Blood Pressure Effects on Cognition and Brain Blood Flow in PD

Launched by UNIVERSITY OF CALIFORNIA, SAN DIEGO · May 26, 2022

Keywords

ClinConnect Summary

This clinical trial is studying how low blood pressure (known as orthostatic hypotension) affects thinking and brain function in people with Parkinson's disease. It aims to find out if there is a specific level of low blood pressure that can impact a person's ability to think clearly, especially when they are standing up. About one-third of individuals with Parkinson's experience this sudden drop in blood pressure, which can lead to feelings of dizziness or fainting. By using advanced wearable technology, the researchers will measure blood pressure and blood flow to the brain while participants complete thinking tests both lying down and standing up.

To be eligible for this study, participants must be at least 50 years old and diagnosed with Parkinson's disease. They should be in the early to moderate stages of the disease, meaning they can walk without assistance. Participants will need to be proficient in English and should not have certain medical conditions or take specific medications that could interfere with the study. Those who join will help researchers understand the relationship between blood pressure, thinking ability, and brain function, which could lead to better treatment options for managing orthostatic hypotension and improving quality of life for people with Parkinson's.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 1. Diagnosis of idiopathic Parkinson Disease using the Movement Disorders Society (MDS) Clinical Diagnostic Criteria
• • 2. Age at least 50 years old
• • 3. Hoehn \& Yahr (H\&Y) stages I-III (early to moderate-stage PD; able to walk without assistance
• • 4. Proficiency in the English language (native English speaker level)
• Exclusion Criteria:
• • 1. Any involuntary movements (i.e., tremor or dyskinesia) \> 3 cm in amplitude (ok if movements are treated with medication), since the motion artifact could interfere with blood pressure monitor data collection
• • 2. Dementia (including PD dementia)
• • 3. History of deep brain stimulation (DBS) surgery
• • 4. Any current unstable, active medical problem, e.g. decompensated heart failure, liver failure, pneumonia, etc.
• • 5. Moderate or severe carotid artery stenosis (according to North American Symptomatic Carotid Endarterectomy Trial (NASCET) criteria
• • 6. History of cerebral infarction or hemorrhage
• • 7. Uncontrolled diabetes or any other systemic disease causing autonomic failure
• • 8. Syncope (fainting) within the past week
• • 9. Illiteracy (unable to read)
• • 10. Taking antihypertensive medications or alpha-adrenergic blocking medications, since these can cause hypotension (see \* below)
• • 11. Impairment of hearing or vision that is not corrected by devices (e.g., hearing aids or glasses)
• • 12. Currently pregnant (will be confirmed by women of child-bearing potential with a urine pregnancy test)
• • 13. Any other condition, which, in the opinion of the investigator, could place the participant at increased risk.
• * Please note that persons may not participate if they are taking any of the following:
• • medications to treat high blood pressure (called "antihypertensives") such as clonidine (Catapres), hydralazine, verapamil, diltiazem (Cartia), or medications ending in "-olol", "-artan", or "-pril")
• • diuretics (also called "water pills") such as furosemide (Lasix), bumetanide (Bumex), hydrochlorothiazide (HCTZ; Microzide), or spironolactone (Aldactone)
• • medications for enlarged prostate such as prazosin (Minipress), terazosin, doxazosin (Cardura), alfuzosin (Uroxatral), or tamsulosin (Flomax)
• • If persons are taking these medications and would like to participate in the study, they will be advised to discuss whether they may discontinue these medications for 48 hours before the study visit with their prescribing doctor.