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Parkinson's disease (PD), which is generally considered to be a motor disorder, is now known to be accompanied in many instances by a variety of cognitive defects. This can be explained considering that PD is a neurodegenerative and progressive disorder of the basal ganglia system, which works modulating not only motor, but also cognitive and emotional behaviours.
Concerning this, some studies suggest that non-demented PD patients may suffer from a voluntary selective visual attention orienting deficit, showing a reduced skill in focusing upon one target, and may be easily distracted from irrelevant but salient stimuli, with a consequent negative impact on their physical health, social interactions and quality of life.
Up to now, the evidence of the role of the basal-ganglia system in modulating visual attention functions is poor and indirect and the effects of dopaminergic and subthalamic nucleus (STN) stimulation (two usual and effective treatments in PD) on attention performances are controversial.
The main objectives of the project are: 1) to assess the visual selective attention as well as the distractibility in PD patients; 2) to study the effects of patient's usual antiparkinsonian treatments, that is dopaminergic and STN stimulation, on visual attention performances.
Secondly, from a clinical and neurophysiologic point of view, the investigators want to study the respective role of the dopaminergic pathways and the sensorimotor and associative/limbic cortico-basal ganglia loops passing across the STN in the visual attention performances.
To precisely answer the objectives of the protocol, the investigators will record the performances of participants during the administration of 3 computerized tests, which are suitable to study visual attention, decision making and motor performances.
The investigators will compare the performances on the computerized tests of two groups of PD patients, one evaluated in different sets of electrical (without stimulation, or selective stimulation of the sensorimotor or associative/limbic part of the STN) stimulation, the other in different conditions of medication (with or without dopaminergic treatment) with those of a group of healthy subjects.
Study Model: parallel-groups study. Three groups of subjects will be enrolled for the study: 2 groups of PD patients (see for details the section groups/cohorts), and a group of healthy controls.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| group #1 | Parkinson's disease patients at a disease's stage characterized by motor complications |
| |
| group #2 | Parkinson's disease patients treated by subthalamic nucleus deep brain stimulation. |
| |
| group #3 | healthy controls |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Recording during computerized tests | Other | Patients will perform more than one experimental session. In each experimental session 3 computerized tasks, which are suitable to study visual attention, decision making and motor performances will be presented. During these tests, participants have to responds the most quickly and accurately possible to the appearance on a computer display of a predetermined target stimuli, presented alone or in an array of signals. The computerized tests are administered in two different conditions of medication: with or without dopaminergic treatment, corresponding to two different experimental sessions. |
| Measure | Description | Time Frame |
|---|---|---|
| reaction time in trials of the computerized tests | Reaction times is recorded during one hour sessions for each patient/control subject (for more details see the Intervention Section) | 1 hour for each experimental session. All participants will perform more than one experimental session, on different days within the same week |
| Measure | Description | Time Frame |
|---|---|---|
| responses accuracy in trials of the computerized tests | responses accuracy is recorded during one hour sessions for each patient/control subject (for more details see the Intervention Section) | 1 hour for each experimental session. All participants will perform more than one experimental session, on different days within the same week |
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PD patients and healthy controls will be matched for age, sex, and education. PD patients: group #1 e group #2
Inclusion Criteria:
Exclusion Criteria:
Healthy controls: group #3
Inclusion Criteria:
Exclusion Criteria:
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Parkinson's disease patients will be selected among those regularly treated in the Centres that take part to the study. Healthy controls will be selected among patient family circle, and the staff of the Centres where the research takes place.
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| Name | Affiliation | Role |
|---|---|---|
| Pierre POLLAK, Professor | Unité des Troubles du Mouvement, Clinique de Neurologie, Grenoble University Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Unité des Troubles du Mouvement, Clinique de Neurologie, Grenoble University Hospital | Grenoble | 38043 | France |
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| ID | Term |
|---|---|
| D010300 | Parkinson Disease |
| D001480 | Basal Ganglia Diseases |
| ID | Term |
|---|---|
| D020734 | Parkinsonian Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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|
| Recording during computerized tests | Other | Patients will perform more than one experimental session. In each experimental session 3 computerized tasks, which are suitable to study visual attention, decision making and motor performances will be presented. During these tests, participants have to responds the most quickly and accurately possible to the appearance on a computer display of a predetermined target stimuli, presented alone or in an array of signals. The computerized tests are administered in three different sets of electrical (without stimulation, or selective stimulation of the sensorimotor or associative/limbic part of the subthalamic nucleus) stimulation, corresponding to three different experimental sessions. |
|
| Recording during computerized tests | Other | Participants will perform more than one experimental session. In each experimental session 3 computerized tasks, which are suitable to study visual attention, decision making and motor performances will be presented. During these tests, participants have to responds the most quickly and accurately possible to the appearance on a computer display of a predetermined target stimuli, presented alone or in an array of signals.The computerized tests are administered twice (in two different experimental sessions) to verify the performance repeatability. |
|
| D009069 | Movement Disorders |
| D000080874 | Synucleinopathies |
| D019636 | Neurodegenerative Diseases |