Doris Wang, MD, PhD
This is a single-center clinical study aiming to improve gait functions in patients with Parkinson's Disease (PD) by using adaptive neurostimulation to the pallidum. The investigators will use a bidirectional deep brain stimulation device with sensing and stimulation capabilities to 1) identify neural biomarkers to detect the onset of walking by recording neural activities from the motor cortical areas and the globus pallidus, 2) understand the impacts of changes in DBS parameters on gait kinematics and optimize setting parameters for enhancing walking performance, 3) develop a movement state-dependent adaptive deep brain stimulation (DBS) paradigm to automatically switch stimulation settings according to different movement states (i.e., walking vs non-walking). The proposed therapy will deliver personalized neurostimulation based on individual physiological biomarkers to enhance gait function in patients with PD. 6 patients with idiopathic Parkinson's disease who have already been implanted with the Medtronic Summit RC+S device will be enrolled in this study.
This study will allow the investigators to evaluate the efficacy of a movement state-dependent adaptive deep brain stimulation paradigm to treat gait dysfunction in individuals with Parkinson's disease (PD). While current DBS therapy improves the appendicular symptoms of PD, such as tremor and bradykinesia, it is less effective for advanced gait symptoms, which manifest as hypokinetic gait patterns, increased gait variability, asymmetry, and disturbed balance. These symptoms are debilitating and represent a major source of morbidity for patients with PD. Studies have suggested that while conv…
Inclusion Criteria: * Ability to give informed consent for the study * Subjects implanted with Summit RC+S investigational DBS system. * Absence of significant cognitive impairment (score of 21 or greater on the Montreal Cognitive Assessment (MoCA) * Signed informed consent * Age 21-75 * Diagnosis of idiopathic PD with duration of motor symptoms for 3 years or greater * Patient has undergone appropriate therapy with oral medications with inadequate relief as determined by a movement disorders neurologist. * UPDRS-III score off medication between 20 and 80 and an improvement of at least 30% in…
Participants receive gait-optimized stimulation settings while walking and Parkinson's disease symptom-optimized settings during non-walking periods.
Participants receive clinically-optimized open-loop deep brain stimulation ot the pallidum.
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