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Trial registered on ANZCTR
Registration number
ACTRN12613000359730
Ethics application status
Approved
Date submitted
27/03/2013
Date registered
5/04/2013
Date last updated
28/11/2019
Date data sharing statement initially provided
28/11/2019
Date results provided
28/11/2019
Type of registration
Retrospectively registered
Titles & IDs
Public title
Evaluating a targeted cognitive training program for the treatment of Freezing of Gait in Parkinson's Disease
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Scientific title
Can targeted cognitive training alleviate symptoms of freezing of gait in patients with Parkinson's Disease?
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Secondary ID [1]
281948
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Nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Freezing of Gait in Parkinson's Disease
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Condition category
Condition code
Neurological
288710
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0
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Parkinson's disease
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The intervention will comprise of a 7-week targeted cognitive training program, aimed at improving aspects of cognition including attention, set-shifting, and processing speed in Parkinson's Disease (PD) patients suffering from freezing of gait (FOG). The program will involve two 2-hour sessions per week where patients will engage in computer-based cognitive training in addition to taking part in group-based discussion. This will be conducted in a specifically designed computer-based cognitive training laboratory, based at the Brain & Mind Research Centre.
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Intervention code [1]
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Rehabilitation
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Comparator / control treatment
An active control group will be employed, matched for time investment, computer-based activity and clinician/researcher and social interaction. This group will watch educational videos relating to topics such as nature, geography and science, and answer corresponding questionnaires, in addition to taking part in group-based discussions.
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Control group
Active
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Outcomes
Primary outcome [1]
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Blinded assessment of time spent frozen during Timed Up-and-Go (TUG) test. This will be assessed on two occasions. Firstly, while taking their usual PD medication regime, and secondly on a morning where they have not taken their PD medication.
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Assessment method [1]
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Timepoint [1]
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Assessed within 3 weeks of final training session and compared with assessment within 3 weeks prior to the first training session
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Secondary outcome [1]
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Investigation of the neural correlates of any training induced changes using functional MRI scans.
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Assessment method [1]
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Timepoint [1]
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Assessed within 3 weeks of final training session and compared with assessment within 3 weeks prior to the first training session
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Secondary outcome [2]
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Measurement of any improvement in psychosocial functioning as assessed through the following questionnaires: Parkinson's Disease Quality of Life Questionnaire (PDQ-39), Hospital Anxiety & Depression Scale (HADS), SCOPA-SLEEP Questionnaire, Thinking Skills Questionnaire and the Cambridge Behavioral Inventory Revised (CBI-R).
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Assessment method [2]
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Timepoint [2]
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Assessed within 3 weeks of final training session and compared with assessment within 3 weeks prior to the first training session
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Secondary outcome [3]
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Measurement of improved cognitive performance as assessed through the following tests: Montreal Cognitive Assessment (MOCA), Hopkins Verbal Learning Test Revised (HAVLT-R), Wechsler Adult Inteligence Scale (WAIS-III) - Digit Span subtest, Trail Making Test A & B, Delis-Kaplan Executive Function System (DKEFS) - Verbal Fluency & Symbol Digit Modalities (Oral) subtests, Cambridge Neuropsychological Test Automated Battery (CANTAB) - Affective Go/No Go & Reaction Time subtests, & Test of Everyday Attention (TEA) – Visual Elevator subtest
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Assessment method [3]
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Timepoint [3]
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Assessed within 3 weeks of final training session and compared with assessment within 3 weeks prior to the first training session
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Eligibility
Key inclusion criteria
This study will recruit 100 PD patients with a clinical history of FOG. We aim to recruit participants based on information obtained from medical assessments (including subjective report of symptoms and Mini Mental State Examination (MMSE) score of 24 or greater) as well as self-report measures of freezing (e.g. a positive score on question 3 of the FOG Questionnaire) completed at the PD Research Clinic located at the Brain and Mind Centre.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
MMSE of less than 24
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Participants will be approached via telephone based on previous medical and neuropsychological assessments at the PD Research Clinic to see if they are interested in taking part in the trial. Other participants may approach the clinic based on advertisement of the trial. Participants will then be sent out detailed information regarding the project in addition to consent forms. Participants will be allocated to groups using a blocked randomisation method conducted by a member of the clinical research team who is not in any way involved in the recruitment, assessment or training in the study. After baseline assessments, participants will receive a sealed envelope with a letter informing them about which group they have been allocated to. The envelopes are prepared by a person who is not involved in the assessment or training in the study.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Participants will be randomised at the time of the baseline assessment using a randomly generated number sequence allocated by a blinded researcher not involved in trial recruitment, data gathering, assessments or training. Randomisation will be undertaken using permuted blocks and stratified by cognitive functioning, with strata defined by MOCA scores of 'less than 26' or 'equal or greater than 26'
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people assessing the outcomes
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Intervention assignment
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/03/2013
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Actual
2/04/2013
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Date of last participant enrolment
Anticipated
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Actual
23/07/2015
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Date of last data collection
Anticipated
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Actual
7/10/2015
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Sample size
Target
100
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Accrual to date
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Final
65
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Recruitment in Australia
Recruitment state(s)
NSW
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Funding & Sponsors
Funding source category [1]
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Charities/Societies/Foundations
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Name [1]
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Michael J Fox Foundation
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Address [1]
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The Michael J. Fox Foundation for Parkinson's Research
Grand Central Station
P.O. Box 4777
New York, NY 10163-4777
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Country [1]
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United States of America
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Primary sponsor type
Individual
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Name
Professor Simon JG Lewis
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Address
Brain & Mind Centre
100 Mallett Street,
Camperdown, 2050,
Sydney, New South Wales
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
285503
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Country [1]
285503
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Human Ethics Committee, University of Sydney
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Ethics committee address [1]
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Level 6 Jane Foss Russell Building G02 University of Sydney NSW 2006
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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Approval date [1]
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13/01/2013
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Ethics approval number [1]
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Protocol No. 2012/2915
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Summary
Brief summary
We will evaluate whether a course of cognitive training can reduce symptoms of FOG in PD. This study will randomize patients into either a 7-week program of cognitive training or a sham control condition. Treatment response will be assessed by video recordings of specific walking tasks (TUG), taken before and after training. In addition, functional brain imaging whilst patients perform a validated virtual reality gait paradigm will be used to determine the brain activation patterns associated with improvements in FOG. This project will hopefully identify an effective novel treatment for FOG that does not involve pharmacological or surgical intervention. The use of brain imaging will also allow us to see why patients might have differential responses to therapy. Identifying the nature of these relationships will hopefully advance our understanding of freezing and lead to new directions for targeting therapy.
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Trial website
http://sydney.edu.au/bmri/research/mental-health-clinical/ageing-brain.php#parkinsons
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Trial related presentations / publications
Lewis, S. J. G. & Barker, R. A. (2009). A pathophysiological model of freezing of gait in Parkinson's disease. Parkinsonism and Related Disorders, 15(5), 333-8 Naismith, S. L., Shine, J. M. & Lewis, S. J. (2010). The specific contributions of set-shifting to freezing of gait in Parkinson's disease. Movement Disorders, 25(8), 1000-4 Shine, J. M., Naismith, S. L. & Lewis, S. J. (2012). The differential yet concurrent contributions of motor, cognitive and affective disturbance to freezing of gait in Parkinson's disease. Clinical Neurology and Neurosurgery: In Press Shine, J. M., Ward, P. B., Naismith, S. L., Pearson, M. & Lewis, S. J. G. (2011). Utilising functional MRI (fMRI) to explore the freezing phenomenon in Parkinson's disease. Journal of Clinical Neuroscience, 18(6), 807-10 Naismith, S. L., Mowszowski, L., Diamond, K. & Lewis, S. J. G. (In Press). Improved memory in Parkinson's Disease: A healthy brain ageing cognitive training program. Movement Disorders.
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Public notes
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Contacts
Principal investigator
Name
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Prof Simon Lewis
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Address
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Brain & Mind Centre
100 Mallett Street,
Camperdown, 2050,
Sydney, New South Wales
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Country
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Australia
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Phone
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+61 2 9351 0702
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Simon Lewis
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Address
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Brain & Mind Centre
100 Mallett Street,
Camperdown, 2050,
Sydney, New South Wales
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Country
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Australia
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Phone
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+61 2 9351 0702
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Simon Lewis
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Address
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Brain & Mind Centre
100 Mallett Street,
Camperdown, 2050,
Sydney, New South Wales
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Country
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Australia
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Phone
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+61 2 9351 0702
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Fax
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Cognitive training for freezing of gait in Parkinson's disease: a randomized controlled trial.
2018
https://dx.doi.org/10.1038/s41531-018-0052-6
N.B. These documents automatically identified may not have been verified by the study sponsor.
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