- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05097001
Dystonia Image-based Programming of Stimulation: A Prospective, Randomized, Double-blind Crossover Trial (DIPS)
The primary objective of this exploratory study is to prospectively evaluate the feasibility of image-guided programming of pallidal deep brain stimulation (DBS) for dystonia. The dystonias are a heterogeneous group of movement disorders that share the core clinical feature of abnormal involuntary muscle contractions in common. Pallidal DBS is an established therapy for severe cases with an average improvement in dystonia severity of 50-60%. However, outcomes are variable and difficult to predict, and clinical trials report up to 25% of Nonresponders. Variability in electrode placement and inappropriate stimulation settings may account for much of this variability in outcome. In addition, improvement in dystonia is delayed, often days to weeks after a change in DBS therapy, complicating programming.
Our group recently developed a computer model to predict optimal individualized stimulation settings in patients based on the outcome of a large cohort of of chronically treated patients. In-silico testing showed a 16.3% better mean group improvement with computer-assisted programming compared with physician-assisted programming and a dramatic reduction in non-responders (from 25% to 5%).
In this prospective study, the computer model will be compared in a randomized, controlled, and double blinded setting against best clinical DBS programming. The primary outcome will be a responder analysis in which dystonia severity will be compared between conventional clinical and model-based programming will be compared.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Martin Reich, Dr.
- Phone Number: 0931-201-0
- Email: Reich_M1@ukw.de
Study Contact Backup
- Name: Florian Lange, Dr.
- Phone Number: 0931-201-0
- Email: Lange_L@ukw.de
Study Locations
-
-
Bavaria
-
Würzburg, Bavaria, Germany, 97080
- Recruiting
- Department of Neurology, University Hospital Würzburg
-
Contact:
- Martin Reich, Dr.
- Phone Number: 0931 201-0
- Email: Reich_M1@ukw.de
-
Contact:
- Florian Lange, Dr.
- Phone Number: 0931 201-0
- Email: Lange_L@ukw.de
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Chronic deep brain stimulation (> 1 year) in the internal globus pallidus in patients with isolated dystonia.
- Deep brain stimulation settings and dystonia medication stable for > 3 months.
- Understanding about and consent to the study and signed informed consent form.
Exclusion Criteria:
- Relevant comorbidities that might interfere with study endpoints (esp. palliative disease and severe neurologic or psychiatric comorbidities).
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: Triple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Computer
Programming based on computer-guided assessment
|
DBS readjustment based on COMPUTER or CLINICAL program
|
Active Comparator: CLINICAL
Programming based on clinically-guided assessment
|
DBS readjustment based on COMPUTER or CLINICAL program
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
successful treatment with model predicted settings
Time Frame: 8 week follow-up
|
The primary efficacy endpoint is based on the blinded physician rating of dystonia severity reflected by Clinical Dystonia Rating Scales (BFMDRS or TWSTRS).
The raters will be internationally recognized leading experts in the field of movement disorders that are not part of the study team or otherwise related to our center.
For both interventions (best clinical settings and model predicted settings) we will calculate the symptom severity score after 4 weeks of continuous stimulation, expressed in percent of the pre-operative score.
The primary endpoint is defined as "successful treatment with model predicted settings" (yes or no).
The value is "yes" if the motor symptoms with model predicted settings are equal or better (tolerance 5%) to clinical settings.
|
8 week follow-up
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
quality of life SF-36 (Short Form-36)
Time Frame: 4 week and 8 week follow-up
|
SF-36 questionnaire (Short Form-36): 36 items [0-36 points, the higher the score, the worse the symptoms]
|
4 week and 8 week follow-up
|
quality of life CDQ24
Time Frame: 4 week and 8 week follow-up
|
CDQ24 questionnaire (Craniocervical dystonia questionnaire 24): 24 items [0-24 points, the higher the score, the worse the symptoms]
|
4 week and 8 week follow-up
|
calculated energy consumption
Time Frame: Baseline visit
|
Energy consumption by the DBS pulse generators
|
Baseline visit
|
time for programming
Time Frame: Baseline visit
|
Time necessary to program the optimal DBS settings
|
Baseline visit
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Martin Reich, Department of Neurology - University Hosiptal Würzburg
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- DIPS
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Dystonia
-
University of Texas Southwestern Medical CenterMassachusetts General HospitalRecruitingDystonia | Dystonia; Idiopathic | Dystonia, Primary | Dystonia, Secondary | Dystonia, Familial | Dystonia Disorder | Dystonias, Sporadic | Dystonia; Orofacial | Dystonia Lenticularis | Dystonia, Paroxysmal | Dystonia 6 | Dystonia 5 | Dystonia 8 | Dystonia 9 | Dystonia 19 | Dystonia 10 | Dystonia 11 | Dystonia 20 | Dystonia 12 | Dystonia... and other conditionsUnited States
-
Fondation Ophtalmologique Adolphe de RothschildCompletedCervical Dystonia, PrimaryFrance
-
University Hospital, MontpellierTerminatedSpasticity | Isolated Cervical Dystonia | Complex DystoniaFrance
-
University of FloridaBachmann Strauss Dystonia & Parkinson Foundation, Inc.Completed
-
National Institute of Neurological Disorders and...Active, not recruitingDystonia | Focal Dystonia | Musician's DystoniaUnited States
-
University Hospital, MontpellierTerminatedTardive Dystonia | Generalized Dystonia | Segmental DystoniaFrance
-
Duke UniversityAmerican Academy of NeurologyNot yet recruiting
-
Institut National de la Santé Et de la Recherche...Assistance Publique - Hôpitaux de ParisNot yet recruiting
-
University of Colorado, DenverCompleted
-
National Institute of Neurological Disorders and...Completed
Clinical Trials on DBS programming
-
Mayo ClinicTerminatedParkinson DiseaseUnited States
-
Vanderbilt UniversityTerminated
-
Allegheny Singer Research Institute (also known...Boston Scientific CorporationRecruitingParkinson Disease | Deep Brain StimulationUnited States
-
University of TorontoRecruiting
-
Great Lakes NeuroTechnologies Inc.Wake Forest University Health Sciences; Ohio State University; Wake Forest UniversityUnknownParkinson DiseaseUnited States
-
Thomas KöglspergerUniversity Hospital Muenster; Heinrich-Heine University, Duesseldorf; University... and other collaboratorsRecruitingParkinson Disease | Telemedicine | Deep Brain StimulationGermany
-
SGX Nova LLCCompletedChronic Back PainUnited States
-
Cairo UniversityRecruitingSystemic Lupus ErythematosusEgypt
-
Academisch Medisch Centrum - Universiteit van Amsterdam...RecruitingParkinson Disease | Deep Brain Stimulation | ImagingNetherlands
-
Vanderbilt University Medical CenterThoratec CorporationCompleted