Analysis of Visual-Motor Task Electrophysiological Activity During Deep Brain Stimulation for Treatment-Resistant Movement Disorders



Status:Recruiting
Conditions:Parkinsons Disease, Neurology, Psychiatric
Therapuetic Areas:Neurology, Psychiatry / Psychology
Healthy:No
Age Range:18 - Any
Updated:4/22/2017
Start Date:May 26, 2011
Contact:Elaine P Considine, R.N.
Email:considinee@ninds.nih.gov
Phone:(301) 435-8518

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Objective

The objective of this pilot study is to characterize the abnormal neuronal firing patterns
of basal ganglia neurons and those in the premotor cortex in patients with
treatment-resistant movement disorders undergoing deep brain stimulation (DBS) surgery.

Study population

Fifteen adult patients with treatment-resistant movement disorders who are undergoing deep
brain stimulation surgery at Suburban Hospital, Bethesda, Maryland, will be studied.

Design

This is a physiology study of treatment-resistant movement disorder patients who have been
scheduled for implantation of a deep brain stimulation device into the Nucleus accumbens.
Prior to surgery, patients will learn a rewarded visual-motor task and undergo
magnetoencephalography. The task will be repeated during DBS surgery, with collection of
information on electrical activity including single neuronal unit and local field
potentials. The task and MEG will be repeated 3-4 months after surgery. The collected data
will be analyzed for coherence patterns during rest and rewarded movements.

Outcome measures

We plan to characterize and quantify the oscillatory activity present in motor circuits of
treatment-resistant movement disorder patients during rewarded visually guided movements. We
hypothesize that during visually guided movements, neuronal coherence will be significantly
increased relative to resting periods. Thus, by better understanding the alteration in
oscillatory patterns in these patients, we hope to develop better DBS stimulation paradigms
in order to better treat this disease in the future.

Objective:

The objective of this pilot study is to characterize the abnormal neuronal firing patterns
of basal ganglia and thalamic neurons and those in the premotor cortex in patients with
treatment-resistant movement disorders undergoing deep brain stimulation (DBS) surgery.
Neuronal activity will be studied in a decision-making task guided by reward. Secondary
objectives will involve study of how activity in the brain is modulated in such a task and
how DBS can influence the cerebral activity related to decision-making.

Study population:

Fifteen adult patients with treatment-resistant movement disorders (Essential tremor or
Parkinson s disease) who are undergoing deep brain stimulation surgery at Suburban Hospital,
Bethesda, Maryland, will be studied.

Design:

This is a physiology study of medically refractory patients who have been scheduled for
implantation of a deep brain stimulation device into basal ganglia or thalamic structures.
Prior to surgery, patients will learn a rewarded visual-motor task and undergo
magnetoencephalography (MEG). The task will be repeated during DBS surgery, with collection
of information on electrical activity including single neuronal unit and local field
potentials. The task and MEG will be repeated 3 and 6 months after surgery.

Outcome measures:

The collected data will be analyzed for coherence patterns during rest and rewarded
movements. We plan to characterize and quantify the oscillatory activity present in motor
circuits of patients during rewarded visually guided movements. We hypothesize that during
visually guided movements, neuronal coherence will be significantly increased relative to
resting periods. Activity during surgery will be compared with MEG recordings in the same
task both before and after surgery. By understanding the alteration in oscillatory patterns
in these patients, we hope to improve DBS stimulation paradigms in order to optimize
treatment protocols.

- INCLUSION CRITERIA:

Adult patients (over 18 years of age) with severe treatment-resistant ET or PD who are
scheduled for deep brain stimulation surgery at Suburban Hospital

Able to provide Informed Consent

EXCLUSION CRITERIA:

Subjects who are not willing or able to safely tolerate the study procedures

Subjects who have untreated depression or psychiatric disorder

Subjects who use illicit substances

Subjects who are pregnant

Subjects who are claustrophobic

Subjects who have metallic dental fillings.

Subjects who have any of the following: cardiac pacemaker; implanted cardiac
defibrillator; aneurysm clip; neuro or bone stimulator; insulin or infusion pump;
implanted drug infusion device; cochlear, otologic, or ear implant; prostate radiation
seeds; IUD (intrauterine device); transdermal medication patch (Nitro); any type of
prosthesis (eye, penile); heart valve prosthesis; shunt (spinal/intraventricular); wire
sutures or surgical staples; bone/joint pin, screw, nail, plate; body tattoos or makeup
(eyeliner/lip); body piercing(s) (non-removable); breast tissue expander; any metallic
implants or objects.
We found this trial at
2
sites
8600 Old Georgetown Road
Bethesda, Maryland 20814
301-896-3100
Suburban Hospital Suburban Hospital is a community-based, not-for-profit hospital serving Montgomery County and the surrounding...
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9000 Rockville Pike
Bethesda, Maryland 20892
Phone: 800-411-1222
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