Multi-modal targeting DBS

• Research type

  Research Study

• Full title

  Pilot study on using mutli-modal targeting and monitoring modalities to improve deep brain stimulation accuracy and safety for movement disorders in the NHS

• IRAS ID

  273497

• Contact name

  Nikolaos Haliasos

• Contact email

  n.haliasos@nhs.net

• Sponsor organisation

  BHRUT

• Duration of Study in the UK

  3 years, 0 months, 1 days

• Research summary

  Parkinson’s disease is a very common neuro-degenerative disorder affecting 10 million people worldwide and 145,000 patients in the UK. During the advanced stages of the disease when the medication therapy is inadequate the gold standard treatment in the NHS is Deep Brain Stimulation (DBS). This is done by a neurosurgical operation where 1 or 2 small electrodes of 1.2mm in diameter are placed 8-10cm inside the patient’s head to target small groups of neurons called the basal ganglia nuclei. The targeting is done by using MRI coordinates and feedback from the patient during the operation – the patient is awake for part of the procedure. The closer the electrodes are positioned to the “sweet spot” inside these neuronal groups of cells the better the outcome and less side-effects. Research groups around the world have already proposed using advanced MRI imaging techniques preoperatively like tractography(DTI) to improve the targetting accuracy of the existing MRI targeting. Also, during the operation phase when patient is awake and giving feedback, researchers have proposed using video and voice analysis as well as hand tremor analysis by electromyography in order to identify subtle changes/minimise side-effects while various electrode positions are being tested prior to finalising the operation. These new modalities of targeting and monitoring patients during DBS surgery are called “multi-modal approaches” (MM).
  The aim of this study would be to conduct a pilot where on top of the conventional way of doing the procedure(CW) we will add the “multi-modal approaches” (MM) to test whether they can reliably be recorded in a standard NHS setup and if they can improve our outcomes in relation to effectiveness and minimisation of side-effects

• REC name

  London - Riverside Research Ethics Committee

• REC reference

  20/LO/0221

• Date of REC Opinion

  30 Jun 2020

• REC opinion

  Further Information Favourable Opinion