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| ID | Type | Description | Link |
|---|---|---|---|
| CDM00060272 | Other Identifier | BSC Protocol Number |
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The objective of the study is to compare different deep brain stimulation (DBS) settings using the commercially approved Boston Scientific Neuromodulation Vercise system.
The study is a prospective, multi-center, double-blind, randomized controlled trial.
This study will compare various program settings for the bilateral stimulation of the STN using the BSC implantable Vercise™ DBS System for the treatment of levodopa-responsive, moderate to severe idiopathic PD.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Short PW | Experimental | Patients with a Vercise DBS system programmed to 30 microseconds pulse width |
|
| Conventional PW | Experimental | Patients with a Vercise DBS system programmed to 60 microseconds pulse width |
|
| Ventral current steering | Experimental | Patients with a Vercise DBS system programmed to steer current ventrally |
|
| Dorsal current steering | Experimental | Patients with a Vercise DBS system programmed to steer current dorsally. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Vercise DBS settings | Device | Deep brain stimulation set at short pulse width and monopolar stimulation using current steering |
|
| Measure | Description | Time Frame |
|---|---|---|
| Therapeutic Window | The therapeutic window refers to the range of stimulus amplitudes that provide a therapeutic effect without side effects. In other words, it is the amplitude difference between the first stimulation-induced side effect threshold (e.g., eye deviation, muscle contraction, and speech) and full rigidity control threshold at 60 µs and 30 µs pulse width DBS settings. | Day 1 programming visit |
| Unified Parkinson's Disease Rating Scale III | The Unified Parkinson's Disease Rating Scale (UPDRS) has four sections (I-IV) that ask patients to rate aspects of their mental state including mood (I), aspects of daily activities (II), aspects of motor function (III), and complications of treatment (IV). Here, we ask subjects to rate their motor function (UPDRS III) following interventions with 30 µs and 60 µs pulse width DBS settings. The UPDRS III scale has 14 categories including speech, facial expression, tremor at rest, action tremor, rigidity, finger tapping ability, ability to open and close hands, ability to rapidly alternate hand movements, leg agility, ability to rise from a chair, posture, gait, response to postural displacement (e.g., push), and bradykinesia. Patients rate each of these categories from 0 to 4, with 0 being normal function and 4 being the worst. Categories assessing appendages are rated for both left and right sides, allowing a maximum score (worst outcome) of 108. | Day 1 programming visit |
| Measure | Description | Time Frame |
|---|---|---|
| Side Effect Thresholds - Single Contact vs. Steering | This endpoint determined how much current (mA) could be applied before side effects appeared when using 60 microsecond pulse widths. Values were obtained for when current was delivered through a single contact or divided between two contacts (steering). | Day 1 programming visit |
| Measure | Description | Time Frame |
|---|---|---|
| Dorsal-Ventral Current Steering Therapeutic Window | The therapeutic window refers to the range of stimulus amplitudes that provide a therapeutic effect without side effects. In other words, this measure reports the stimulus amplitude difference between the full rigidity control threshold and the first stimulation induced side effect threshold at current steering settings (current divided 50% between adjacent electrodes). |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Roshini Jain | Boston Scientific Neuromodulation Corporation | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Boston Scientific Clinical Research Information toll free number | Valencia | California | 91355 | United States | ||
Interim analysis showed 16 patients to be a sufficient sample size for primary endpoints.
All subjects in Phase 1 received all Phase 1 treatments (Short PW, Conventional PW, Dorsal Steering, and Ventral Steering), so treatments are described as milestones below. The remaining 24 patients were assessed in Phase 2 for secondary/exploratory endpoints comparing single contact stimulation vs. current steering.
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| ID | Title | Description |
|---|---|---|
| FG000 | All Arms (Phase 1) | Patients with a Vercise DBS system programmed to 30 microseconds pulse width Patients with a Vercise DBS system programmed to 60 microseconds pulse width Patients with a Vercise DBS system programmed to steer current ventrally Patients with a Vercise DBS system programmed to steer current dorsally. |
| FG001 | All Arms (Phase 2) | Patients with a Vercise DBS system programmed to 30 microseconds pulse width Patients with a Vercise DBS system programmed to 60 microseconds pulse width Patients with a Vercise DBS system programmed to steer current Patients with a Vercise DBS system programmed to single contact stimulation |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | All Arms (Phase 1) | Patients with a Vercise DBS system programmed to 30 microseconds pulse width |
| BG001 | All Arms (Phase 2) | Patients with a Vercise DBS system programmed to 60 microseconds pulse width |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Therapeutic Window | The therapeutic window refers to the range of stimulus amplitudes that provide a therapeutic effect without side effects. In other words, it is the amplitude difference between the first stimulation-induced side effect threshold (e.g., eye deviation, muscle contraction, and speech) and full rigidity control threshold at 60 µs and 30 µs pulse width DBS settings. | Therapeutic window for current steering settings was not a primary outcome measure but is described later as an "Other" outcome measure. | Posted | Mean | Standard Deviation | mA | Day 1 programming visit |
|
1 day
Patients in this study only had 1 visit. Adverse event data were not collected for Phase 2.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | All Arms | Patients with a Vercise DBS system programmed to 4 different settings including:
|
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Stephen Carcieri, PhD | Boston Scientific | 661-949-4756 | Stephen.Carcieri@bsci.com |
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| ID | Term |
|---|---|
| D010300 | Parkinson Disease |
| ID | Term |
|---|---|
| D020734 | Parkinsonian Disorders |
| D001480 | Basal Ganglia Diseases |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
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| Resting Tremor Severity - Single Contact vs. Steering |
Resting tremor was measured by a motion sensor system (Kinesia System) while either using a single contact or steering current between two contacts. Stimulation was at amplitudes defined as the therapeutic threshold for rigidity. The Kinesia System was worn by patients to measure motion parameters including linear acceleration and angular velocity during different tasks, then provided an output score on a scale of 0 (no symptoms) to 4 (severe symptoms). |
| Day 1 programming visit |
| Finger Tapping Amplitude - Single Contact vs. Steering | Severity of finger-tapping bradykinesia was measured by a motion sensor system (Kinesia System) when either using a single contact or steering current between two contacts. Stimulation was at amplitudes defined as the therapeutic threshold for rigidity. The Kinesia System was worn by patients to measure motion parameters including linear acceleration and angular velocity during different tasks, then provided an output score on a scale of 0 (no symptoms) to 4 (severe symptoms). | Day 1 programming visit |
| Day 1 programming visit |
| Resting Tremor Severity - Pulse Width and Dorsal-Ventral Steering | Resting tremor was measured by a motion sensor system (Kinesia System) at 60 µs, 30 µs, and current steering settings, at amplitudes defined as the therapeutic threshold for rigidity. The Kinesia System was worn by patients to measure motion parameters including linear acceleration and angular velocity during different tasks, then provided an output score on a scale of 0 (no symptoms) to 4 (severe symptoms). | Day 1 programming Visit |
| Finger Tapping Amplitude - Pulse Width and Dorsal-Ventral Steering | Severity of finger-tapping bradykinesia was measured by a motion sensor system (Kinesia System) at 60 µs, 30 µs, and dorsal and ventral current steering settings. Stimulation was at amplitudes defined as the therapeutic threshold for rigidity. The Kinesia System was worn by patients to measure motion parameters including linear acceleration and angular velocity during different tasks, then provided an output score on a scale of 0 (no symptoms) to 4 (severe symptoms). | Day 1 programming visit |
| A.o. LKH Univ.-Kliniken Innsbruck |
| Innsbruck |
| Austria |
| University Berlin, Charite Virchow | Berlin | Germany |
| Uniklinik Köln | Cologne | Germany |
| Universitaetsklinikum Dusseldorf | Düsseldorf | Germany |
| Universitatsklinikum Campus Kiel | Kiel | Germany |
| Universitaetsklinikum Wuerzburg | Würzburg | Germany |
| Osp. S. Maria Della Misericordia | Udine | Italy |
| Southmead Hospital Bristol | Bristol | United Kingdom |
| Charing Cross Hospital | London | United Kingdom |
| BG002 | Total | Total of all reporting groups |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
Patients with a Vercise DBS system programmed to 60 microseconds pulse width |
|
|
| Primary | Unified Parkinson's Disease Rating Scale III | The Unified Parkinson's Disease Rating Scale (UPDRS) has four sections (I-IV) that ask patients to rate aspects of their mental state including mood (I), aspects of daily activities (II), aspects of motor function (III), and complications of treatment (IV). Here, we ask subjects to rate their motor function (UPDRS III) following interventions with 30 µs and 60 µs pulse width DBS settings. The UPDRS III scale has 14 categories including speech, facial expression, tremor at rest, action tremor, rigidity, finger tapping ability, ability to open and close hands, ability to rapidly alternate hand movements, leg agility, ability to rise from a chair, posture, gait, response to postural displacement (e.g., push), and bradykinesia. Patients rate each of these categories from 0 to 4, with 0 being normal function and 4 being the worst. Categories assessing appendages are rated for both left and right sides, allowing a maximum score (worst outcome) of 108. | All subjects were analyzed at both pulse widths. Primary outcomes were only intended to be assessed for different pulse widths and not current steering. | Posted | Mean | Standard Deviation | UPDRS III score | Day 1 programming visit |
|
|
|
| Secondary | Side Effect Thresholds - Single Contact vs. Steering | This endpoint determined how much current (mA) could be applied before side effects appeared when using 60 microsecond pulse widths. Values were obtained for when current was delivered through a single contact or divided between two contacts (steering). | The 24 patients reported here are a separate population from the 16 patients who were enrolled for primary endpoint analysis (40 total patients). | Posted | Mean | Standard Deviation | mA | Day 1 programming visit |
|
|
|
| Secondary | Resting Tremor Severity - Single Contact vs. Steering | Resting tremor was measured by a motion sensor system (Kinesia System) while either using a single contact or steering current between two contacts. Stimulation was at amplitudes defined as the therapeutic threshold for rigidity. The Kinesia System was worn by patients to measure motion parameters including linear acceleration and angular velocity during different tasks, then provided an output score on a scale of 0 (no symptoms) to 4 (severe symptoms). | The 24 patients reported here are a separate population from the 16 patients who were enrolled for primary endpoint analysis (40 total patients). | Posted | Mean | Standard Deviation | units on a scale | Day 1 programming visit |
|
|
|
| Secondary | Finger Tapping Amplitude - Single Contact vs. Steering | Severity of finger-tapping bradykinesia was measured by a motion sensor system (Kinesia System) when either using a single contact or steering current between two contacts. Stimulation was at amplitudes defined as the therapeutic threshold for rigidity. The Kinesia System was worn by patients to measure motion parameters including linear acceleration and angular velocity during different tasks, then provided an output score on a scale of 0 (no symptoms) to 4 (severe symptoms). | The 24 patients reported here are a separate population from the 16 patients who were enrolled for primary endpoint analysis (40 total patients). | Posted | Mean | Standard Deviation | units on a scale | Day 1 programming visit |
|
|
|
| Other Pre-specified | Dorsal-Ventral Current Steering Therapeutic Window | The therapeutic window refers to the range of stimulus amplitudes that provide a therapeutic effect without side effects. In other words, this measure reports the stimulus amplitude difference between the full rigidity control threshold and the first stimulation induced side effect threshold at current steering settings (current divided 50% between adjacent electrodes). | The therapeutic window of short pulse widths vs. conventional pulse widths was a primary outcome measure and is reported as such in another section of this report. | Posted | Mean | Standard Deviation | mA | Day 1 programming visit |
|
|
|
| Other Pre-specified | Resting Tremor Severity - Pulse Width and Dorsal-Ventral Steering | Resting tremor was measured by a motion sensor system (Kinesia System) at 60 µs, 30 µs, and current steering settings, at amplitudes defined as the therapeutic threshold for rigidity. The Kinesia System was worn by patients to measure motion parameters including linear acceleration and angular velocity during different tasks, then provided an output score on a scale of 0 (no symptoms) to 4 (severe symptoms). | Posted | Mean | Standard Deviation | units on a scale | Day 1 programming Visit |
|
|
|
| Other Pre-specified | Finger Tapping Amplitude - Pulse Width and Dorsal-Ventral Steering | Severity of finger-tapping bradykinesia was measured by a motion sensor system (Kinesia System) at 60 µs, 30 µs, and dorsal and ventral current steering settings. Stimulation was at amplitudes defined as the therapeutic threshold for rigidity. The Kinesia System was worn by patients to measure motion parameters including linear acceleration and angular velocity during different tasks, then provided an output score on a scale of 0 (no symptoms) to 4 (severe symptoms). | Posted | Mean | Standard Deviation | units on a scale | Day 1 programming visit |
|
|
|
| 0 |
| 15 |
| 0 |
| 15 |
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| D009422 | Nervous System Diseases |
| D009069 | Movement Disorders |
| D000080874 | Synucleinopathies |
| D019636 | Neurodegenerative Diseases |