High-dose Accelerated Theta Burst Stimulation to Restore PD-induced Motor Network Dysconnectivity
University of Michigan
Summary
Parkinson disease (PD) is a common disorder in which reduced speed of movement results from inadequate brain production of the chemical dopamine. The most effective treatment for Parkinson disease is the use of drugs that provide dopamine replacement therapy (DRT). However, as the disease progresses there are prominent DRT-resistant features of Parkinson disease that are a major source of disability. These include cognitive (attention, memory) impairments and gait disorders such as freezing and falls. Repetitive transcranial magnetic stimulation (rTMS), a form of non-invasive brain stimulation, holds promise for the study and treatment of motor and cognitive deficits in persons with Parkinson's. To date, there are no conclusive results regarding an optimal rTMS protocol for recovery of motor and cognitive deficits in Parkinson's disease. This study is designed to promote clinical rehabilitation neuroscience research, and aims to improve rehabilitation in persons with Parkinson's with freezing of gait. This work will evaluate the use of a new accelerated, high dose, non-invasive brain stimulation method for treatment of freezing of gait in PD and will test how applying targeted accelerated stimulation to the brain improves gait disturbance due to PD.
Description
* The proposed research will characterize how inter-individual brain and behavior differences (i.e., gait function behavior and fMRI functional connectivity) at baseline relate to the treatment response. * This knowledge will provide important information about how interventions can be personalized and optimized. * The work may increase understanding of the underlying neurobiological mechanisms of neuromodulation for rehabilitation in patients with gait disturbances due to PD. * Impact: Results will provide insights into the effects of the neuromodulatory treatment on gait and motor dysfunctio…
Eligibility
- Age range
- 45–90 years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: 1. Parkinson disease (PD) with PD diagnosis based on the recent Movement Disorder Society criteria 2. PD subjects \>45 years and \<90 will be studied 3. H\&Y2-3 (early PD) subjects will be recruited 4. English speaker 5. Able to provide written consent prior to admission Exclusion Criteria: 1. The presence of other neurologic disease or neurologic findings on examination 2. Depression: Geriatric Depression Scale (GDS) score \>11 3. Evidence of a stroke or mass lesion on prior structural brain imaging (CT or MRI) 4. Are younger than 45 or older than 90 years old 5. Non-En…
Interventions
- DevicerTMS
A MagPro X100 magnetic stimulator with a 90mm figure-8 coil (MC-B70, MagVenture Inc.) will be used to apply rTMS to targeted locations marked on the structural MRI using a frameless infrared stereotactic neuronavigation system (Brainsight, Rogue Research).
Location
- University of MichiganAnn Arbor, Michigan