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| ID | Type | Description | Link |
|---|---|---|---|
| OCR48773 | Other Identifier | University of Florida |
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The purpose of this research is to learn more about how the brain works in people with essential tremor, and how it changes after treatment with High-Intensity Focused Ultrasound (HiFU). Essential tremor is a movement disorder that causes shaking, usually in the hands, and can make everyday tasks difficult. HiFU is a treatment that uses focused sound waves to target a small area in the brain involved in tremor. In this study, the investigators aim to understand how this treatment affects the brain's networks by using safe, non-invasive tests such as brain imaging, brain wave recordings, and movement assessments.
Participation in this study will last for approximately eight months. Participants will be asked to attend a total of six study visits. These include a screening visit to see if a potential participant qualifies for the study, an assessment visit before treatment and treatment visits. Prior to and after treatment (one day, six weeks, and six months after treatment), participants will have Magnetoencephalography (MEG), Functional Magnetic Resonance Imaging (fMRI), Sensor-Based Gait and Motor Function Assessments and Self-Report Questionnaires.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Essential Tremor refractory to at least 2 first line tremor medications | Experimental | Eligible patients will have MRI and fMRI scans, MEG recordings, sensor-based motor assessments, clinical evaluations and questionnaires and rating scales before the treatment, right after, and again at 6 weeks and 6 months afterward. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| MRI and fMRI scans | Diagnostic Test | functional MRI, diffusion tensor imaging, anatomical MRI |
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| Measure | Description | Time Frame |
|---|---|---|
| Change in brain electrical activity measured by magnetoencephalography (MEG) before and after treatment with focused ultrasound | Brain electrical activity will be recorded using magnetoencephalography (MEG) before treatment and at follow-up visits after treatment. MEG signals are collected as time-series data and processed to derive quantitative measures of functional brain connectivity that inform how interconnected different brain regions are. The primary outcome is the average change in these connectivity measures from pre-treatment baseline to post-treatment follow-up across participants. | baseline to 7 months |
| Measure | Description | Time Frame |
|---|---|---|
| Correlation between change in tremor amplitude and change in MEG connectivity | Pearson correlation coefficient evaluating the correlation between the change in wearable sensor-derived tremor amplitude (acceleration magnitude, m/s2) and the change in MEG connectivity metrics. Unit of Measure: Correlation coefficient (r) ranging from -1 to 1 | Baseline (pre-treatment) to 6 months post-treatment |
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Inclusion:
Exclusion:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| subeikshanan venkatesan, MBBS | Contact | 352-273-9000 | subeikshanan.venkatesan@neurology.ufl.edu |
| Name | Affiliation | Role |
|---|---|---|
| Justin Hilliard, MD | University of Florida | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| UF Health | Recruiting | Gainesville | Florida | 32610 | United States |
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| ID | Term |
|---|---|
| D020329 | Essential Tremor |
| ID | Term |
|---|---|
| D009069 | Movement Disorders |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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| ID | Term |
|---|---|
| D008279 | Magnetic Resonance Imaging |
| D011795 | Surveys and Questionnaires |
| ID | Term |
|---|---|
| D014054 | Tomography |
| D003952 | Diagnostic Imaging |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
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| MEG | Diagnostic Test | non-invasive electrophysiological technology that provides high temporal and spatial resolution to examine large-scale cortical dynamics. |
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| Sensor-based motor assessments | Diagnostic Test | research-grade wearable sensors equipped with gyroscopes and accelerometers to precisely and accurately quantify patients' tremors. These sensors will be worn on the wrist or finger, capturing data as patients perform standardized tremor assessment tasks, such as spiral drawing task, writing task, commonly used in essential tremor evaluation. Gait and balance assessments will be conducted by synchronizing multiple sensors placed on the upper and lower extremities as well as the midline. Gait and balance data will be collected during tasks such as the 7-meter walk test, 360-degree turn test, and postural sway. |
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| Clinical evaluations | Other | vital signs, health status review, and neurological exam. |
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| Questionnaires and rating scales that | Other | daily functioning, mood, memory, and tremor |
|
| Correlation between change in tremor frequency and change in MEG connectivity | Pearson correlation coefficient evaluating the correlation between the change in wearable sensor-derived tremor frequency (Hz) and the change in MEG connectivity metrics. Correlation coefficient (r) ranging from -1 to 1 | Baseline (pre-treatment) to 6 months post-treatment |
| Correlation between change in gait parameters and change in MEG connectivity | Pearson correlation coefficient evaluating the correlation between the change in wearable sensor-derived gait parameters during a standardized walk test and the change in MEG connectivity metrics. Correlation coefficient (r) ranging from -1 to 1 | Baseline (pre-treatment) to 6 months post-treatment |
| Correlation between change in postural sway and change in MEG connectivity | Pearson correlation coefficient evaluating the correlation between the change in wearable balance sensor-derived postural sway and the change in MEG connectivity metrics. Correlation coefficient (r) ranging from -1 to 1 | Baseline (pre-treatment) to 6 months post-treatment |
| Correlation between change in 360-degree turn performance and change in MEG connectivity | Pearson correlation coefficient evaluating the correlation between the change in 360-degree turn performance (duration and number of steps), obtained from wearable sensors, and the change in MEG connectivity metrics. Correlation coefficient (r) ranging from -1 to 1 | Baseline (pre-treatment) to 6 months post-treatment |
| Change from Baseline in MEG-derived Functional Connectivity Strength | Assessment of the longitudinal change in MEG-derived functional connectivity strength over multiple time points. Unitless connectivity coefficient, reported as Z-score difference | Baseline (pre-treatment) to 6 months post-treatment |
| Change from Baseline in MEG-derived Directed Connectivity | Assessment of the longitudinal change in MEG-derived directed (effective) connectivity over multiple time points. Unitless influence coefficient, reported as Z-score difference | Baseline (pre-treatment) to 6 months post-treatment |
| Change from Baseline in MEG-derived Oscillatory Band Power | Assessment of the longitudinal change in MEG-derived oscillatory band (delta, theta, alpha, beta, gamma) power over multiple time points. Unit of Measure: fT²/Hz, reported as average of differences | Baseline (pre-treatment) to 6 months post-treatment |
| Change from Baseline in MEG-derived Network Coherence | Assessment of the longitudinal change in MEG-derived network coherence over multiple time points. Unit of Measure: Unitless coherence index, reported as Z-score difference | Baseline (pre-treatment) to 6 months post-treatment |
| Correlation between sonication energy and MEG connectivity | Pearson correlation coefficient evaluating the relationship between total sonication energy (Joules, J) and MEG-derived network measures including functional connectivity strength, directed connectivity, oscillatory band power, and network coherence. Unit of Measure: Correlation coefficient (r) ranging from -1 to 1 | Baseline (pre-treatment) to 6 months post-treatment |
| Baseline (pre-treatment) to 6 months post-treatment | Pearson correlation coefficient evaluating the relationship between peak intra-procedural temperature (degrees Celsius, °C) and MEG-derived network measures including functional connectivity strength, directed connectivity, oscillatory band power, and network coherence. Correlation coefficient (r) ranging from -1 to 1 | Baseline (pre-treatment) to 6 months post-treatment |
| Correlation between number of sonications and MEG connectivity | Pearson correlation coefficient evaluating the relationship between the total number of sonications (count) and MEG-derived functional connectivity strength Unit of Measure: Correlation coefficient (r) ranging from -1 to 1 | Baseline (pre-treatment) to 6 months post-treatment |
| Correlation between lesion volume and MEG connectivity | Pearson correlation coefficient evaluating the relationship between lesion volume (cubic millimeters, mm³) and MEG-derived functional connectivity strength Unit of Measure: Correlation coefficient (r) ranging from -1 to 1 | Baseline (pre-treatment) to 6 months post-treatment |
| Correlation between patient age and MEG connectivity | Pearson correlation coefficient evaluating the relationship between patient age (years) and MEG-derived functional connectivity strength Unit of Measure: Correlation coefficient (r) ranging from -1 to 1 | Baseline (pre-treatment) to 6 months post-treatment |
| Correlation between disease duration and MEG connectivity | Pearson correlation coefficient evaluating the relationship between disease duration (years) and MEG-derived functional connectivity strength Correlation coefficient (r) ranging from -1 to 1 | Baseline (pre-treatment) to 6 months post-treatment |
| Correlation between change from baseline in CRST score and MEG connectivity | Pearson correlation coefficient evaluating the relationship between change from baseline in tremor severity as measured by the Clinical Rating Scale for Tremor (CRST score, points) and MEG-derived functional connectivity strength. Unit of Measure: Correlation coefficient (r) ranging from -1 to 1 | Baseline (pre-treatment) to 6 months post-treatment |
| Correlation between change from baseline in tremor amplitude and MEG connectivity | Pearson correlation coefficient evaluating the relationship between change from baseline in wearable sensor-derived tremor amplitude (acceleration magnitude, m/s²) and MEG-derived functional connectivity strength. Unit of Measure: Correlation coefficient (r) ranging from -1 to 1 | Baseline (pre-treatment) to 6 months post-treatment |
| Correlation between change from baseline in tremor frequency and MEG connectivity | Pearson correlation coefficient evaluating the relationship between change from baseline in tremor frequency (Hertz, Hz), measured using a wearable sensor and MEG-derived functional connectivity strength. Unit of Measure: Correlation coefficient (r) ranging from -1 to 1 | Baseline (pre-treatment) to 6 months post-treatment |
| Correlation between change from baseline in gait speed and MEG connectivity | Pearson correlation coefficient evaluating the relationship between change from baseline in gait speed (meters per second, m/s) during a standardized walk test, obtained using wearable sensors and MEG-derived functional connectivity strength. Unit of Measure: Correlation coefficient (r) ranging from -1 to 1 | Baseline (pre-treatment) to 6 months post-treatment |
| Correlation between change from baseline in postural sway and MEG connectivity | Pearson correlation coefficient evaluating the relationship between change from baseline in postural sway (acceleration magnitude, m/s²) from wearable sensors and MEG-derived functional connectivity strength. Unit of Measure: Correlation coefficient (r) ranging from -1 to 1 | Baseline (pre-treatment) to 6 months post-treatment |
| Correlation between change from baseline in 360-degree turn performance and MEG-derived functional connectivity strength. | Pearson correlation coefficient evaluating the relationship between change from baseline in 360-degree turn duration (seconds) and number of steps (count) from wearable sensors, and MEG-derived network measures. Unit of Measure: Correlation coefficient (r) ranging from -1 to 1 | Baseline (pre-treatment) to 6 months post-treatment |
| D003625 |
| Data Collection |
| D004812 | Epidemiologic Methods |
| D008919 | Investigative Techniques |
| D017531 | Health Care Evaluation Mechanisms |
| D011787 | Quality of Health Care |
| D017530 | Health Care Quality, Access, and Evaluation |
| D011634 | Public Health |
| D004778 | Environment and Public Health |