To explore the safety, feasibility and net symptomatic effects of multiple (3x/week, for 4 weeks) intermittent hypoxia treatment sessions in individuals with PD. Secondary outcomes include exploring induction of relevant neuroprotective pathways as measured in serum.
Intermittent hypoxia therapy is a non-pharmacological intervention used by athletes and individuals with cardiovascular disease, amongst others. The safety and feasibility of (intermittent) hypoxia therapy and its short-term effects on Parkinson's disease (PD) symptoms were assessed in a previous exploratory phase I trial. However, the net effects of multiple hypoxia treatment sessions on PD symptoms are unknown. The results of the previous phase I trial informed the study design of the newly proposed phase 1b-2a safety and efficacy trial. 45 minutes of normobaric intermittent hypoxia (FiO2 0.16 for 5 minutes interspersed with 5 minutes normoxia) will be delivered via a hypoxicator (a device that titrates decreased fractional oxygen from room air) through an oxygen mask in the hospital and subsequently at participants' homes. Interventions will be conducted 3 times a week, for 4 weeks in total.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
40
Commercially available hypoxic generator, modified to allow for convenient remote interventions by non-expert participants.
Commercially available hypoxic generator, modified to allow for convenient remote interventions by non-expert participants, without active elements.
Dpt. of Physiology, Radboud University Medical Center
Nijmegen, Netherlands
Radboud University Medical Center
Nijmegen, Netherlands
Number and nature of adverse events
Time frame: 2 months
Feasibility questionnaire, overall study success
Higher indicates better score
Time frame: 1 month
MDS-UPDRS part II and III
Lower indicates better score
Time frame: 1 month
Purdue pegboard test (PPT)
Higher indicates better score
Time frame: 1 month
Timed up & Go Test (TUGT)
Lower indicates better score
Time frame: 1 month
Exercise tolerance (6-minute walk test, 6MWT)
Higher indicates better score
Time frame: 1 month
Accelerometry data for tremor amplitude
Lower indicates better score
Time frame: 1 month
Accelerometry data for pronation-supination
Higher indicates better score
Time frame: 1 month
Hematocrit
Higher indicates better result
Time frame: 1 month
Neurofilament light chain (NfL)
Higher indicates better result
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Time frame: 1 month
BDNF
Higher indicates better result
Time frame: 1 month
Platelet-derived growth factor receptor beta (PDGFRβ)
Higher indicates better result
Time frame: 1 month
Clusterin
Higher indicates better result
Time frame: 1 month
GFAP
Higher indicates better result
Time frame: 1 month
UCH-L1
Higher indicates better result
Time frame: 1 month