Clinical Research Directory

Slowing Parkinson's Early Through Exercise Dosage-United Kingdom

Parkinson's disease (PD) is the fastest growing neurological condition worldwide and currently has no treatment that slows or prevents it. Research shows that regular exercise may help protect the brain and delay symptoms. This study will test whether a long-term, home-based exercise programme can help people who are at increased risk of Parkinson's because they have a reduced sense of smell (called "hyposmia"). Hyposmia is a common early sign that can appear years before the movement symptoms of Parkinson's. The study, called Slow-SPEED UK, will recruit 110 adults aged 40 and over who have hyposmia and are currently not very active (walking less than 7,000 steps a day). Participants will first complete a four-week baseline period to confirm eligibility, then be randomly assigned (like flipping a coin) to one of two groups: Full-dose exercise group - encouraged to gradually double their daily step count using a fitness tracker and smartphone app. Low-dose control group - encouraged to increase daily steps by 10% using the same tools. Both groups will use the study's fitness tracker and app, which provides goals, feedback, and motivation through gamification. The programme lasts 18 months, with assessments at the start, mid-point (9 months), and end (18 months). Some participants may also give optional blood or skin samples to help researchers explore biological changes linked to early Parkinson's. The main question this study will answer is whether a remote, app-based programme can successfully increase daily step counts in people with hyposmia. Researchers will also look at whether exercise affects other outcomes such as exercise intensity, mood, sleep, smell, movement, quality of life, and early biological markers of Parkinson's. The study is designed as a feasibility trial. This means its main goal is to test whether the programme is practical, acceptable, and safe for participants. Results will inform larger future studies that could test whether structured exercise can delay or prevent Parkinson's disease in at-risk groups. Because exercise is already known to have many health benefits, all participants are expected to gain from taking part, regardless of whether they eventually develop Parkinson's.

Topical Versus Injection PRP for Olfactory Dysfunction

The goal of this clinical trial is to determine whether two different delivery methods of autologous platelet-rich plasma (PRP) can improve olfactory function in adults with persistent olfactory dysfunction lasting more than three months. The main questions it aims to answer are: 1. Does carrier-assisted topical application of PRP lead to comparable or better improvement in smell function than intranasal injection of PRP? 2. Which method provides greater patient comfort and fewer adverse effects? Researchers will compare carrier-assisted topical PRP application to intranasal PRP injection to see if one approach is more effective in restoring olfactory function. Participants will: 1. Receive a single PRP treatment delivered either by injection or via a PRP-soaked carrier placed into the olfactory cleft. 2. Continue daily olfactory training for three months following the intervention. 3. Undergo smell testing (Sniffin' Sticks) before and after treatment and complete quality-of-life questionnaires.

Treatment of Olfactory Dysfunction Using Vagus Nerve Stimulation

Hyposmia, a reduced sense of smell, is commonly linked to viral infections like COVID-19. Currently, the sole recommended treatment is olfactory training, a method that is both time-intensive and limited in its effectiveness. Our team has previously evaluated a new type of olfactory training using nasal inserts that show increased adherence to training (compared to standard olfactory training using common household odors) but with similar treatment effect. The investigators recently demonstrated that brief transcutaneous vagus nerve stimulation (VNS) in the cymba conchae region affected participants olfactory abilities but only when a stimulation frequency relevant to olfactory bulb processing frequencies was used. The notion that VNS might modulate olfactory functions stems from findings in rats where VNS of the cervical nerve inhibited neurons within the periglomerular layers of the olfactory bulb. Although there is no known monosynaptic connection between the vagus nerve and the olfactory system in humans, VNS activates areas with mono-synaptic connections to the olfactory bulb, such as amygdala, hippocampus, and the hypothalamus. Given that VNS modulates the olfactory bulb in rats and our treatment protocol modulate olfactory functions in humans, the investigators hypothesize that VNS, when paired with olfactory training, will enhance olfactory functions in patients with hyposmia.

Mechanical and Sensorial Training in the Olfactive Rehabilitation of Patients With Total Laryngectomy

To assess the efficacy of two olfactory rehabilitation protocols (Nasal Airflow-Inducing Maneuver (NAIM) with or without ol-factory training) on olfactory function (sniffing stick test) and quality of life (questionnaire Self-MOQ and EORTC QLQ-H\&N35) in patients with total laryngectomy.

Olfactory Training on Smell Dysfunction Patients in HK

* Causes of olfactory dysfunction can be classified into conductive and sensorineural causes. * Conductive causes are mainly due to structural nasal problem, which can be treated by nasal surgery * Sensorineural causes included post-infection, post-head injury, post Head and Neck irradiation and other central nervous system diseases. * Olfactory Training is well established treatment for sensorineural olfactory dysfunction in foreign countries. * Olfactory Training by neurological chemosensory stimulation using aromatic substances delivered via electronic portable aromatic rehabilitation (EPAR) diffuser was proved to be effective treatment in COVID-19 related olfactory dysfunction in recent Hong Kong study. * However, there is a lack of local study on the effect of Olfactory Training in other non-COVID-19 sensorineural causes of olfactory dysfunction in Hong Kong population.

Scents of Progress: Leveraging a Novel Device for Olfactory Training in Older Adults

The goal of this clinical trial is to learn if ScentCare, a novel olfactory training device and accompanying companion web-based application, will lead to improved olfactory and well-being outcomes in elderly patients with Olfactory Dysfunction (OD). The main question it aims to answer is: \- What effect does the olfactory training device (ScentCare) and accompanying companion web-based application have on olfaction? Researchers will compare ScentCare to solving Sudoku puzzles to see the effects of olfactory training using this novel device on olfaction. Previous studies have used Sudoku puzzles when studying the effect of smell training. Since smell training is thought to work by stimulating and engaging higher order cognition, Sudoku is a suitable activity for participants in the control group since it serves as a correlate with similar degree of stimulation. Participants will: * Use ScentCare (intervention) or solve Sudoku puzzles (control) twice daily for 3 months. * Visit the clinic twice, once upon enrollment and once three months later. * Complete a formal smell test using Sniffin' Sticks smell test at the beginning of the study and again at the end of the study (3 months) during the initial and follow up visit. * Complete questionnaires at the beginning of the study and again at the end of the study (3 months) during the initial and follow up visit.

Olfactory Training As a Treatment for Olfactory Dysfunction Post COVID-19

Olfactory dysfunction is a defining symptom of COVID-19 infection. Studies have demonstrated improved olfaction in patients with post infectious olfactory dysfunction after an olfactory training (OT). The aim of this study is to assess the clinical outcomes of olfactory training (12 weeks) therapy in the treatment of persistent olfactory dysfunctions after COVID-19. Specially, we aim to compare the effectiveness of two different olfactory training (different odors). A group will train themselves with 4 scents (rose, orange, clove and eucalyptus) and another group with 4 different scents (cheese, coffee, strawberries and lemon). Olfaction sensory evaluation will be performed by using different olfaction tests (Sniffin' Sticks and UPSIT) and complete questionnaires to assess olfactory perception and particularly parosmia and phantosmia.