Clinical Trial for Near Infrared Endoventricular Illumination for Neuroprotection in Very Early Cases of Parkinson's Disease (Ev-NIRT) (Ev-NIRT)

  • STATUS
    Recruiting
  • End date
    May 25, 2026
  • participants needed
    14
  • sponsor
    University Hospital, Grenoble
Updated on 25 May 2022

Summary

Parkinson's disease has only pharmacological (essentially dopaminergic) and surgical treatment (essentially high-frequency deep brain stimulation), that are symptomatically effective. none of them is curative, and has the ability to slow down the disease and to protect dopaminergic neurons from death by neurodegeneration. Experimental results, based on preclinical studies, suggest that brain illumination in the Near-InfraRed (NIR) range is likely to slow down this neurodegenerative process.

Thus, a medical device system (called Ev-NIRT) has been developed for 670 nm intracerebral illumination of the substantia nigra pars compacta (SNpc), and is planned to be tested for the treatment of Parkinson's disease.

In this pilot study the investigators will evaluate the feasibility and tolerance of surgery and brain illumination thanks to the Ev-NIRT medical device, in a group of 7 de novo Parkinson's patients implanted with the innovative medical device. Patients will be monitored for 4 years.

Description

The level of neuroprotection induced by illumination at 670nm appears effective in preclinical studies, and justify the transfer into a clinical trial. The investigators currently have developed and produced implantable devices, to be implanted into the brain through a minimally invasive endoventricular route. The electrical energy required is supplied by the batteries adapted from those used for deep brain stimulation.

The feasibility of trans ventricular implantation is ensured by the experience gained by our team in the endoventricular stimulation of the posterior hypothalamus in the cluster headache.

In this clinical study, the investigators will evaluate the tolerance and safety of intraventricular surgical technic and illumination by the Ev-NIRT medical device implanted into the brain of 7 patients with Parkinson's disease. idiopathic, aged 25-65 years, at a very early stage (less than 2 years of evolution). The NIR illumination will begin immediately after surgery.

The investigators will also evaluate secondarily, the neuroprotective effect of this new treatment modality, by comparing the decrease of dopaminergic neurons by Positron Emission Tomography (PET)-scan using [11C]PE2I) tracer of implanted patients to that of a control group of 7 patients whose characteristics in terms of duration of evolution and clinical severity are identical, but who are not implanted, and therefore not exposed to NIR illumination.

The PET-scan-PE2I exam is conducted in both groups annually for 4 years (a total of 5 measurements) and compared to the PE2I PET obtained at the beginning of participation in the study. A group-wide comparison will be made between the NIR group and the control group.

Details
Condition Very Early Stage of Parkinson's Disease
Treatment Ev-NIRT
Clinical Study IdentifierNCT04261569
SponsorUniversity Hospital, Grenoble
Last Modified on25 May 2022

Eligibility

Yes No Not Sure

Inclusion Criteria

Clinically diagnosed idiopathic Parkinson's disease according to MDS criteria developed by R.B. Postuma (Anang et al, Neurology, 2014)
Dopaminergic denervation confirmed in PET [11C]PE2I with a decrease in tracer fixation at the striatum level of at least 30% on average compared to the white matter fixation of the cerebellum
Patients willing to start dopaminergic treatment
Very early stage of the disease
Diagnosis of recent Parkinson's disease (less than two years after a neurologist's diagnosis)
Hoehn and Yahr Stage 1 to 2
Maximum 2 tremor on the MDS-UPDRS scale
Naive of any anti-Parkinsonian treatment
Between 25 and 65 years of age
Score on Beck Depression Inventory (BDI) scale below the value of 20
Easy handling of the French language in oral and written language
Social security affiliates or beneficiaries of such a scheme
Informed and written consent signed by the patient

Exclusion Criteria

All categories of protected persons: pregnant woman, parturient, breastfeeding mother, person deprived of liberty by judicial or administrative decision, person subject to a measure of legal protection, hospitalized for psychiatric disorder
Carcinological history in the previous 5 years, not stabilized
Uncontrolled medical condition that may lead to complications
Preoperative brain Magnetic Resonance Imaging (MRI) showing brain damage that may be responsible for Parkinson's syndrome or a significant surgical risk (e.g. vascular malformation)
Surgical or anesthetic contraindication
History of brain infection with herpes virus
Contraindication to MRI (claustrophobia, non-compatible mri metal prosthesis, etc.)
Predictable need for frequent use of MRI scans after surgery
Unstabilized psychotropic treatment
Patient with cognitive impairment at the outset of illness (Montreal Cognitive Assessment (MoCA) score - 26)
Atypias suspecting atypical Parkinson's syndrome
Chronic treatment with L-Dopa or dopamine agonist
Presence of another serious pathology (major depressive episode, suicidal patient, active psychosis ...)
Participation in another interventional clinical trial
Wearing pace makers other than brain
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