Dystonia
Conditions
Keywords
Dystonia, Movement disorders, Deep Brain Stimulation, DBS, Local Field potentials, biomarker, Magnetoencephalography, MEG, fMRI
Brief summary
The goal of this prospective open label study is to elucidate the pathophysiology of dystonia and to understand how deep brain stimulation (DBS) influences brain networks. The investigators will enroll patients with dystonia implanted with DBS of the Globus Pallidus internus (GPi) with sensing implantable neurostimulators, capable of measuring GPi local field potentials (LFPs). The main questions it aims to answer are: * does DBS influence pallidal LFPs in the long term? * how the basal-ganglia-thalamo-cortical circuit is modified after DBS? * do LFPs changes correlate with clinical improvement? Participants will undergo to serial clinical evaluations, magnetoencephalography (MEG) and functional Magnetic Resonance Imaging (fMRI) studies. Primarily, the data obtained from our study might help in clarifying basic pathological electrophysiological features of dystonia. These features might be secondarily used in future to provide a framework for an effective application of closed-loop DBS in Dystonia.
Interventions
DIAGNOSTIC_TESTfMRI
fMRI in patients with dystonia implanted with deep brain stimulation with neurostimulators capable of recording local field potentials
DIAGNOSTIC_TESTEEG-MEG
EEG-MEG in patients with dystonia implanted with deep brain stimulation with neurostimulators capable of recording local field potentials
DIAGNOSTIC_TESTregistration of local field potentials
registration of local field potential in patients with dystonia implanted with deep brain stimulation
DIAGNOSTIC_TESTgenetic panel
genetic panel for dystonia
Sponsors
Fondazione I.R.C.C.S. Istituto Neurologico Carlo Besta
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
12 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients diagnosed with idiopathic or genetic dystonia who have already undergone DBS surgery of the globus pallidus internus * Patient implanted with a neurostimulator capable of chronically recording LFPs and which is fully compatible with magnetic fields up to 3 Tesla. * Age\>12 years
Exclusion criteria
* Evidence of CNS pathology or any other acquired conditions (perinatal, infective, toxic, neoplastic, vascular, psychogenic) responsible for the dystonia phenomenology, * Focal distribution of dystonia * Contraindications to brain MRI or EEG/MEG * Adult subjects unable to express consent to inclusion in the study * Pregnancy, and breastfeeding.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Local field potentials | 1 year | To confirm the prominent pallidal low frequency oscillations in GPi (LFPs in alpha and theta bands) in dystonic patients and to evaluate the modifications in LFPs after DBS in the long term. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Coherence LFPs-MEG | 1 year | To evaluate coherence and/or correlation between GPi acivity and the neural activity in the basal ganglia-thalamo-cortical circuitry. LFPs signals will be co-registered to both EEG/MEG and resting state fMRI. |
| Clinical correlations | 1 year | to find a correlation between modulation of pallidal low-frequency activity and patient's clinical improvement. |
Countries
Italy
Contacts
CONTACTVincenzo Levi, M.D.
CONTACTNico Golfrè Andreasi, M.D.
PRINCIPAL_INVESTIGATORVincenzo Levi, MD
Fondazione IRCCS Istituto Neurologico Carlo Besta
Outcome results
None listed