Targeting Apathy With Music in Parkinson's Disease

Condition(s) studied

Investigational drug(s) / intervention(s)

Music listening: This intervention involves listening to participant-selected music that they have evaluated as rewarding/motivating. YouTube Music will be used to build both personalized music and podcast interventions.

Podcast listening: This intervention involves listening to participant-selected podcasts of neutral content. YouTube Music will be used to build both personalized music and podcast interventions.

Study summary

Parkinson's Disease (PD) is often accompanied by non-motor symptoms that make treatment more difficult. One such symptom is apathy (lack of motivation and emotion). There are no treatments for apathy in PD, and this remains a major unmet need in PD patients. One possible way to target apathy in PD patients is listening to music, which has been shown to help improve apathy in older adults. Little work has explored the mechanism in which music targets apathy. Thus, the goal of this study is to understand how music listening can impact the brain towards decreasing apathy in PD patients.

Eligibility

Primary outcome measure(s)

• Change in seed-based functional connectivity between auditory, reward, and motor areas (implicated in musical reward processing) during a music-listening task, before and after an 8-week audio-based intervention — 8 weeks
  fMRI - task-based functional magnetic resonance imaging
• Change in seed-based functional connectivity between auditory, reward, and motor areas (implicated in musical reward processing) at rest, before and after an 8-week audio-based intervention — 8 weeks
  rsfMRI - resting state functional magnetic resonance imaging
• Change in univariate whole-brain analysis at rest before and after an 8-week audio-based intervention — 8 weeks
  rsfMRI - resting state functional magnetic resonance imaging; observing activity across the brain and in specific regions of interest (ROIs), including reward, auditory, and motor areas
• Change in univariate whole-brain analysis during a music listening task before and after an 8-week audio-based intervention — 8 weeks
  fMRI - task-based functional magnetic resonance imaging; observing activity across the brain and in specific regions of interest (ROIs), including reward, auditory, and motor areas
• Change in fMRI representational similarity analysis during a music listening task before and after an 8-week audio-based intervention — 8 weeks
  fMRI - task-based functional magnetic resonance imaging; observing correlated BOLD (blood oxygen level dependent) activity across the brain and in specific regions of interest (ROIs), including reward, auditory, and motor areas
• Change in fMRI representational similarity analysis at rest before and after an 8-week audio-based intervention — 8 weeks
  rsfMRI - resting state functional magnetic resonance imaging; observing correlated BOLD (blood oxygen level dependent) activity across the brain and in specific regions of interest (ROIs), including reward, auditory, and motor areas
• Short-term clinical measure of apathy before and after an 8-week audio-based intervention -Positive and Negative Affective Schedule (PANAS) — 8 weeks
  The PANAS is a self-reported 20-item scale with 2 major subscales: Positive affect score and Negative affect score. Items are scored on a scale of 1-5. Scores range from 10-50 for both the Positive and Negative Affect, with higher scores representing higher levels of Positive/Negative affect.
• Short-term clinical measure of apathy after a 4-week washout period post-intervention - Positive and Negative Affective Schedule (PANAS) — 4 weeks
  The PANAS is a self-reported 20-item scale with 2 major subscales: Positive affect score and Negative affect score. Items are scored on a scale of 1-5. Scores range from 10-50 for both the Positive and Negative Affect, with higher scores representing higher levels of Positive/Negative affect.
• Short-term clinical measure of apathy before and after an 8-week audio-based intervention - Visual Analogue Scale (VAS) — 8 weeks
  The VAS is a visual scale with a rating from 1-10; participants are to indicate the level of apathy and motivation felt at their current state. Higher values indicate more severe apathy.
• Short-term clinical measure of apathy after a 4-week washout period post-intervention - Visual Analogue Scale (VAS) — 4 weeks
  The VAS is a visual scale with a rating from 1-10; participants are to indicate the level of apathy and motivation felt at their current state. Higher values indicate more severe apathy.
• Long-term clinical measure of apathy before and after an 8-week audio-based intervention - Starkstein Apathy Scale (SAS) — 8 weeks
  The SAS is a 14-item clinical scale used to evaluate apathy in clinical populations. Higher scores indicate more severe apathy. Scores range from 0-42. Participants who score \>=14 are considered as having clinical apathy.
• Long-term clinical measure of apathy after a 4-week washout period post-intervention - Starkstein Apathy Scale (SAS) — 4 weeks
  The SAS is a 14-item clinical scale used to evaluate apathy in clinical populations. Higher scores indicate more severe apathy. Scores range from 0-42. Participants who score \>=14 are considered as having clinical apathy.
• Clinical assessment of apathy before and after an 8-week audio-based intervention - Lille Apathy Rating Scale (LARS) — 8 weeks
  The LARS is a 33-item assessment with 9 subscales: everyday productivity, interests, taking the initiative, novelty seeking, motivation - voluntary actions, emotional responses, concern, social life, and self-awareness. There is a mix of open-ended (items scored between -2 and 2) and multiple choice items (items scored between -1 and 1). Scores range from -36 to 36. Higher scores indicate more severe apathy.
• Clinical assessment of apathy after a 4-week washout period post-intervention - Lille Apathy Rating Scale (LARS) — 4 weeks
  The LARS is a 33-item assessment with 9 subscales: everyday productivity, interests, taking the initiative, novelty seeking, motivation - voluntary actions, emotional responses, concern, social life, and self-awareness. There is a mix of open-ended (items scored between -2 and 2) and multiple choice items (items scored between -1 and 1). Scores range from -36 to 36. Higher scores indicate more severe apathy.
• Clinical assessment of apathy in Parkinson's Disease before and after an 8-week audio-based intervention - Movement Disorders Society Unified Parkinson's Disease Rating Scale - apathy item (MDS-UPDRS) — 8 weeks
  The MDS-UPDRS is a clinical assessment of motor and non-motor symptoms in individuals with Parkinson's Disease. It consists of four subscales. Subscales 1, 3, and 4 are administered by a trained individual with subscale 2 being self reported. Each item is rated from 0 to 4.
• Clinical assessment of apathy in Parkinson's Disease after a 4-week washout period post-intervention - Movement Disorders Society Unified Parkinson's Disease Rating Scale - apathy item — 4 weeks
  The MDS-UPDRS is a clinical assessment of motor and non-motor symptoms in individuals with Parkinson's Disease. It consists of four subscales. Subscales 1, 3, and 4 are administered by a trained individual with subscale 2 being self reported. Each item is rated from 0 to 4.
• Assessment of musical reward sensitivity before and after an 8-week audio-based intervention - Barcelona Musical Reward Questionnaire (BMRQ) — 8 weeks
  The BMRQ is a validated 20-item assessment of musical reward sensitivity (how responsive a participant is to the rewarding effects of music listening). It has 5 subscales: musical seeking, emotion evocation, mood regulation, social reward, and sensory-motor. Items are scored from 1-5. Higher scores indicate higher sensitivity to reward.
• Assessment of musical reward sensitivity after a 4-week washout period post-intervention - Barcelona Musical Reward Questionnaire (BMRQ) — 4 weeks
  The BMRQ is a validated 20-item assessment of musical reward sensitivity (how responsive a participant is to the rewarding effects of music listening). It has 5 subscales: musical seeking, emotion evocation, mood regulation, social reward, and sensory-motor. Items are scored from 1-5. Higher scores indicate higher sensitivity to reward.
• Grip force response (GFR) during a music listening fMRI task before and after an 8-week audio-based intervention — 8 weeks
  GFR is a physical effort measure; it is a validated measure of apathy in Parkinson's Disease (Zhu et al., 2021)
• Grip force duration and fatigue during a music listening fMRI task before and after an 8-week audio-based intervention — 8 weeks
  Grip force duration and fatigue are physical effort measures; they are validated measures of apathy in Parkinson's Disease (Zhu et al., 2021)

Trial sites (1)

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