Identifying Circuit Dynamics Underlying Motor Dysfunction in Parkinson's Disease Using Real-Time Neural Control
David Escobar
Summary
A prospective cohort of patients scheduled to undergo deep brain stimulation (DBS) implantation surgery for the treatment of Parkinson's disease as per standard of care will be invited to participate in this study. This mechanistic study is aimed at better understanding the role of basal ganglia beta band (11-35 Hz) oscillations and resonance in the manifestation of Parkinson's disease (PD) motor signs using closed-loop electrical neurostimulation, levodopa medication, and computational modeling. The ultimate goal of this study is to inform the development of closed-loop neuromodulation technology that can be programmed and adjusted in real time based on patient-specific neural activity.
Description
While much research has been dedicated to understanding the pathophysiology of Parkinson's disease (PD), the neural dynamics underlying the manifestation of motor signs remain unclear. Studies over the past two decades have shown a correlation of the amplitude and incidence of beta band oscillations in the subthalamic nucleus (STN) with changes in bradykinesia and rigidity mediated by levodopa or deep brain stimulation (DBS) therapies. Yet, no study has conclusively or deductively demonstrated a causal link. A limitation to establishing causality is the lack of available neuromodulation tools…
Eligibility
- Age range
- 18–80 years
- Sex
- All
- Healthy volunteers
- No
Key Inclusion Criteria: * Ability to provide informed consent. * Clinical diagnosis of idiopathic Parkinson's disease. * Determined, as per standard of care, to be a candidate for deep brain stimulation (DBS) surgery targeting the subthalamic nucleus. * Ability to tolerate delays in taking daily standard Parkinson's disease medications. Key Exclusion Criteria: * Secondary Parkinsonism, stroke, or progressive central nervous system disease other than Parkinson's disease. * Patient has a condition that, in the opinion of the investigators, would significantly increase the risk of interfering…
Interventions
- DeviceNeurostimulation
Electrical stimulation delivered via deep brain stimulation electrodes based on measurements of brain activity.
- DrugCarbidopa 25/Levodopa 100Mg Tab
Anti-parkinsonian medication.
Location
- Cleveland ClinicCleveland, Ohio