Ignite Creation Date:
2024-10-26 @ 3:41 PM
Last Modification Date:
2024-10-26 @ 3:41 PM
Study NCT ID:
NCT06618157
Status:
NOT_YET_RECRUITING
Last Update Posted:
None
First Post:
2024-09-26
Brief Title:
Connectomic Guided DBS for Parkinsons Disease
Sponsor:
None
Organization:
None
Study Overview
Official Title:
Connectomic Guided Deep Brain Stimulation DBS for Parkinsons Disease
Status:
NOT_YET_RECRUITING
Status Verified Date:
2024-09
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
No
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
The objective of this research is to use advanced connectomic imaging models to identify disease-relevant axonal pathway targets for better tremor control in Parkinsons disease patients while avoiding undesirable side effects with the goal of increasing precision and facilitating the choice of optimal DBS parameters for certain disease phenotypes The investigators hypothesize that patient centered subthalamic nucleus deep brain stimulation of cerebellothalamic axonal pathways and pallidothalamic tract activation can provide better tremor control while avoiding worsening dyskinesias in patients with Parkinsons disease with significant tremor
Detailed Description:
Patients with Parkinsons disease PD can suffer from significant disability due to tremors rigidity bradykinesia or motor fluctuations in addition to non-motor symptoms of the disease Deep brain stimulation DBS is the main surgical approach approved by the US Food and Drug Administration FDA for the treatment of medication-refractory PD Despite recent advances the selection of DBS parameters is based on trial-and-error experimentation by specialists over the course of months Better understanding of the optimal network targets for symptomatic control would allow for therapy improvement and simplify the DBS programming process increase efficiency and possibly increase access to care
Most studies of structural connectivity in PD have focused on the analysis of the subthalamic nucleus STN Previous studies analyzing structural connectivity of STN DBS have shown that specific motor symptoms benefit from the activation of different networks Several tracts such as the cerebellothalamic tract CBT pallidothalamic PT and corticospinal tract CST course through the STN and might be relevant for DBS targeting For patients with essential tremor stimulation of the CBT might provide better tremor control but studies in PD are lacking
The investigators will use connectomic models to better understand the mechanistic qualities of axonal pathways in the STN in Parkinsons disease and address the need for phenotype driven stimulation in PD Estimating targeted axonal pathways by using connectomic models may guide personalized decision-making and targeting of DBS It has the potential to improve clinical outcomes and reduce the number of visits needed for DBS optimization
The study involves the extraction of data collected during routine clinical care and data collected during the intervention study
Data collected during routine clinical care includes
Demographic characteristics age gender ethnicity race
Clinical characteristics disease duration Movement Disorders Society Unified Parkinsons Disease Rating Scale MDS-UPDRS III prior to DBS implementation levodopa equivalent daily dose of medications
Imaging data DBS lead location stimulation model activation pathway recruitment curves percent of each pathway activated with clinical DBS settings
Most studies of structural connectivity in PD have focused on the analysis of the subthalamic nucleus STN Previous studies analyzing structural connectivity of STN DBS have shown that specific motor symptoms benefit from the activation of different networks Several tracts such as the cerebellothalamic tract CBT pallidothalamic PT and corticospinal tract CST course through the STN and might be relevant for DBS targeting For patients with essential tremor stimulation of the CBT might provide better tremor control but studies in PD are lacking
The investigators will use connectomic models to better understand the mechanistic qualities of axonal pathways in the STN in Parkinsons disease and address the need for phenotype driven stimulation in PD Estimating targeted axonal pathways by using connectomic models may guide personalized decision-making and targeting of DBS It has the potential to improve clinical outcomes and reduce the number of visits needed for DBS optimization
The study involves the extraction of data collected during routine clinical care and data collected during the intervention study
Data collected during routine clinical care includes
Demographic characteristics age gender ethnicity race
Clinical characteristics disease duration Movement Disorders Society Unified Parkinsons Disease Rating Scale MDS-UPDRS III prior to DBS implementation levodopa equivalent daily dose of medications
Imaging data DBS lead location stimulation model activation pathway recruitment curves percent of each pathway activated with clinical DBS settings
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
None
Is a FDA Regulated Device?:
None
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None