Parkinson's disease
Conditions
Interventions
five patients with PD will undergo stereotactic implantation of electrodes guided by the technique of magnetic resonance tractography. Postoperative radiological evaluation will inform the contacts pr
(ii) flow electrode at low frequency (<70 Hz)
(iii) high frequency rostral electrode + low frequency caudal electrode
(iv) electrodes disconnected. A neurologist blind to the above conditions will perform an assessment using the following scales: (i) UPDRS
(ii) Berg
(iii) March Blocking
(iv) Epworth
(v) PDQ-39. Patients will also be evaluated in a gait laboratory, using a force platform and accelerometers. Assessments for each condition will start in the fourth week after surgery and will be spac
Procedure/surgery
E01.370.350.578.750
Sponsors
Faculdade de Medicina da Univeridade de São Paulo
Faculdade de Medicina da Univeridade de São Paulo
Eligibility
Inclusion criteria
Inclusion criteria: Patients diagnosed with idiopathic PD according to Queen Square Brain Bank criteria 23. The diagnosis will be given by a neurologist specializing in movement disorders. Presence of moderate PD, at least 4 years from the onset of motor symptoms. Persistent motor dysfunction for at least 1 month despite drug adjustment. Patients with moderate to severe gait disturbances and refractory balance to drug treatment. Thus, they should have: score 3 (moderate) or 4 (severe) in items 12 and 13 of part II of the MDS-UPDRS and score 3 (moderate) or 4 (severe) in items 9, 10, 11 and 12 of part III UPDRS being on medication (medication status ON). Cognitive performance appropriate to preoperative care. Understanding of the stimulation system and recognition of adverse events. Willingness of the caregiver or family member, and the patient himself, to come in frequent returns to ensure the best brain stimulation parameters.
Exclusion criteria
Exclusion criteria: Age under 18 years. Parkinsonism Associated With Other Degenerative Diseases Secondary Parkinsonism. Prior surgical treatment of PD symptoms. Patients without clinical conditions for the surgical procedure due to noncompensated systemic disease. Behavioral disorders and hallucinations associated with dopamine drug use and without drug control. Patients with less than two years of schooling or visually impaired who cannot perform properly on neuropsychological tests. Depression. Dementia associated with PD Refusal to undergo neurosurgical procedure. Refusal to accept the informed consent form.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Presentation of the expected outcome: It is expected to evaluate: 1. Intensity of symptoms stiffness, tremor and bradykinesia; ;Presentation of the expected outcome: It is expected to evaluate: 2. Severity of FOG and imbalance; | — |
Secondary
| Measure | Time frame |
|---|---|
| We will study the impact on motor performance and quality of life of patients with PD presenting gait disturbance and balance refractory to drug treatment | — |
Countries
Brazil
Contacts
Public ContactFabio;Fábio Godinho;Godinho
FMUSP;FMUSP
Outcome results
None listed