Clinical and neurophysiological assessments of DBS frequency in PD

• Research type

  Research Study

• Full title

  Clinical and neurophysiological assessments of DBS frequency in Parkinson’s disease

• IRAS ID

  124694

• Contact name

  Patricia Limousin

• Contact email

  p.limousin@ucl.ac.uk

• Sponsor organisation

  UCL, UCLH/UCL/Royal Free Joint Research Office

• Research summary

  Deep brain stimulation (DBS) is a surgical treatment of advanced Parkinson disease for patients with important fluctuations of neurological state. It consists of introducing two electrodes, one for each side, in deep structures of the brain, the subthalamic nuclei (STN). The electrodes are connected to a pacemaker placed under the skin in the thoracic area. Several electrical parameters can be adjusted in order to reach the best clinical effect namely: the frequency, the pulse width and the voltage. Despite DBS being used for many years, its mechanism of action is not fully understood.
  After several years of DBS many patients develop postural instability, gait and speech disorders. Those problems have been attributed to disease progression. Nevertheless recent studies have shown that those problems might improve using a lower frequency of stimulation than the one commonly used. We have conducted a pilot study that has confirmed this important observation. Therefore we have decided to conduct this study to understand better the role of the DBS frequency.
  The aims of this study are to assess the clinical impact of different frequency of DBS and to explore the underlying electrophysiological mechanisms.

  We want to recruit 15 patients with DBS and study the effect of different frequency of stimulation on several tasks. The tasks will involve some simple movements such as finger tapping and more complex movements with a more cognitive involvement. The patient will be assessed during different sessions with different frequencies of DBS. In parallel we will measure the modifications of activation of the cortex by using Transcranial Magnetic Stimulation, a non invasive method of investigation giving light magnetic impulsion on the skull facing region of interest of the brain.
  This study will permit to evaluate clinical impact of different frequency of stimulation and to try to understand the underlying physiological mechanisms.

• REC name

  London - Stanmore Research Ethics Committee

• REC reference

  13/LO/1255

• Date of REC Opinion

  26 Sep 2013

• REC opinion

  Further Information Favourable Opinion