Essential Tremor, Parkinson Disease
Conditions
Keywords
deep brain stimulation, levodopa medication, motor cortex, basal ganglia, thalamus
Brief summary
The brain networks controlling movement are complex, involving multiple areas of the brain. Some neurological disorders, like Parkinson's disease (PD) and essential tremor (ET), cause abnormalities in these brain networks. Deep brain stimulation is a treatment that is used to treat these types of neurological diseases and is thought to help patients by modulating brain networks responsible for movement. Levodopa medication is also used to modulate this brain networks in patients with PD. The overall objective is to develop a unified theory of basal ganglia thalamocortical (BGTC) circuit dynamics that accounts for disease symptomatology, movement, and their inter-relationship. The underlying hypothesis, is that the rigidity and bradykinesia of PD are fundamentally related to excessive functional coupling across nodes in the BGTC motor circuit impeding effective information flow. In this research, the investigator will take advantage of the unique opportunity provided by awake deep brain stimulation surgery to learn more about how the brain functions in a diseased state and how deep brain stimulation changes these networks to make movement more normal. The investigator will simultaneously assess cortical and subcortical electrophysiology in relation to clinical symptoms and behavioral measures and in response to deep brain stimulation, cortical stimulation, and pharmacologic therapy in patients undergoing Deep Brain Stimulation (DBS) implantation surgery.
Interventions
Apomorphine injected for therapeutic relief
Subcortical simulation of the deep brain stimulation surgery target site will be applied by clinically placed deep brain stimulation electrodes at the previously determined therapeutic setting
Sponsors
University of California, Los Angeles
National Institute of Neurological Disorders and Stroke (NINDS)
University of Texas Southwestern Medical Center
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
BASIC_SCIENCE
Masking
NONE
Intervention model description
Basic science study of effects of therapeutic interventions on intracranial physiology
Eligibility
Sex/Gender
ALL
Age
18 Years to 89 Years
Healthy volunteers
No
Inclusion criteria
* Diagnosis of Parkinson's disease who have been recommended to undergo deep brain stimulation for management of their movement disorder * Preoperative MRI without evidence of cortical or subdural adhesions or vascular abnormalities * Willingness and ability to cooperate during conscious operative procedure for up to 40 minutes
Exclusion criteria
* Patients with recent use (within one week) of anticoagulant or antiplatelet agents * Neurocognitive testing indicating amnestic cognitive deficits
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| cortical ECoG and subcortical recordings | baseline | Cortical ECoG and subcortical LFP recordings will occur during DBS implantation surgery during the behavioral assessments and/or Inbrija administration. |
| Behavioral assessment | baseline | Each patient will complete a task that assesses the kinematics of movement, self-initiation of movement, and/or effect of Inbrija on movement |
Countries
United States
Contacts
Primary ContactNader Pouratian, MD, PhD
Backup ContactSachil Chilukuri
Outcome results
None listed