Tau PET imaging in sporadic and LRRK2 Parkinson's disease

Evaluation of Tau-Pathology in Sporadic and LRRK2 Parkinson's Disease Using [18F]PI-2620: A High-resolution PET Imaging Study Using NeuroEXPLORER (NX PI-2160 in PD)

Using the tau PET tracer [18F]PI-2620 and a high-resolution NX PET camera, this will see if people with sporadic or LRRK2 Parkinson's disease have more tau protein in their brains than healthy and disease controls.

Quick facts

• Phase: Phase 2
• Study type: Interventional
• Enrollment: 60 (estimated)
• Ages: 45 Years to 85 Years
• Sex: All
• Sponsor: Michael J. Fox Foundation for Parkinson's Research (Academic / other)
• Locations: 1 site (New Haven, Connecticut)
• Trial ID: NCT07020026 on ClinicalTrials.gov

What this trial studies

This Phase 2 interventional imaging project will use [18F]PI-2620 PET with the NeuroEXPLORER (NX) high-resolution camera to measure regional tau binding in people with sporadic PD, LRRK2 PD, PSP/CBS, and healthy volunteers. In year 1 the cohort will include approximately 10 sporadic PD, 10 LRRK2 PD, 5 PSP/CBS, and 5 healthy controls, with some participants scanned on both the NX and a conventional PET camera for direct comparison. Year 2 completes recruitment and first-year participants will return at 12 months for repeat NX imaging to assess longitudinal change. The study will leverage clinical and imaging data from PPMI participants to reduce participant burden and enable longitudinal analyses.

Who should consider this trial

Good fit: Adults aged 45–85 with sporadic or LRRK2 Parkinson's disease who can provide informed consent and attend PET imaging visits, as well as comparison participants with PSP/CBS or without neurological disease, are ideal candidates.

Not a fit: People outside the 45–85 age range, those who cannot undergo PET imaging (for example due to pregnancy, severe claustrophobia, or inability to travel to the New Haven site), or those with conditions unrelated to tau pathology are unlikely to benefit from this imaging-focused project.

Why it matters

Potential benefit: If successful, this could improve detection and tracking of tau-related pathology in Parkinson's disease and help guide patient selection and outcome measures for future therapies.

How similar studies have performed: Tau PET tracers such as [18F]PI-2620 have shown clear signal in Alzheimer's disease and some primary tauopathies, but applying tau PET to Parkinson's disease—especially comparing sporadic and LRRK2 cases and using the NX camera—is relatively novel and exploratory.

Eligibility criteria

Inclusion Criteria:

General inclusion criteria include the following:

1. Ability to comply with the study procedures and attend follow-up visits.
2. Written informed consent from the participant or legal guardian.
3. Male or Female between 45 years and 85 years of age (Females must meet additional criteria specified below, as applicable) a. Females must be of non-childbearing potential or using a highly effective method of birth control 14 days prior to until at least 24 hours after injection of \[18F\]PI-2620 or DaTscan.

i. Non-childbearing potential is defined as a female that must be either postmenopausal (no menses for at least 12 months prior to PET scan) or surgically sterile (bilateral tubal ligation, bilateral oophorectomy or hysterectomy).

ii. Highly effective method of birth control is defined as practicing at least one of the following: A birth control method that results in a less than 1% per year failure rate when used consistently and correctly, such as oral contraceptives for at least 3 months prior to injection, an intrauterine device (IUD) for at least 2 months prior to injection, or barrier methods, e.g., diaphragm or combination condom and spermicide. Periodic abstinence (e.g., calendar, ovulation, symptothermal, post-ovulation methods) is not acceptable.

b. Females of childbearing potential must not be pregnant, breastfeeding or lactating, or planning pregnancy during the duration of the study.

c. Non PPMI participant females of childbearing potential must have a negative serum pregnancy test at Screening and all females of childbearing potential must have negative urine pregnancy test prior to \[18F\]PI-2620 injection on day of Baseline PET scan.

d. Non PPMI participant females of childbearing potential must have a negative urine pregnancy test prior to Screening Visit DaTscan injection.

Healthy Controls:

a) Enrolled in the PPMI study as a healthy subject.

Disease specific inclusion criteria:

a) Parkinson's disease

a. Enrolled in the PPMI study as a sporadic PD or LRRK2 PD participant. b. Known CSF alpha synuclein seeding amplification assay status. c. Known Plasma phosphorylated Tau217 status. b) Progressive Supranuclear Palsy (PSP):

1. Diagnosis of progressive supranuclear palsy (PSP) based on the Clinical diagnosis of progressive supranuclear palsy: The movement disorder society criteria (Höglinger et al., 2017).
2. Symptom onset within 2-5 years prior to screening.
3. Progressive motor symptoms including vertical supranuclear gaze palsy, postural instability, and other signs of parkinsonism.
4. Evidence of striatal degeneration in form of abnormal DaTscan (previously obtained DaTscan since onset of motor symptoms may be used).

c) Corticobasal Syndrome (CBS):

1. Diagnosis of corticobasal syndrome (CBS) based on clinical criteria, with asymmetric motor and cognitive dysfunction (Armstrong et al., 2013).
2. Presence of limb apraxia, dystonia, alien limb phenomenon, and/or parkinsonism (e.g., rigidity, bradykinesia).
3. Cognitive decline as indicated by impairment in attention, executive function, or memory.
4. Evidence of striatal degeneration in form of abnormal DaTscan (previously obtained DaTscan since onset of motor symptoms may be used).

Exclusion Criteria:

1. Any other medical or psychiatric condition or lab abnormality, which in the opinion of the investigator might preclude participation.
2. For those receiving Screening DaTscan:

   • Received any of the following medications that could interfere with the imaging and unwilling or medically unable to hold them for five half-lives before SPECT imaging: alpha methyldopa, methylphenidate, amphetamine derivatives or modafinil, bupropion, phentermine, phencyclidine, fentanyl, or medication commonly considered to interfere with Ioflupane binding per standard clinical practice.
3. Received any of the following drugs: dopamine receptor blockers (neuroleptics), metoclopramide and reserpine, within 6 months of Screening Visit for non-PPMI participants or within 6 months of Baseline Visit for PPMI participants.
4. Any structural abnormality or finding on previously obtained or screening brain MRI suggestive of clinically significant neurological disorders other than the diseases of interest (in the opinion of the investigator).
5. Any other reason that in the opinion of the investigator, including abnormal labs, that could interfere with the safety with radiotracer injection, would render the participant unsuitable for the study enrollment.

Where this trial is running

New Haven, Connecticut

• Institute for Neurodegenerative Disorders / XingImaging, LLC — New Haven, Connecticut, United States (Recruiting)

Study contacts

• Study coordinator: Ashley Romano, RN

Conditions Parkinson's Disease