Cough According to Stimulus Type in PD
| Status: | Completed |
|---|---|
| Conditions: | Parkinsons Disease |
| Therapuetic Areas: | Neurology |
| Healthy: | No |
| Age Range: | 50 - 80 |
| Updated: | 2/17/2019 |
| Start Date: | April 2015 |
| End Date: | February 13, 2019 |
Airway Protection Deficits According to Stimulus Type in Parkinson's Disease
Aspiration pneumonia (APn) occurs at a higher rate in patients with Parkinson's disease (PD)
versus healthy adults. This is of particular public health concern given that death secondary
to aspiration pneumonia and lung infection is a leading cause of death in persons with PD.
Swallowing and cough function are affected in PD, putting people with PD at significant risk
for uncompensated aspiration (aspiration without adequate cough response). One challenge in
the management of airway protective deficits related to PD is the chronic and progressive
nature of the disease, where swallowing dysfunction appears subtly in the form of
microaspiration, reducing the perceived urgency of the swallowing disorder by both clinicians
and patients. The long-term goal of this research is to advance the management of airway
protection deficits in patients with neurodegenerative disease in order to decrease morbidity
and mortality due to aspiration related lung infection. The objective here is to further
specify deficits leading to uncompensated airway compromise in PD in order to advance the
clinical management of these patients, leading to an immediate positive impact.
versus healthy adults. This is of particular public health concern given that death secondary
to aspiration pneumonia and lung infection is a leading cause of death in persons with PD.
Swallowing and cough function are affected in PD, putting people with PD at significant risk
for uncompensated aspiration (aspiration without adequate cough response). One challenge in
the management of airway protective deficits related to PD is the chronic and progressive
nature of the disease, where swallowing dysfunction appears subtly in the form of
microaspiration, reducing the perceived urgency of the swallowing disorder by both clinicians
and patients. The long-term goal of this research is to advance the management of airway
protection deficits in patients with neurodegenerative disease in order to decrease morbidity
and mortality due to aspiration related lung infection. The objective here is to further
specify deficits leading to uncompensated airway compromise in PD in order to advance the
clinical management of these patients, leading to an immediate positive impact.
The study will be completed in one visit, and take about an hour. All study procedures are
done in the investigators quiet clinical research area at the Center for Movement Disorders
and Neurorestoration (Room 7). If participants agree to be in this research study, after
participants sign the informed consent form, the investigators will ask participants some
questions related to participants health history. These questions include:
Do participants have a history of any breathing disorders or diseases (asthma,
emphysema/chronic obstructive pulmonary disease (COPD), etc), or severe chest injury?
- Do participants have any history of stroke, or any neurologic disease besides
Parkinson's disease?
- Have participants smoked in the last 5 years?
- Have participants had any chest infections within the last 5 the weeks?
- Do participants have a history of head and neck cancer?
- Are participants allergic to capsaicin, hot peppers, Zostrix cream, or other medicines?
The investigators will ask these questions to make sure participants do not have a history of
any illnesses that would affect their ability to cough or that would make it unsafe for them
to participate. If participants answer yes to any of these questions, they will not be able
to continue in the study.
Next, the investigators will begin to measure participants reflex cough. First, the
investigators will attach a small microphone with a clip to participants shirt that will
record participants cough responses. The investigators will have participants inhale a "hot
pepper" vapor at five different concentrations. The hot pepper vapors will be separately
delivered through a mouthpiece attached to a hand-held nebulizer (a device that makes vapors
out of liquids). The investigators will deliver each type of vapor to participants 3 times
each for a total of 15 presentations. After inhaling each vapor and coughing if participants
need to, the investigators will ask participants to rate their urge to cough using a scale of
0-10, with 0 equaling no urge to cough, and 10 equaling the greatest urge to cough. If
participants do not cough to any of the vapors, the investigators will present one final
stronger dose. There will be a 2 minute break in between each presentation of the vapor, and
water will be available at all times throughout the study. This will take approximately 40
minutes.
Next, the investigators will continue to measure participants reflex cough using a slightly
different test. The investigators will have participants inhale water vapor (fog) and a low
concentration of hot pepper vapor. Both types of vapor will be in separate nebulizers, like
the ones the investigators just used. For these vapors, participants will breathe in and out
through the nebulizer's mouthpiece until participants cough, or for up to 1 minute. The
investigators will try each one 3 times, for a total of 6 tries.
done in the investigators quiet clinical research area at the Center for Movement Disorders
and Neurorestoration (Room 7). If participants agree to be in this research study, after
participants sign the informed consent form, the investigators will ask participants some
questions related to participants health history. These questions include:
Do participants have a history of any breathing disorders or diseases (asthma,
emphysema/chronic obstructive pulmonary disease (COPD), etc), or severe chest injury?
- Do participants have any history of stroke, or any neurologic disease besides
Parkinson's disease?
- Have participants smoked in the last 5 years?
- Have participants had any chest infections within the last 5 the weeks?
- Do participants have a history of head and neck cancer?
- Are participants allergic to capsaicin, hot peppers, Zostrix cream, or other medicines?
The investigators will ask these questions to make sure participants do not have a history of
any illnesses that would affect their ability to cough or that would make it unsafe for them
to participate. If participants answer yes to any of these questions, they will not be able
to continue in the study.
Next, the investigators will begin to measure participants reflex cough. First, the
investigators will attach a small microphone with a clip to participants shirt that will
record participants cough responses. The investigators will have participants inhale a "hot
pepper" vapor at five different concentrations. The hot pepper vapors will be separately
delivered through a mouthpiece attached to a hand-held nebulizer (a device that makes vapors
out of liquids). The investigators will deliver each type of vapor to participants 3 times
each for a total of 15 presentations. After inhaling each vapor and coughing if participants
need to, the investigators will ask participants to rate their urge to cough using a scale of
0-10, with 0 equaling no urge to cough, and 10 equaling the greatest urge to cough. If
participants do not cough to any of the vapors, the investigators will present one final
stronger dose. There will be a 2 minute break in between each presentation of the vapor, and
water will be available at all times throughout the study. This will take approximately 40
minutes.
Next, the investigators will continue to measure participants reflex cough using a slightly
different test. The investigators will have participants inhale water vapor (fog) and a low
concentration of hot pepper vapor. Both types of vapor will be in separate nebulizers, like
the ones the investigators just used. For these vapors, participants will breathe in and out
through the nebulizer's mouthpiece until participants cough, or for up to 1 minute. The
investigators will try each one 3 times, for a total of 6 tries.
Inclusion Criteria:
- Within age limits
- For PD group: confirmed diagnosis of idiopathic parkinson's disease
Exclusion Criteria:
- Uncontrolled hypertension
- Difficulty complying due to neuropsychological dysfunction (i.e., severe depression)
- Allergy to capsaicin or hot peppers
- History of head or neck cancer
- Neurological disorders other than PD (i.e., stroke, etc.)
1. control participants only: any history of neurologic disorders including PD
- History of smoking in the last 5 years
- Breathing disorders or diseases
We found this trial at
1
site
Gainesville, Florida 32607
Phone: 352-273-3805
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