This study will examine the effects of lithium 20mg/day compared to placebo on MRI and blood-based biomarkers among 20 early-stage Parkinson's disease patients.
In observational studies, small daily doses of lithium have been associated with a 77% reduced risk of developing Parkinson's disease (PD). In addition, lithium therapy has been effective in preventing neuronal death and behavioral symptoms in several PD animal models. Recently, our group has shown 24-weeks of low-dose lithium therapy in PD to improve both MRI and blood-based biomarkers implying that lithium may be slowing the progression of the disease. However, these findings stem from only three of four patients receiving MRIs. A larger study will be required to determine if these promising results can be replicated. The proposed study will enroll 20 additional PD patients who will be randomly assigned to receive either lithium 20mg/day or identically-appearing placebo capsules for 24 weeks. This will be a double-blind study meaning that neither the patients nor the study team will know to which therapy patients have been assigned. Positive results from this study will support further research on lithium that could eventually support lithium as a disease-modifying therapy for PD that could improve patients' long-term prognoses.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
20
UBMD Neurology
Williamsville, New York, United States
MRI-derived free water (FW) levels.
FW in the posterior substantia nigra (pSN), dorsomedial nucleus of the thalamus (DMN-T) and the nucleus basalts of Meynert (nbM).
Time frame: Change from baseline (BL) to 24 week
Peripheral blood mononuclear cell (PBMC) nuclear receptor-related 1 protein (Nurr1) mRNA expression
PBMC Nurr1 mRNA expression using Taqman PCR.
Time frame: Change from baseline (BL) to 24 week
Serum neurofilament light chain (NfL)
Serum NfL assessed using SIMOA platform by Quanterix (Lexington, MA)
Time frame: Change from baseline (BL) to 24 week
PBMC superoxide dismutase type-1 (SOD-1) mRNA expression
PBMC SOD-1 mRNA expression using Taqman PCR
Time frame: Change from baseline (BL) to 24 week
PBMC pS9/total glycogen synthase kinase-3B (GSK-3B) ratio
Assessed using ELISA
Time frame: Change from baseline (BL) to 24 week
PBMC pThr308 and pS473/total protein kinase B (Akt) ratios
Assessed using ELISA
Time frame: Change from baseline (BL) to 24 week
Serum interleukin-6
Assessed using ELISA
Time frame: Change from baseline (BL) to 24 week
Serum glial fibrillary acidic protein (GFAP)
Serum GFAP assessed using SIMOA platform by Quanterix (Lexington, MA)
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Time frame: Change from baseline (BL) to 24 week
Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part III (Motor Examination)
Assessed in the "on" state. Score range 0-132 with higher scores indicating worse outcomes.
Time frame: Change from baseline (BL) to 24 week
Montreal Cognitive Assessment (MoCA)
Score range 0-30 with higher scores indicating better outcomes.
Time frame: Change from baseline (BL) to 24 week
Parkinson's Anxiety Scale
Score range 0-48 with higher scores indicating worse outcomes.
Time frame: Change from baseline (BL) to 24 week
Geriatric Depression Scale-15
Score range 0-15 with higher scores indicating worse outcomes.
Time frame: Change from baseline (BL) to 24 week
Fatigue Severity Scale
Score range 9-63 with higher scores indicating worse outcomes.
Time frame: Change from baseline (BL) to 24 week
Insomnia Severity Index
Score range 0-28 with higher scores indicating worse outcomes.
Time frame: Change from baseline (BL) to 24 week
Parkinson's Disease Questionnaire-8
Score range 0-32 with higher scores indicating worse outcomes.
Time frame: Change from baseline (BL) to 24 week
Levodopa equivalent daily dose (LEDD)
Higher scores indicate higher dose of dopaminergic therapy.
Time frame: Change from baseline (BL) to 24 week