Improving Accuracy of Implanting Stimulation Electrodes
Conditions
Brief summary
The goal is to establish another anatomical referencing system in order to achieve an even higher accuracy when implanting stimulation electrodes.
Detailed description
The main goal is to find out what are the optimal distances to these reference fiber tracts when stimulating and to find the optimal target. This has to be evaluated for each target, such as globus pallidus (Gpi), subthalamic nucleus (STN) and ventral intermediate nucleus of the thalamus (VIM) separately. This is of special importance as the investigators can demonstrate the internal capsule, which is often a generator of stimulation-induced side effects: tetanic muscle contractions, dysarthria and gaze deviations.
Interventions
PROCEDUREDeep Brain Stimulation
Deep Brain Stimulation
Sponsors
Nova Scotia Health Authority
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
Yes
Inclusion criteria
* Patient qualifying for deep brain stimulation on the basis of a movement disorder (Parkinson's Disease, tremor, dystonia) or chronic pain disease. * Informed consent
Exclusion criteria
* Lack of consent * Electrical or other devices that preclude the performance of an MRI
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| distance between stimulation electrode and motor fibers in mm | Intraoperative | Distances between the stimulation electrode and motor fibers as depicted on fiber tracking in millimeters in correlation to the threshold current for eliciting clinical side effects |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Stimulation thresholds in milliampere (mA) | Intraoperative | Threshold of intraoperative stimulation intensity in milliamp, which elicits capsular side effects |
| Change in disease score units on the UPDRS rating scale | twelve months | Assessment of therapeutic effects using Unified Parkinson disease rating scale (UPDRS) |
| Change in disease score units on the FTRS rating scale | twelve months | Assessment of therapeutic effects using, Fahn-Tremor Rating Scale (FTRS) |
| Intraoperative intensity of stimulation in milliampere (mA) | Intraoperative | Intraoperative intensity of stimulation in milliamp, which elicits an activation of contralateral muscle groups (musculus interosseus dorsalis and the musculus tibialis anterior) |
| Change in disease score units on the TWSTR rating scale | twelve months | Assessment of therapeutic effects using Toronto Western Spasmodic torticollis rating scale (TWSTR) |
| Change in disease score units on the PDQ-39 rating scale | twelve months | Assessment of therapeutic effects using Parkinsons Disease QuestionnairePDQ-39 |
| Change in disease score units on the BFMDRS rating scale | twelve months | Assessment of therapeutic effects using Burke-Fahn-Marsden dystonia rating scale (BFMDRS) |
Countries
Canada
Contacts
Primary ContactLutz Weise, MD
Outcome results
None listed