Parkinson Disease
Conditions
Brief summary
Parkinson's disease (PD) is a disabling, progressive condition characterised by severe problems with movement for which medical treatment in the longer term can be unsatisfactory. Deep brain stimulation (DBS) is a treatment, which directly stimulates the nerve cells affected inside the brain to help overcome the difficulties with movement. Classically, DBS stimulates in a manner that is constant. Many patients develop severe problems with walking, so-called freezing of gait, which can be unresponsive to constant DBS. In this study the investigators will test if left-right alternating DBS helps to improve gait problems by potentially promoting left-right alternating up- and down-modulated brain activity, which was found during walking in a previous study. The investigators will test if alternating DBS improves the ability to adjust walking speed and to walk freely compared to constant DBS.
Interventions
DEVICEAlternating DBS
Constant DBS will be changed to DBS that is up- and downmodulated alternating between the left and right stimulation side.
Sponsors
University College, London
University of Oxford
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
BASIC_SCIENCE
Masking
NONE
Masking description
Participants and the UPDRS examiner are blinded to the stimulation condition.
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* PD patients with bilateral subthalamic nucleus DBS electrodes and stimulators implanted for at least 6 months * Able to give consent.
Exclusion criteria
* Lack of capacity to consent * Cognitive impairment/lack of capacity to perform experimental task. The investigators will additionally conduct a short (10 min) quantitative assessment of cognitive function using a validated test (MMSE). Patients with a score \< 20 will be excluded from the study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Stepping control will be assessed as the ability to adjust the stepping speed (m/s) in each stimulation condition. | Immediate recording | Stepping speed (m/s) will be assessed. |
| Stepping control will be assessed as the ability to limit the variance in stepping speed (m/s) in each stimulation condition. | Immediate recording | Stepping variance (m/s) will be assessed. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The investigators will test if patients automatically adjust to the stimulation rhythm | Immediate recording | Stepping entrainment |
| The investigators will how well other motor symptoms including tremor, rigidity and bradykinesia are controlled with alternating DBS. | Immediate recording | United Parkinsons Disease Rating Scale motor (Part III) scores will be compared between stimulation conditions. |
Countries
United Kingdom
Contacts
Primary ContactPeter Brown, MD
Outcome results
None listed