenergic Blocker Therapy on Cardiac and Striatal Transporter Uptake in Pre-Motor and Symptomatic Parkinson's Disease" (Pro#00053136)
• • Capacity to give informed consent
• Exclusion Criteria:
• • Secondary Parkinsonism, including tardive
• • Concurrent dementia defined by a score lower than 22 on the MoCA
• • Concurrent severe depression defined by a BDI fast screen score greater than 13
• • Comorbidities related to SNS hyperactivity
• • Heart failure (LVEF \<45%)
• • Recent myocardial revascularization (\<12 weeks)
• • Hypertension (SBP\>150mmHg or DBP\>100mmHg)
• • Chronic Atrial fibrillation
• • Concurrent Use of Beta-adrenergic antagonist
• • Diabetes mellitus
• • COPD
• • Untreated Sever Sleep Apnea; Apnea-Hypopnea Index (AHI) \> 30/h.
• • Severely reduced kidney function (Glomerular Filtration Rate\<30ml/min)
• • Contraindications to the use of carvedilol
• • Asthma or bronchospasm
• • Recent myocardial infarction (\<48 h)
• • Ongoing unstable angina
• • Cardiogenic shock or prolonged hypotension
• • Second or Third-Degree AV block
• • Significant valvular aortic stenosis
• • Obstructive cardiomyopathy, or constrictive pericarditis
• • Resting Heart Rate (RHR)\< 45 Or Bradycardia (HR\<60) with at least one of the following symptoms; Lightheadedness, dizziness, weakness, Altered mental status, Shortness of breath, Pre-Syncope, Syncope, Sick Sinus Syndrome, Stroke within the past 1 month, Severe Hepatic Dysfunction
• • Allergy/hypersensitivity to iodine or study medication