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Deep Brain Stimulation (DBS) is an effective therapy for patients with medically refractory primary dystonia. However, DBS programming for dystonia is not standardized and multiple clinic visits are frequently required to adequately control symptoms. We aim to longitudinally record brain signals from patients using a novel neurostimulator that can record brain signals. We will correlate brain signals to clinical severity scores to identify pathological rhythms in the absence of DBS, and we will study the effects of DBS on these signals in order to guide clinical programming. We are going to recruit patients who receive the Medtronic Percept device, which allows for brain signal recordings (this feature is FDA approved). The investigators will be conducting an observational study using this device to collect data that the subjects receive as standard of care.
The development of newer technologies has allowed clinicians and researchers to better understand pathophysiological underpinnings of different disorders managed with neuromodulation. There is a paucity of information, however, on dystonia, likely due to its rarity of cases and variability in phenomenology to allow generalization of findings. Possible abnormal brain signals, such as high activity in theta band (defined as rhythms in the 4-12Hz range ), have been proposed by small case series. The development of newer technologies has allowed clinicians and researchers to better understand pathophysiological underpinnings of different disorders managed with neuromodulation. There is a paucity of information, however, on dystonia, likely due to its rarity of cases and variability in phenomenology to allow generalization of findings. Possible abnormal brain signals, such as high activity in theta band (defined as rhythms in the 4-12Hz range ), have been proposed by small case series
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patients with dystonia | Patients with dystonia who have clinically been deemed candidates for DBS surgery. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Deep brain stimulation (DBS) | Device | Deep brain stimulation is an FDA approved therapy that involves surgical implantation of electrodes in deep brain targets and an implantable pulse generator delivers electrical pulses. |
| Measure | Description | Time Frame |
|---|---|---|
| Unified Dystonia Rating Scale (UDRS) | A clinical scale fo dystonia severity (0-4, 0:no symptoms, 4:extreme) | 12 months |
| Burke-Fahn-Marsden Dystonia Rating Scale | A clinical scale fo dystonia severity (0-4, 0:no symptoms, 4:extreme) | 12 months |
| Toronto Western Spasmodic Torticollis Rating Scale | A clinical scale of dystonia severity (0-4, 0:no symptoms, 4:extreme) | 12 months |
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Inclusion Criteria:
Exclusion Criteria:
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Patients with dystonia, who have been cleared for DBS surgery or receiving a battery change who will receive the Percept battery.
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| Name | Affiliation | Role |
|---|---|---|
| Aysegul Gunduz, PhD | University of Florida | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Florida | Gainesville | Florida | 32611 | United States |
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| ID | Term |
|---|---|
| D004421 | Dystonia |
| ID | Term |
|---|---|
| D020820 | Dyskinesias |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D012816 | Signs and Symptoms |
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| ID | Term |
|---|---|
| D046690 | Deep Brain Stimulation |
| ID | Term |
|---|---|
| D004599 | Electric Stimulation Therapy |
| D013812 | Therapeutics |
| D013514 | Surgical Procedures, Operative |
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| D013568 |
| Pathological Conditions, Signs and Symptoms |