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Fox SH. Outcome Selection for Research Studies in Movement Disorders. Mov Disord Clin Pract 2024. [PMID: 38828689 DOI: 10.1002/mdc3.14087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 04/02/2024] [Indexed: 06/05/2024] Open
Affiliation(s)
- Susan H Fox
- University of Toronto, Movement Disorder Clinic, Edmond J Safra Program in Parkinson Disease, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
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Dumican M, Harper K, Malczewski A. Self-Reported Voice and Swallow Questionnaires' Alignment with Unified Parkinson's Disease Rating Scale Questions: A Preliminary Study. J Voice 2024:S0892-1997(24)00094-8. [PMID: 38614893 DOI: 10.1016/j.jvoice.2024.03.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 03/18/2024] [Accepted: 03/19/2024] [Indexed: 04/15/2024]
Abstract
PURPOSE The purpose of this manuscript was twofold: to investigate how clinical voice and swallow questionnaires align with self-reports from speech/voice and swallow domains of the Unified Parkinson's Disease Rating Scale (UPDRS), and how decline in self-reported speech/voice measures predict decline in self-reported swallowing measures. METHODS This observational, preliminary cross-sectional study included 15 people diagnosed with Idiopathic Parkinson's Disease. Participants completed the Voice Related Quality of Life (V-RQOL), Sydney Swallow Questionnaire (SSQ), and cognitive screening (Montreal Cognitive Assessment; MoCA) to account for cognitive impairment during self-reported speech/voice and swallow measures. They also completed the speech/voice and swallow components of the UPDRS. RESULTS There were significant associations between the SSQ and UPDRS question 2.3 (chewing/swallowing) (P < 0.001), but not between UPDRS question 2.1 (speech/voice) and V-RQOL. However, the MoCA was significantly and directionally associated with V-RQOL scores (P = 0.01). Finally, the V-RQOL was significantly associated with SSQ scores in a multiple regression model (P = 0.02). CONCLUSIONS Speech/voice and swallow-related questions from the UPDRS may be viable initial screening tools to facilitate faster and earlier laryngeal function testing. Substantially more research should be undertaken to assess how well these UPDRS question domains are indicative of underlying speech/voice or swallow dysfunction.
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Gonzalez-Robles C, Bartlett M, Burnell M, Clarke CS, Haar S, Hu MT, Huxford B, Jha A, Lawton M, Noyce A, Piccini P, Pushparatnam K, Rochester L, Siu C, van Wamelen D, Williams-Gray CH, Zeissler ML, Zetterberg H, Carroll CB, Foltynie T, Weil RS, Schrag A. Embedding Patient Input in Outcome Measures for Long-Term Disease-Modifying Parkinson Disease Trials. Mov Disord 2024; 39:433-438. [PMID: 38140767 DOI: 10.1002/mds.29691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 10/30/2023] [Accepted: 11/30/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Clinical trials of disease-modifying therapies in PD require valid and responsive primary outcome measures that are relevant to patients. OBJECTIVES The objective is to select a patient-centered primary outcome measure for disease-modification trials over three or more years. METHODS Experts in Parkinson's disease (PD), statistics, and health economics and patient and public involvement and engagement (PPIE) representatives reviewed and discussed potential outcome measures. A larger PPIE group provided input on their key considerations for such an endpoint. Feasibility, clinimetric properties, and relevance to patients were assessed and synthesized. RESULTS Although initial considerations favored the Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part III in Off, feasibility, PPIE input, and clinimetric properties supported the MDS-UPDRS Part II. However, PPIE input also highlighted the importance of nonmotor symptoms, especially in the longer term, leading to the selection of the MDS-UPDRS Parts I + II sum score. CONCLUSIONS The MDS-UPDRS Parts I + II sum score was chosen as the primary outcome for large 3-year disease-modification trials. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Cristina Gonzalez-Robles
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | | | - Matthew Burnell
- Medical Research Council Clinical Trials Unit, University College London, London, United Kingdom
| | - Caroline S Clarke
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Shlomi Haar
- Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Michele T Hu
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Brook Huxford
- Preventive Neurology Unit, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
| | - Ashwani Jha
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Michael Lawton
- Population Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Alastair Noyce
- Preventive Neurology Unit, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
| | - Paola Piccini
- Department of Brain Sciences, Imperial College London, London, United Kingdom
| | | | - Lynn Rochester
- Translational and Clinical Research Institute Clinical Ageing Research Unit, Newcastle University, Newcastle, United Kingdom
| | - Carroll Siu
- Expert by experience, Canterbury, United Kingdom
| | - Daniel van Wamelen
- Department of Neurology, Centre of Expertise for Parkinson and Movement Disorders, King's College London, London, United Kingdom
| | | | | | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden
| | - Camille B Carroll
- Translational and Clinical Research Institute Clinical Ageing Research Unit, Newcastle University, Newcastle, United Kingdom
- Faculty of Health, University of Plymouth, Plymouth, United Kingdom
| | - Thomas Foltynie
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Rimona S Weil
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
- Dementia Research Centre, Movement Disorders Centre, University College London, London, United Kingdom
| | - Anette Schrag
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
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Ribba B, Simuni T, Marek K, Siderowf A, Diack C, Pierrillas PB, Monnet A, Ricci B, Nikolcheva T, Pagano G. Modeling of Parkinson's Disease Progression and Implications for Detection of Disease Modification in Treatment Trials. JOURNAL OF PARKINSON'S DISEASE 2024; 14:1225-1235. [PMID: 39058452 PMCID: PMC11380229 DOI: 10.3233/jpd-230446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/28/2024]
Abstract
Background Objectively measuring Parkinson's disease (PD) signs and symptoms over time is critical for the successful development of treatments aimed at halting the disease progression of people with PD. Objective To create a clinical trial simulation tool that characterizes the natural history of PD progression and enables a data-driven design of randomized controlled studies testing potential disease-modifying treatments (DMT) in early-stage PD. Methods Data from the Parkinson's Progression Markers Initiative (PPMI) were analyzed with nonlinear mixed-effect modeling techniques to characterize the progression of MDS-UPDRS part I (non-motor aspects of experiences of daily living), part II (motor aspects of experiences of daily living), and part III (motor signs). A clinical trial simulation tool was built from these disease models and used to predict probability of success as a function of trial design. Results MDS-UPDRS part III progresses approximately 3 times faster than MDS-UPDRS part II and I, with an increase of 3 versus 1 points/year. Higher amounts of symptomatic therapy is associated with slower progression of MDS-UPDRS part II and III. The modeling framework predicts that a DMT effect on MDS-UPDRS part III could precede effect on part II by approximately 2 to 3 years. Conclusions Our clinical trial simulation tool predicted that in a two-year randomized controlled trial, MDS-UPDRS part III could be used to evaluate a potential novel DMT, while part II would require longer trials of a minimum duration of 3 to 5 years underscoring the need for innovative trial design approaches including novel patient-centric measures.
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Affiliation(s)
- Benjamin Ribba
- Roche Pharma Research and Early Development (pRED), Roche Innovation Center, F. Hoffmann-La Roche Ltd., Basel, Switzerland
| | - Tanya Simuni
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Kenneth Marek
- Institute for Neurodegenerative Disorders, New Haven, CT, USA
| | - Andrew Siderowf
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Cheikh Diack
- Roche Pharma Research and Early Development (pRED), Roche Innovation Center, F. Hoffmann-La Roche Ltd., Basel, Switzerland
| | - Philippe Bernard Pierrillas
- Roche Pharma Research and Early Development (pRED), Roche Innovation Center, F. Hoffmann-La Roche Ltd., Basel, Switzerland
| | - Annabelle Monnet
- Roche Product Development, F. Hoffmann La Roche Ltd., Basel, Switzerland
| | - Benedicte Ricci
- Roche Pharma Research and Early Development (pRED), Roche Innovation Center, F. Hoffmann-La Roche Ltd., Basel, Switzerland
| | - Tania Nikolcheva
- Roche Product Development, F. Hoffmann La Roche Ltd., Basel, Switzerland
| | - Gennaro Pagano
- Roche Pharma Research and Early Development (pRED), Roche Innovation Center, F. Hoffmann-La Roche Ltd., Basel, Switzerland
- University of Exeter Medical School, London, UK
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Zeissler ML, Boey T, Chapman D, Rafaloff G, Dominey T, Raphael KG, Buff S, Pai HV, King E, Sharpe P, O'Brien F, Carroll CB. Investigating trial design variability in trials of disease-modifying therapies in Parkinson's disease: a scoping review protocol. BMJ Open 2023; 13:e071641. [PMID: 38070893 PMCID: PMC10729184 DOI: 10.1136/bmjopen-2023-071641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 11/05/2023] [Indexed: 12/18/2023] Open
Abstract
INTRODUCTION Parkinson's disease (PD) is a debilitating neurological disorder for which the identification of disease-modifying interventions represents a major unmet need. Diverse trial designs have attempted to mitigate challenges of population heterogeneity, efficacious symptomatic therapy and lack of outcome measures that are objective and sensitive to change in a disease modification setting. It is not clear whether consensus is emerging regarding trial design choices. Here, we report the protocol of a scoping review that will provide a contemporary update on trial design variability for disease-modifying interventions in PD. METHODS AND ANALYSIS The Population, Intervention, Comparator, Outcome and Study design (PICOS) framework will be used to structure the review, inform study selection and analysis. The databases MEDLINE, Web of Science, Cochrane and the trial registry ClinicalTrials.gov will be systematically searched to identify published studies and registry entries in English. Two independent reviewers will screen study titles, abstracts and full text for eligibility, with disagreements being resolved through discussion or by a third reviewer where necessary. Data on general study information, eligibility criteria, outcome measures, trial design, retention and statistically significant findings will be extracted into a standardised form. Extracted data will be presented in a descriptive analysis. We will report our findings using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Review extension. ETHICS AND DISSEMINATION This work will provide an overview of variation and emerging trends in trial design choices for disease-modifying trials of PD. Due to the nature of this study, there are no ethical or safety considerations. We plan to publish our findings in a peer-reviewed journal.
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Affiliation(s)
- Marie-Louise Zeissler
- Newcastle University, Newcastle upon Tyne, UK
- Faculty of Health, University of Plymouth, Plymouth, UK
| | - Timothy Boey
- School of Medicine, University of Liverpool, Liverpool, Merseyside, UK
| | - Danny Chapman
- Faculty of Health, University of Plymouth, Plymouth, UK
| | - Gary Rafaloff
- Parkinson's Research Advocate, Westlake, Florida, USA
| | - Thea Dominey
- Faculty of Health, University of Plymouth, Plymouth, UK
| | - Karen G Raphael
- Oral & Maxillofacial, Radiology and Medicine, New York University, Brooklyn, New York, USA
- Parkinson's Research Advocate, New York, New York, USA
| | - Susan Buff
- Parkinson's Research Advocate, Sunnyvale, California, USA
| | | | - Emma King
- University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - Paul Sharpe
- Faculty of Health, University of Plymouth, Plymouth, UK
| | | | - Camille B Carroll
- Newcastle University, Newcastle upon Tyne, UK
- Faculty of Health, University of Plymouth, Plymouth, UK
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Giang WC, Zheng H, Gibson B, Patel B, Ramirez-Zamora A, Winter S, Jeghers M, Li Y, Classen S. Does in-vehicle automation help individuals with Parkinson's disease? A preliminary analysis. Front Neurol 2023; 14:1225751. [PMID: 37900602 PMCID: PMC10603248 DOI: 10.3389/fneur.2023.1225751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 09/18/2023] [Indexed: 10/31/2023] Open
Abstract
Introduction PD is a progressive neurodegenerative disorder that affects, according to the ICF, body systems (cognitive, visual, and motor), and functions (e.g., decreased executive functions, decreased visual acuity, impaired contrast sensitivity, decreased coordination)-all which impact driving performance, an instrumental activity of daily living in the domain of "Activity" and "Participation" according to the ICF. Although there is strong evidence of impaired driving performance in PD, few studies have explored the real-world benefits of in-vehicle automation technologies, such as in-vehicle information systems (IVIS) and advanced driver assistance systems (ADAS), for drivers with PD. These technologies hold potential to alleviate driving impairments, reduce errors, and improve overall performance, allowing individuals with PD to maintain their mobility and independence more safely and for longer periods. This preliminary study aimed to fill the gap in the literature by examining the impact of IVIS and ADAS on driving safety, as indicated by the number of driving errors made by people with PD in an on-road study. Methods Forty-five adults with diagnosed PD drove a 2019 Toyota Camry equipped with IVIS and ADAS features (Toyota Safety Sense 2.0) on a route containing highway and suburban roads. Participants drove half of the route with the IVIS and ADAS systems activated and the other half with the systems deactivated. Results The results suggest that systems that assume control of the driving task, such as adaptive cruise control, were most effective in reducing driving errors. Furthermore, individual differences in cognitive abilities, particularly memory, were significantly correlated with the total number of driving errors when the systems were deactivated, but no significant correlations were present when the systems were activated. Physical capability factors, such as rigidity and bradykinesia, were not significantly correlated with driving error. Discussion Taken together, these results show that in-vehicle driver automation systems can benefit drivers with PD and diminish the impact of individual differences in driver cognitive ability.
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Affiliation(s)
- Wayne C.W. Giang
- Department of Industrial and Systems Engineering, Herbert Wertheim College of Engineering, University of Florida, Gainesville, FL, United States
| | - Haolan Zheng
- Department of Industrial and Systems Engineering, Herbert Wertheim College of Engineering, University of Florida, Gainesville, FL, United States
| | - Beth Gibson
- Department of Occupational Therapy, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Bhavana Patel
- Department of Neurology, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Adolfo Ramirez-Zamora
- Department of Neurology, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Sandra Winter
- Department of Occupational Therapy, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Mary Jeghers
- Department of Occupational Therapy, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Yuan Li
- Department of Occupational Therapy, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Sherrilene Classen
- Department of Occupational Therapy, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
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Zou H, Goetz CG, Stebbins GT, Schrag A, Mestre TA, Luo S. Summing MDS-UPDRS Parts 1 + 2 (Non-motor and Motor Experience of Daily Living): The Patient's Voice. Mov Disord 2023; 38:1363-1364. [PMID: 37087725 PMCID: PMC10764068 DOI: 10.1002/mds.29417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 04/04/2023] [Indexed: 04/24/2023] Open
Affiliation(s)
- Haotian Zou
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Christopher G. Goetz
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Glenn T. Stebbins
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Anette Schrag
- University College London Institute of Neurology, University College London, London, United Kingdom
| | - Tiago A. Mestre
- Ottawa Hospital Research Institute, Brain and Mind Research Institute, University of Ottawa, Ottawa, Ontario, Canada
- Division of Neurology, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Sheng Luo
- Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina, USA
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