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| Name | Class |
|---|---|
| University College, London | OTHER |
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Parkinson's disease (PD) is a disabling, progressive condition characterised by severe problems with movement for which medical treatment in the longer term can be unsatisfactory. Deep brain stimulation (DBS) is a treatment, which directly stimulates the nerve cells affected inside the brain to help overcome the difficulties with movement. Classically, DBS stimulates in a manner that is constant. Many patients develop severe problems with walking, so-called freezing of gait, which can be unresponsive to constant DBS. In this study the investigators will test if left-right alternating DBS helps to improve gait problems by potentially promoting left-right alternating up- and down-modulated brain activity, which was found during walking in a previous study. The investigators will test if alternating DBS improves the ability to adjust walking speed and to walk freely compared to constant DBS.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Within-subjects comparison of constant and alternating DBS | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Alternating DBS | Device | Constant DBS will be changed to DBS that is up- and downmodulated alternating between the left and right stimulation side. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Stepping control will be assessed as the ability to adjust the stepping speed (m/s) in each stimulation condition. | Stepping speed (m/s) will be assessed. | Immediate recording |
| Stepping control will be assessed as the ability to limit the variance in stepping speed (m/s) in each stimulation condition. | Stepping variance (m/s) will be assessed. | Immediate recording |
| Measure | Description | Time Frame |
|---|---|---|
| The investigators will test if patients automatically adjust to the stimulation rhythm | Stepping entrainment | Immediate recording |
| The investigators will how well other motor symptoms including tremor, rigidity and bradykinesia are controlled with alternating DBS. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Peter Brown, MD | Contact | 01865 572 482 | peter.brown@ndcn.ox.ac.uk |
| Name | Affiliation | Role |
|---|---|---|
| Peter Brown, MD | University of Oxford | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University College London Hospitals NHS Trust | Recruiting | London | WC1N 3BG | United Kingdom |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 29760182 | Background | Fischer P, Chen CC, Chang YJ, Yeh CH, Pogosyan A, Herz DM, Cheeran B, Green AL, Aziz TZ, Hyam J, Little S, Foltynie T, Limousin P, Zrinzo L, Hasegawa H, Samuel M, Ashkan K, Brown P, Tan H. Alternating Modulation of Subthalamic Nucleus Beta Oscillations during Stepping. J Neurosci. 2018 May 30;38(22):5111-5121. doi: 10.1523/JNEUROSCI.3596-17.2018. Epub 2018 May 14. |
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Anonymised data will be made available at https://data.mrc.ox.ac.uk/ once collected and fully analysed
Anonymised data will be made available at https://data.mrc.ox.ac.uk/ once collected and fully analysed
Please see https://data.mrc.ox.ac.uk/
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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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Participants and the UPDRS examiner are blinded to the stimulation condition.
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United Parkinsons Disease Rating Scale motor (Part III) scores will be compared between stimulation conditions. |
| Immediate recording |
| University of Oxford | Active, not recruiting | Oxford | OX3 9DU | United Kingdom |
| D009422 | Nervous System Diseases |
| D009069 | Movement Disorders |
| D000080874 | Synucleinopathies |
| D019636 | Neurodegenerative Diseases |