Cortical Electrophysiology of Response Inhibition in Parkinson's Disease
Emory University
Summary
Patients with Parkinson's Disease will be studied before, during, and after a deep brain stimulation implantation procedure to see if the stimulation location and the size of the electrical field produced by subthalamic nucleus (STN) DBS determine the degree to which DBS engages circuits that involve prefrontal cortex executive functions, and therefore have a direct impact on the patient's ability to inhibit actions.
Description
Patients with Parkinson's disease (PD) commonly develop difficulties with executive function due to neurodegeneration in neuronal networks that involve the prefrontal cortex and associative territories of the basal ganglia, even in early stages of the disease. Executive cognitive functions serve to direct behavior toward a goal and modify actions to accommodate changing demands. One of the key components of executive control is the ability to cancel or inhibit habitual responses. Motor response inhibition is critical in everyday life, for example, to stop crossing the street when a speeding ca…
Eligibility
- Age range
- 45–75 years
- Sex
- All
- Healthy volunteers
- Yes
Inclusion Criteria for Persons with Parkinson's Disease for Aim 1: * diagnosis of idiopathic Parkinson's disease (PD) * Hoehn and Yahr (H\&Y) stage 2-4 (off medication) Exclusion Criteria for Persons with Parkinson's Disease for Aim 1: * severe tremor at rest or severe dyskinesia which would cause significant artifacts in electrophysiological signals * inability to hold antiparkinsonian medications for research recordings * dementia * non-English speaker Inclusion Criteria for Persons with Parkinson's Disease for Aim 2: * diagnosis of idiopathic PD * there is a clinical indication for DBS…
Interventions
- DrugLevodopa
Participants will take levodopa in dosages prescribed by their care provider. Patients will be instructed to not take their regularly prescribed PD medications for 12 hours prior to the study assessment, as is typical for clinical evaluations in patients with PD. Participants will be tested in both levodopa-off (after 12 hours of not having medication) and levodopa-on states.
- DeviceClinical DBS Setting
Deep brain stimulation performed with the patients' optimized clinical setting.
- DeviceSham DBS
Deep brain stimulation performed with sham stimulation.
- DeviceDBS Setting Maximizing Prefrontal Activation
Deep brain stimulation performed to maximize the activation of the prefrontal cortico-STN projections.
- DeviceDBS Setting Minimizing Prefrontal Activation
Deep brain stimulation performed to minimize the activation of the prefrontal cortico-STN projections.
Locations (2)
- Emory University HospitalAtlanta, Georgia
- Emory Brain Health CenterAtlanta, Georgia