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Trial registered on ANZCTR
Registration number
ACTRN12623000147684
Ethics application status
Approved
Date submitted
2/02/2023
Date registered
14/02/2023
Date last updated
14/02/2023
Date data sharing statement initially provided
14/02/2023
Type of registration
Retrospectively registered
Titles & IDs
Public title
A ten-year study on the effects of strategic light exposure on the primary and secondary features of Parkinson's disease.
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Scientific title
A ten-year study on the use of light treatment on the prodromal, motoric and psychiatric symptoms of Parkinson's disease.
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Secondary ID [1]
308623
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Bronowski Institute BIBN 02207
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Universal Trial Number (UTN)
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Trial acronym
LT10-PD
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Parkinson's disease
328890
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Condition category
Condition code
Neurological
325883
325883
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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 involves exposure to polychromatic light (Light Therapy) emitted from a medical device specifically designed to treat the motor impairment, insomnia, fatigue, depression and anxiety of Parkinson’s disease. As is the case for treatment of other disorders with these symptoms (such as Seasonal Affective Disorder: SAD), patients will be treated for 1 hour per day with a measure amount of light at 3,000 to 5,000 LUX. Patients will be monitored and assessed during face-to-face consultations on a regularly scheduled basis. This is to ensure that the light is delivered to optimize phototransduction and to maximize the therapeutic effect. The duration of treatment will be for at least 2 months, up to 10 years. The treatment will be delivered and guided by a clinician with over 30 years of experience in treating sleep and psychiatric disorders using this methodology. The patient will be thoroughly briefed and monitored to ensure the light is delivered at the right time in the circadian cycle. The device will be used at home for an hour and ongoing device use will be monitored to ensure compliance. The Chief Investigator will be in contact with other health professionals to ensure treatment is compatible with other ongoing treatments. Treatments will be delivered daily at the critical time in the circadian cycle and patients will be monitored/assessed every week to week and a half.
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Intervention code [1]
325342
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Treatment: Devices
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Comparator / control treatment
No control group per se is purposely employed as patients are part of an ongoing clinic. However, performance measures before the patient undergoes treatment is employed as the starting baseline and serves as the control measures. As it is the standard practice in the clinic, the efficacy of any treatment is achieved by making statistical comparisons with the baseline measures.
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Control group
Active
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Outcomes
Primary outcome [1]
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Primary Outcome 1: Change in the time to sleep and time to awaken as a result of 1 hour of light exposure. The instrument employed will be a sleep diary kept by the patient and by structured interview.
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Assessment method [1]
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Timepoint [1]
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Timepoint: The time points for this study are just prior to commencing treatment and then at the following intervals of 1 month, 2 months, 3 months, 4 months, 5 months, 6 months, then every 4 to 6 months thereafter, for as long as the patient remains in the program. The final assessment for the study will occur as close as is possible to 10 years, from the time treatment commenced. Primary Timepoints: The Primary time points for this study are just prior to commencing treatment and then at each year for years 1 through 10.
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Primary outcome [2]
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Primary Outcome 2: Change in sleep features including the total amount of sleep, the number of awakenings, and how readily the patient falls back to sleep as a result of 1 hour of light exposure. All sleep features will be analyzed together. The instrument employed will be a sleep diary kept by the patient and by structured interview.
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Assessment method [2]
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Timepoint [2]
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Timepoint: The time points for this study are just prior to commencing treatment and then at the following intervals of 1 month, 2 months, 3 months, 4 months, 5 months, 6 months, then every 4 to 6 months thereafter, for as long as the patient remains in the program. The final assessment for the study will occur as close as is possible to 10 years, from the time treatment commenced. Primary Timepoints: The Primary time points for this study are just prior to commencing treatment and then at each year for years 1 through 10.
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Primary outcome [3]
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Primary Outcome 3: Change in REM sleep behaviour disorder (RSBD) as a result of 1 hour of light exposure. The instrument employed will be a sleep diary kept by the patient and by structured interview.
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Assessment method [3]
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Timepoint [3]
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Timepoint: The time points for this study are just prior to commencing treatment and then at the following intervals of 1 month, 2 months, 3 months, 4 months, 5 months, 6 months, then every 4 to 6 months thereafter, for as long as the patient remains in the program. The final assessment for the study will occur as close as is possible to 10 years, from the time treatment commenced. Primary Timepoints: The Primary time points for this study are just prior to commencing treatment and then at each year for years 1 through 10.
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Secondary outcome [1]
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Secondary Outcome 1: Change in Fatigue as a result of 1 hour of light exposure. The instrument employed will be by structured interview and rated on a Likert scale rated in severity from 1 to 10 with 10 being the most severe.
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Assessment method [1]
418058
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Timepoint [1]
418058
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Timepoint: The time points for this study are just prior to commencing treatment and then at the following intervals of 1 month, 2 months, 3 months, 4 months, 5 months, 6 months, then every 4 to 6 months thereafter, for as long as the patient remains in the program. The final assessment for the study will occur as close as is possible to 10 years, from the time treatment commenced.
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Secondary outcome [2]
418059
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Secondary Outcome 2: Change in motor performance on the timed motor test (Elbow to fist) as a result of 1 hour of light exposure. The instrument employed will be by clinical assessment and will be timed and expressed in seconds.
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Assessment method [2]
418059
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Timepoint [2]
418059
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Timepoint: The time points for this study are just prior to commencing treatment and then at the following intervals of 1 month, 2 months, 3 months, 4 months, 5 months, 6 months, then every 4 to 6 months thereafter, for as long as the patient remains in the program. The final assessment for the study will occur as close as is possible to 10 years, from the time treatment commenced.
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Secondary outcome [3]
418061
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Secondary Outcome 3: Change in motor performance on the timed motor test (floor to knee) as a result of 1 hour of light exposure. The instrument employed will be by clinical assessment and will be timed and expressed in seconds.
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Assessment method [3]
418061
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Timepoint [3]
418061
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Timepoint: The time points for this study are just prior to commencing treatment and then at the following intervals of 1 month, 2 months, 3 months, 4 months, 5 months, 6 months, then every 4 to 6 months thereafter, for as long as the patient remains in the program. The final assessment for the study will occur as close as is possible to 10 years, from the time treatment commenced.
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Secondary outcome [4]
418062
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Secondary Outcome 4: Change in depression (affect) as a result of 1 hour of light exposure. The instrument employed will be by clinical assessment rated on a Likert scale rated in severity from 1 to 10 with 10 being the most severe.
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Assessment method [4]
418062
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Timepoint [4]
418062
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Timepoint: The time points for this study are just prior to commencing treatment and then at the following intervals of 1 month, 2 months, 3 months, 4 months, 5 months, 6 months, then every 4 to 6 months thereafter, for as long as the patient remains in the program. The final assessment for the study will occur as close as is possible to 10 years, from the time treatment commenced.
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Secondary outcome [5]
418063
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Secondary Outcome 5: Change in dyskinesia as a result of 1 hour of light exposure. The instrument employed will be by structured interview and rated on a Likert scale rated in severity from 1 to 10 with 10 being the most severe.
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Assessment method [5]
418063
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Timepoint [5]
418063
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Timepoint: The time points for this study are just prior to commencing treatment and then at the following intervals of 1 month, 2 months, 3 months, 4 months, 5 months, 6 months, then every 4 to 6 months thereafter, for as long as the patient remains in the program. The final assessment for the study will occur as close as is possible to 10 years, from the time treatment commenced.
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Secondary outcome [6]
418064
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Secondary Outcome 6: Change in Parkinsonian primary feature of Bradykinesia as a result of 1 hour of light exposure. The instrument employed will be by structured interview and rated on a Likert scale rated in severity from 1 to 10 with 10 being the most severe.
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Assessment method [6]
418064
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Timepoint [6]
418064
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Timepoint: The time points for this study are just prior to commencing treatment and then at the following intervals of 1 month, 2 months, 3 months, 4 months, 5 months, 6 months, then every 4 to 6 months thereafter, for as long as the patient remains in the program. The final assessment for the study will occur as close as is possible to 10 years, from the time treatment commenced.
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Secondary outcome [7]
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Secondary Outcome 7: Change in anxiety as a result of 1 hour of light exposure. The instrument employed will be by structured interview and rated on a Likert scale rated in severity from 1 to 10 with 10 being the most severe.
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Assessment method [7]
418065
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Timepoint [7]
418065
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Timepoint: The time points for this study are just prior to commencing treatment and then at the following intervals of 1 month, 2 months, 3 months, 4 months, 5 months, 6 months, then every 4 to 6 months thereafter, for as long as the patient remains in the program. The final assessment for the study will occur as close as is possible to 10 years, from the time treatment commenced.
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Secondary outcome [8]
418368
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Secondary Outcome 6: Change in Parkinsonian primary feature of Rigidity as a result of 1 hour of light exposure. The instrument employed will be by structured interview and rated on a Likert scale rated in severity from 1 to 10 with 10 being the most severe.
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Assessment method [8]
418368
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Timepoint [8]
418368
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Timepoint: The time points for this study are just prior to commencing treatment and then at the following intervals of 1 month, 2 months, 3 months, 4 months, 5 months, 6 months, then every 4 to 6 months thereafter, for as long as the patient remains in the program. The final assessment for the study will occur as close as is possible to 10 years, from the time treatment commenced.
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Secondary outcome [9]
418369
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Secondary Outcome 6: Change in Parkinsonian primary feature of Tremor as a result of 1 hour of light exposure. The instrument employed will be by structured interview and rated on a Likert scale rated in severity from 1 to 10 with 10 being the most severe.
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Assessment method [9]
418369
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Timepoint [9]
418369
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Timepoint: The time points for this study are just prior to commencing treatment and then at the following intervals of 1 month, 2 months, 3 months, 4 months, 5 months, 6 months, then every 4 to 6 months thereafter, for as long as the patient remains in the program. The final assessment for the study will occur as close as is possible to 10 years, from the time treatment commenced.
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Eligibility
Key inclusion criteria
Any patient diagnosed with Parkinson's disease by a qualified medical practitioner. Being an exploratory trial, we are examining the generalizability of any therapeutic effects to the general diagnosis of Parkinson's disease.
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Minimum age
No limit
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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
Nil
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
All patients are assigned to the treatment group when they enter the clinic.
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
As is standard operating procedure in the research clinic, statistical comparisons will be made at pre-selected time points at 1 month and 1,2,3,4,5,6,7 thru 10 years after entering the program, each compared to the baseline score. Using the same statistical approach as in previous work we first determine the suitability applying parametric analysis using an ANOVA for repeated measures. The data will be tested for homogeneity of variance and skewedness so as not to violate any assumptions of parametric testing. On this basis, if parametric analysis cannot be applied than non-parametric analysis will be employed. Due to the decreasing number of patients at each time point attributable to the natural attrition of patient numbers over such a long time period, a Related Samples Wilcoxon Signed Rank Test will be used comparing the baseline measurement before treatment with each time point thereafter. If multiple comparisons are employed then a Bonferroni correction will be applied. Tables and graphs will be constructed to accommodate the most meaningful expression of data.
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Recruitment
Recruitment status
Active, not recruiting
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Date of first participant enrolment
Anticipated
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Actual
10/01/2012
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Date of last participant enrolment
Anticipated
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Actual
15/06/2018
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Date of last data collection
Anticipated
15/02/2023
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Actual
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Sample size
Target
114
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Accrual to date
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Final
114
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment postcode(s) [1]
39390
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3442 - Woodend North
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Funding & Sponsors
Funding source category [1]
312862
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Charities/Societies/Foundations
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Name [1]
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Dr Gregory L. Willis
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Address [1]
312862
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The Bronowski Clinic
40 Davy Street
Woodend, Vic. 3442
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Country [1]
312862
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Australia
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Primary sponsor type
Charities/Societies/Foundations
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Name
The Bronowski Institute of Behavioural Neuroscience
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Address
40 Davy Street
Woodend, Vic 3442 Australia
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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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N/A
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Address [1]
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N/A
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Country [1]
314520
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
312139
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The Bronowski Institute Ethical Standards Committee (ESC)
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Ethics committee address [1]
312139
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40 Davy Street, Woodend VIC, Australia
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Ethics committee country [1]
312139
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Australia
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Date submitted for ethics approval [1]
312139
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01/12/2011
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Approval date [1]
312139
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14/12/2011
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Ethics approval number [1]
312139
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BRON-LT2-APRCONF-5-12-22
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Summary
Brief summary
The involvement of the circadian system is becoming an increasingly important topic in respect to the aetiology and treatment of Parkinson’s disease (PD). PD is traditionally described as, a disorder predominantly of motor impairment, mediated by nigro-striatal DA (NSD) function. However, the secondary symptoms that proceed and accompany the disease during its course tell a different story. Insomnia, fatigue, depression and sleep disturbance are four of the most troublesome symptoms of PD that not only herald disease onset but also exacerbate primary symptoms and rob patients of their quality of life. Realigning circadian phase is the mechanism by which we can intervene in circadian function and phototherapy is the most effective method for doing so. Unfortunately, only a few studies have examined the efficacy of phototherapy as it relates to the protracted, ongoing nature of the disease itself. The present study examines the effect of light treatment for as long as ten years during the course of PD by monitoring primary and secondary symptoms at regular intervals. Improvement in circadian based symptoms observed including insomnia, fatigue, sleep architecture and depression may occur, and it is hypothesized that motor function will be subtle and occur incrementally. It is hypothesized that Improvement in both motor and secondary symptoms will occur for the duration of the study as long as patients used the treatment daily. The sequence of symptom recovery from secondary symptoms to motor impairment is expected to be slow suggesting that an incremental process of improvement is in tow, representing an inverse of the degenerative sequelae that continues over decades. Such a process would emulate the slow incremental process that characterizes the reparative process seen with pure disorders of circadian function. Recent findings suggesting that weakened circadian rhythmicity is associated with increased risk of PD thereby corroborating the possibility that “tweaking” the circadian system with a potent Zeitgeber may interfere with internal timing to slow the degenerative process of PD.
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Trial website
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Trial related presentations / publications
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Public notes
N/A
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Contacts
Principal investigator
Name
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Dr Gregory L. Willis
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Address
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The Bronowski Institute of Behavioural Neuroscience
40 Davy Street
Woodend
Victoria 3442
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Country
123618
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Australia
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Phone
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+61 4 11514980
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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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Jane Holth
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Address
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The Bronowski Institute of Behavioural Neuroscience
40 Davy street
Woodend, Victoria 3442
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Country
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Australia
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Phone
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+61 3 54271741
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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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Greg Willis
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Address
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The Bronowski Institute of Behavioural Neuroscience
40 Davy Street
Woodend
Victoria 3442
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Country
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Australia
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Phone
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+61411514980
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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
Raw data will be presented in formal publication.
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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
No additional documents have been identified.
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