Parkinson Disease
Conditions
Keywords
Deep brain stimulation, Dual-task walking, Executive function
Brief summary
Parkinson's disease (PD) is the second most common neurodegenerative disease after Alzheimer's disease. Motor symptoms include rigidity, bradykinesia, tremor, and postural instability, these motor symptoms can cause gait dysfunction. Non-motor symptoms include depression, dysarthria, cognitive disability, and sleep disturbance. Although these symptoms can be improved through drug treatment, when the course of PD reaches the middle to late stage, it will still face the situation of weakened drug efficacy and the drug side effects increased. When medication can no longer adequately control the motor symptoms of PD, deep brain stimulation (DBS) becomes a powerful option. DBS is a surgical treatment that involves implanting one or more electrodes into specific areas of the brain, which deliver electrical stimulation to regulate or destroy abnormal neural signal patterns in the target area. The effect of DBS has been proven whether it is in improving motor-related symptoms or non-motor-related symptoms, but there are still some areas that have not been compared before and after the surgery, such as: gait variability, executive functions and dual-task walking. In addition, the parameters of electrical stimulation for DBS will also affect the clinical characteristics of patients. Due to the large difference between individual cases, the recommendation of the electrical stimulation frequency still not be established. Therefore, the influence of DBS and its parameters on the symptoms of PD is a topic worthy of discussion. Purposes: (1) To investigate the long-term effects of DBS on the symptoms of PD. (2) To investigate the effects of DBS stimulation frequencies on walking performance and executive function in individuals with PD.
Interventions
PROCEDUREDeep brain stimulation with high frequency
Deep brain stimulation implanted at the patients' Substantia Nigra
PROCEDUREDeep brain stimulation with low frequency
Deep brain stimulation implanted at the patients' Substantia Nigra
Sponsors
National Yang Ming Chiao Tung University
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
50 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Idiopathic PD * Age: 50\ 80 yrs old * Hoehn and Yahr stage ≤ IV after DBS operation * Implanted DBS system for at least 6 months * MMSE ≥24
Exclusion criteria
* Other neurological disorders * Any major systemic, psychiatric, visual, and musculoskeletal disturbances or other causes of walking inability
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Dual-task gait performance: Stride length | Three days after frequency adjustment | Using the OPTO gait system to evaluate stride length |
| Dual-task gait performance: Double limb support time | Three days after frequency adjustment | Using the OPTO gait system to evaluate double limb support time |
| Executive function - Inhibition control | Three days after frequency adjustment | Using the Stroop test to evaluate inhibition control |
| Executive function - Shifting attention | Three days after frequency adjustment | Using the Trail Making Test to evaluate shifting attention |
| Executive function - Working memory | Three days after frequency adjustment | Using the Digit span test to evaluate working memory |
| Cognitive function | Every 6-month up to 2 years | Using the Montreal Cognitive Assessment (MoCA) to evaluate cognitive function |
| Non-motor symptoms | Every 6-month up to 2 years | Using the Non-motor Symptoms Scale (NMSS) to non-motor symptoms |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Balance performance | Every 6-month up to 2 years | Using the Mini-BEST test to evaluate balance performance |
| Usual gait performance: Stride length | Three days after frequency adjustment | Using the OPTO gait system to evaluate stride length |
| Parkinson's Disease patients' Quality of life | Every 6-month up to 2 years | Using the Parkinson's Disease Questionnaire (PDQ-39) evaluate quality of life |
| Motor symptoms | Every 6-month up to 2 years | Using the Unified Parkinson's Disease Rating Scale (UPDRS) part 3 to evaluate motor symptoms |
| Usual gait performance: Double limb support time | Three days after frequency adjustment | Using the OPTO gait system to evaluate double limb support time |
| Brain activity: Prefrontal Cortex | Three days after frequency adjustment | Using Functional near-infrared spectroscopy (fNIRS) to evaluate brain activity of Prefrontal Cortex with the formula: Hb diff=HbO-HbR |
| Brain activity: Supplementary Motor Cortex | Three days after frequency adjustment | Using Functional near-infrared spectroscopy (fNIRS) to evaluate brain activity of Supplementary Motor Area with the formula: Hb diff=HbO-HbR |
| Brain activity: Premotor Cortex | Three days after frequency adjustment | Using Functional near-infrared spectroscopy (fNIRS) to evaluate brain activity of Premotor Cortex with the formula: Hb diff=HbO-HbR |
| Functional activity: Gait and balance performance | Every 6-month up to 2 years | Using the Timed up and go test to evaluate functional activity |
| Functional activity: Lower limb function | Every 6-month up to 2 years | Using the 30s Chair Stand Test to evaluate functional activity |
Countries
Taiwan
Contacts
Primary ContactYea-Ru Yang, PhD
Outcome results
None listed