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Temporale Interferentie Stimulatie op Motorische Symptomen bij de Ziekte van Parkinson
Effecten en Mechanismen van Niet-invasieve Diepe Hersenstimulatie bij Patiënten met de Ziekte van Parkinson
Het doel van deze klinische studie is om te onderzoeken of een vorm van hersenstimulatie, transcraniële temporele interferentiestimulatie (TIS) van de interne globus pallidus (GPi), kan helpen bij het verbeteren van bewegingssymptomen bij mensen met de ziekte van Parkinson. De studie zal ook onderzoeken hoe TIS de hersenactiviteit verandert die verband houdt met deze verbeteringen.
De belangrijkste vragen die deze studie wil beantwoorden zijn:
- Hoeveel kunnen herhaalde TIS-sessies de bewegingssymptomen bij mensen met de ziekte van Parkinson verbeteren?
- Kunnen deze verbeteringen tot twee maanden na het einde van de behandeling aanhouden?
- Welke veranderingen in hersenactiviteit treden op samen met de verbeteringen?
Onderzoekers zullen mensen die actieve TIS ontvangen vergelijken met mensen die sham (placebo-achtige) stimulatie ontvangen om te zien of actieve TIS leidt tot betere bewegingsresultaten.
Deelnemers zullen:
- 10 sessies van actieve of sham TIS ontvangen gedurende twee weken
- Bewegingsbeoordelingen uitvoeren tijdens de tweeweekse behandeling en opnieuw 2, 4 en 8 weken daarna
- Hersenactiviteitsbeoordelingen uitvoeren voor en na de tweeweekse behandeling
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
Studietype
Inschrijving (Werkelijk)
Fase
- Niet toepasbaar
Contacten en locaties
Studie Locaties
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Shanghai Municipality
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Shanghai, Shanghai Municipality, China, 200438
- Shanghai University of Sport
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Beschrijving
Inclusiecriteria:
- Door een arts vastgestelde idiopathische ziekte van Parkinson (PD) volgens de diagnostische criteria van de Movement Disorder Society (MDS), met begin na de leeftijd van 40 jaar.
- Stabiel antiparkinsonmedicatieregime, inclusief levodopabevattende therapie, onveranderd gedurende ten minste 4 weken voor en tijdens het onderzoek.
- Hoehn en Yahr (H&Y) stadia 1,5 tot 3 en het vermogen om zonder hulp te lopen.
- Afwezigheid van dementie, gedefinieerd als een Montreal Cognitive Assessment (MoCA) score ≥ 21.
Exclusiecriteria:
- Elke contra-indicatie voor MRI of transcraniële temporale interferentiestimulatie (TIS), inclusief claustrofobie, metalen implantaten in het hoofd of hart, of een voorgeschiedenis van elektroconvulsietherapie.
- Huidig gebruik van antipsychotica, antidepressiva of andere dopamine-modulerende medicijnen.
- Aanwezigheid van orthopedische aandoeningen die de motorische beoordelingen kunnen beïnvloeden, zoals artrose of recente orthopedische chirurgie (binnen de afgelopen 6 maanden).
- Voorgeschiedenis van door een arts vastgestelde ernstige psychiatrische aandoening.
- Door een arts vastgestelde cardiovasculaire risico's die deelname aan lichaamsbeweging of het onderzoek kunnen contra-indiceren.
- Eerdere voorgeschiedenis van diepe hersenstimulatie (DBS) chirurgie.
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Dubbele
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
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Experimenteel: TIS Groep
Deelnemers in deze arm zullen gedurende een interventieperiode van twee weken actieve transcraniële temporele interferentiestimulatie ontvangen die gericht is op de interne globus pallidus.
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Transcraniële tijdelijke interferentiestimulatie (TIS) is een niet-invasieve hersenstimulatietechniek die twee hoogfrequente wisselstromen via hoofdhuidelektroden toedient om een laagfrequent interferentieveld in diepe hersengebieden te genereren.
In deze studie richt TIS zich op de interne globus pallidus (GPi) om neurale activiteit te moduleren bij mensen met de ziekte van Parkinson.
Deelnemers ontvangen 10 stimulatiesessies over twee weken.
De schijn-TIS-conditie gebruikt dezelfde opstelling maar past laagfrequente stromen toe zonder een interferentiepatroon te genereren.
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Sham-vergelijker: Sham Group
Participants in this arm will receive sham transcranial temporal interference stimulation using the same electrode placement and experimental setup as the active intervention.
However, both electrode pairs delivered currents at 2000 Hz without a frequency offset, resulting in a flat interference envelope while maintaining similar scalp sensations.
The sham procedure consists of 10 sessions delivered over a two-week period, without therapeutic stimulation.
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Transcraniële tijdelijke interferentiestimulatie (TIS) is een niet-invasieve hersenstimulatietechniek die twee hoogfrequente wisselstromen via hoofdhuidelektroden toedient om een laagfrequent interferentieveld in diepe hersengebieden te genereren.
In deze studie richt TIS zich op de interne globus pallidus (GPi) om neurale activiteit te moduleren bij mensen met de ziekte van Parkinson.
Deelnemers ontvangen 10 stimulatiesessies over twee weken.
De schijn-TIS-conditie gebruikt dezelfde opstelling maar past laagfrequente stromen toe zonder een interferentiepatroon te genereren.
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Change From Baseline in the Movement Disorder Society-Unified Parkinson's Disease Rating Scale-III (MDS-UPDRS III) Score
Tijdsspanne: Baseline, immediately after 1 and 2 weeks of intervention, 2 weeks, 4 weeks, and 8 weeks after intervention.
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Change in motor symptoms assessed using the Movement Disorder Society-Unified Parkinson's Disease Rating Scale-III (MDS-UPDRS III).
The total score ranges from 0 to 132, with higher scores indicating more severe motor impairment (worse outcome).
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Baseline, immediately after 1 and 2 weeks of intervention, 2 weeks, 4 weeks, and 8 weeks after intervention.
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Participants With a ≥5-point Reduction From Baseline in the Movement Disorder Society-Unified Parkinson's Disease Rating Scale-III (MDS-UPDRS III) Score
Tijdsspanne: Baseline, immediately after 1 and 2 weeks of intervention, 2 weeks, 4 weeks, and 8 weeks after intervention.
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A responder was defined as a participant with a reduction of at least 5 points from baseline in the Movement Disorder Society-Unified Parkinson's Disease Rating Scale Part III (MDS-UPDRS III) total score.
Scores range from 0 to 132, with higher scores indicating more severe motor impairment; therefore, a reduction in score indicates improvement.
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Baseline, immediately after 1 and 2 weeks of intervention, 2 weeks, 4 weeks, and 8 weeks after intervention.
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Change From Baseline in the Movement Disorder Society-Unified Parkinson's Disease Rating Scale-I (MDS-UPDRS I) Score
Tijdsspanne: Baseline, immediately after 1 and 2 weeks of intervention, 2 weeks, 4 weeks, and 8 weeks after intervention.
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Change in non-motor symptoms assessed using the Movement Disorder Society-Unified Parkinson's Disease Rating Scale-I (MDS-UPDRS I) (Non-Motor Experiences of Daily Living).
The total score ranges from 0 to 52, with higher scores indicating more severe non-motor symptoms (worse outcome).
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Baseline, immediately after 1 and 2 weeks of intervention, 2 weeks, 4 weeks, and 8 weeks after intervention.
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Change From Baseline in the Movement Disorder Society-Unified Parkinson's Disease Rating Scale-II (MDS-UPDRS II) Score
Tijdsspanne: Baseline, immediately after 1 and 2 weeks of intervention, 2 weeks, 4 weeks, and 8 weeks after intervention.
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Change in motor symptoms affecting daily living assessed using the Movement Disorder Society-Unified Parkinson's Disease Rating Scale-II (MDS-UPDRS II) (Motor Experiences of Daily Living).
The total score ranges from 0 to 52, with higher scores indicating more severe motor difficulties in daily living (worse outcome).
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Baseline, immediately after 1 and 2 weeks of intervention, 2 weeks, 4 weeks, and 8 weeks after intervention.
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Change From Baseline in the Epworth Sleepiness Scale Score
Tijdsspanne: Baseline, immediately after 1 and 2 weeks of intervention, 2 weeks, 4 weeks, and 8 weeks after intervention.
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Change in daytime sleepiness assessed using the Epworth Sleepiness Scale .
The Epworth Sleepiness Scale is a self-administered questionnaire consisting of 8 items, with total scores ranging from 0 to 24, where higher scores indicate greater daytime sleepiness (worse outcome).
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Baseline, immediately after 1 and 2 weeks of intervention, 2 weeks, 4 weeks, and 8 weeks after intervention.
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Change From Baseline in the Parkinson's Disease Sleep Scale-2 Score
Tijdsspanne: Baseline, immediately after 1 and 2 weeks of intervention, 2 weeks, 4 weeks, and 8 weeks after intervention.
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Change in sleep disturbances assessed using the Parkinson's Disease Sleep Scale-2. The Parkinson's Disease Sleep Scale-2 is a patient-reported questionnaire consisting of 15 items, with total scores ranging from 0 to 60, where higher scores indicate more severe sleep disturbances (worse outcome). |
Baseline, immediately after 1 and 2 weeks of intervention, 2 weeks, 4 weeks, and 8 weeks after intervention.
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Change From Baseline in the Gait Performance Measures
Tijdsspanne: Baseline, immediately after 1 and 2 weeks of intervention, 2 weeks, 4 weeks, and 8 weeks after intervention.
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Changes in gait performance will be assessed using an instrumented gait mat during single-task and dual-task walking conditions. Spatiotemporal gait parameters, including gait speed, step length, stride length, step width, cadence, and gait variability, will be collected during standardized walking trials. Improvements in gait performance are indicated by increased gait speed, longer step and stride length, and reduced gait variability under both single-task and dual-task conditions. |
Baseline, immediately after 1 and 2 weeks of intervention, 2 weeks, 4 weeks, and 8 weeks after intervention.
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Change From Baseline in the Balance Performance Measures
Tijdsspanne: Baseline, immediately after 1 and 2 weeks of intervention, 2 weeks, 4 weeks, and 8 weeks after intervention.
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Changes in balance performance will be assessed using a force platform during standardized standing balance tasks. Center of pressure (COP) parameters, including COP path length, sway area, and sway velocity, will be derived from force platform recordings to quantify postural stability. Improved balance performance is indicated by reduced COP displacement, smaller sway area, and lower sway velocity. |
Baseline, immediately after 1 and 2 weeks of intervention, 2 weeks, 4 weeks, and 8 weeks after intervention.
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Change From Baseline in the Magnetic Resonance Imaging (MRI) Measures
Tijdsspanne: Baseline and immediately after the intervention
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Changes in brain structure and/or function will be assessed using magnetic resonance imaging (MRI). MRI data will be acquired to evaluate intervention-related changes in brain regions associated with motor control. Imaging-derived measures may include structural and functional metrics obtained from standardized MRI protocols. |
Baseline and immediately after the intervention
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Change From Baseline in the Movement Disorder Society-Unified Parkinson's Disease Rating Scale Part III-bradykinesia Subscore
Tijdsspanne: Baseline, immediately after 1 and 2 weeks of intervention, 2 weeks, 4 weeks, and 8 weeks after intervention.
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Change from baseline in the bradykinesia subscore of the Movement Disorder Society-Unified Parkinson's Disease Rating Scale Part III (MDS-UPDRS III).
The total bradykinesia subscore ranges from 0 to 48, with higher scores indicating more severe bradykinesia.
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Baseline, immediately after 1 and 2 weeks of intervention, 2 weeks, 4 weeks, and 8 weeks after intervention.
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Change From Baseline in the Movement Disorder Society-Unified Parkinson's Disease Rating Scale Part III-rigidity Subscore
Tijdsspanne: Baseline, immediately after 1 and 2 weeks of intervention, 2 weeks, 4 weeks, and 8 weeks after intervention.
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Change from baseline in the rigidity subscore of the Movement Disorder Society-Unified Parkinson's Disease Rating Scale Part III (MDS-UPDRS III).
The total rigidity subscore ranges from 0 to 20, with higher scores indicating more severe rigidity.
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Baseline, immediately after 1 and 2 weeks of intervention, 2 weeks, 4 weeks, and 8 weeks after intervention.
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Change From Baseline in the Movement Disorder Society-Unified Parkinson's Disease Rating Scale Part III-axial Subscore
Tijdsspanne: Baseline, immediately after 1 and 2 weeks of intervention, 2 weeks, 4 weeks, and 8 weeks after intervention.
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Change from baseline in the axial signs subscore of the Movement Disorder Society-Unified Parkinson's Disease Rating Scale Part III (MDS-UPDRS III).
The total axial signs subscore ranges from 0 to 20, with higher scores indicating more severe axial motor impairment.
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Baseline, immediately after 1 and 2 weeks of intervention, 2 weeks, 4 weeks, and 8 weeks after intervention.
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Change From Baseline in the Movement Disorder Society-Unified Parkinson's Disease Rating Scale Part III-tremor Subscore
Tijdsspanne: Baseline, immediately after 1 and 2 weeks of intervention, 2 weeks, 4 weeks, and 8 weeks after intervention.
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Change from baseline in the tremor subscore of the Movement Disorder Society-Unified Parkinson's Disease Rating Scale Part III (MDS-UPDRS III).
The total tremor subscore ranges from 0 to 40, with higher scores indicating more severe tremor.
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Baseline, immediately after 1 and 2 weeks of intervention, 2 weeks, 4 weeks, and 8 weeks after intervention.
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Andere uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Change From Baseline in the Home Diary Assessment of Motor States (Medication-ON Without Dyskinesia)
Tijdsspanne: Baseline, weekly averages during weeks 1 and 2 of the intervention
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The motor state will be recorded by participants using a self-completed home diary during waking hours in 30-minute intervals from awakening until bedtime. For each interval, participants will record one of the following motor states: ON with good control, ON with mild dyskinesia, ON with severe dyskinesia, or OFF. Baseline assessment will be defined as the average percentage of waking time spent in ON states over three consecutive days immediately prior to the intervention. The 1-week assessment will be defined as the average percentage of waking time spent in ON states over the five intervention days of the first intervention week, and the 2-week assessment as the average over the five intervention days of the second intervention week. The outcome measure is defined as the percentage of total recorded waking time spent in ON states, calculated from the home diary data. A higher percentage of time spent in ON states indicates milder motor symptoms and better motor control. |
Baseline, weekly averages during weeks 1 and 2 of the intervention
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Change From Baseline in the Home Diary Assessment of Motor States (Medication-OFF)
Tijdsspanne: Baseline, weekly averages during weeks 1 and 2 of the intervention
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The motor state will be recorded by participants using a self-completed home diary during waking hours in 30-minute intervals from awakening until bedtime. For each interval, participants will record one of the following motor states: ON with good control, ON with mild dyskinesia, ON with severe dyskinesia, or OFF. Baseline assessment will be defined as the average percentage of waking time spent in the Medication-OFF state over three consecutive days immediately prior to the intervention. Week 1 and Week 2 assessments will be calculated as the average percentage of waking time spent in the Medication-OFF state over the five intervention days of each intervention week. The outcome measure is defined as the percentage of total recorded waking time spent in the Medication-OFF state, calculated from the home diary data. A lower percentage of time spent in the Medication-OFF state indicates milder motor symptoms and better motor control. |
Baseline, weekly averages during weeks 1 and 2 of the intervention
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Change From Baseline in the Parkinson's Disease Questionnaire-39 (PDQ-39) Summary Index
Tijdsspanne: Baseline, immediately after 1 and 2 weeks of intervention, 2 weeks, 4 weeks, and 8 weeks after intervention.
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Change in quality of life assessed using the Parkinson's Disease Questionnaire-39 (PDQ-39).
The PDQ-39 consists of 39 items across 8 domains, with total scores ranging from 0 to 100, where higher scores indicate poorer health-related quality of life (worse outcome).
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Baseline, immediately after 1 and 2 weeks of intervention, 2 weeks, 4 weeks, and 8 weeks after intervention.
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Change From Baseline in the Parkinson's Disease Questionnaire-39 (PDQ-39) Mobility Domain Score
Tijdsspanne: Baseline, immediately after 1 and 2 weeks of intervention, 2 weeks, 4 weeks, and 8 weeks after intervention.
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Change from baseline in the mobility domain score of the Parkinson's Disease Questionnaire-39 (PDQ-39), a disease-specific measure of health-related quality of life in Parkinson's disease.
Domain scores were standardized to a scale from 0 to 100, with higher scores indicating poorer mobility-related quality of life.
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Baseline, immediately after 1 and 2 weeks of intervention, 2 weeks, 4 weeks, and 8 weeks after intervention.
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Change From Baseline in the Parkinson's Disease Questionnaire-39 (PDQ-39) Activities of Daily Living Domain Score
Tijdsspanne: Baseline, immediately after 1 and 2 weeks of intervention, 2 weeks, 4 weeks, and 8 weeks after intervention.
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Change from baseline in the activities of daily living domain score of the Parkinson's Disease Questionnaire-39 (PDQ-39), a disease-specific measure of health-related quality of life in Parkinson's disease.
Domain scores were standardized to a scale from 0 to 100, with higher scores indicating poorer activities of daily living-related quality of life.
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Baseline, immediately after 1 and 2 weeks of intervention, 2 weeks, 4 weeks, and 8 weeks after intervention.
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Change From Baseline in the Parkinson's Disease Questionnaire-39 (PDQ-39) Emotional Well-being Domain Score
Tijdsspanne: Baseline, immediately after 1 and 2 weeks of intervention, 2 weeks, 4 weeks, and 8 weeks after intervention.
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Change from baseline in the emotional well-being domain score of the Parkinson's Disease Questionnaire-39 (PDQ-39), a disease-specific measure of health-related quality of life in Parkinson's disease.
Domain scores were standardized to a scale from 0 to 100, with higher scores indicating poorer activities of emotional well-being-related quality of life.
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Baseline, immediately after 1 and 2 weeks of intervention, 2 weeks, 4 weeks, and 8 weeks after intervention.
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Change From Baseline in the Parkinson's Disease Questionnaire-39 (PDQ-39) Stigma Domain Score
Tijdsspanne: Baseline, immediately after 1 and 2 weeks of intervention, 2 weeks, 4 weeks, and 8 weeks after intervention.
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Change from baseline in the stigma domain score of the Parkinson's Disease Questionnaire-39 (PDQ-39), a disease-specific measure of health-related quality of life in Parkinson's disease.
Domain scores were standardized to a scale from 0 to 100, with higher scores indicating poorer activities of stigma-related quality of life.
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Baseline, immediately after 1 and 2 weeks of intervention, 2 weeks, 4 weeks, and 8 weeks after intervention.
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Change From Baseline in the Parkinson's Disease Questionnaire-39 (PDQ-39) Social Support Domain Score
Tijdsspanne: Baseline, immediately after 1 and 2 weeks of intervention, 2 weeks, 4 weeks, and 8 weeks after intervention.
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Change from baseline in the social support domain score of the Parkinson's Disease Questionnaire-39 (PDQ-39), a disease-specific measure of health-related quality of life in Parkinson's disease.
Domain scores were standardized to a scale from 0 to 100, with higher scores indicating poorer activities of social support-related quality of life.
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Baseline, immediately after 1 and 2 weeks of intervention, 2 weeks, 4 weeks, and 8 weeks after intervention.
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Change From Baseline in the Parkinson's Disease Questionnaire-39 (PDQ-39) Cognitions Domain Score
Tijdsspanne: Baseline, immediately after 1 and 2 weeks of intervention, 2 weeks, 4 weeks, and 8 weeks after intervention.
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Change from baseline in the cognitions domain score of the Parkinson's Disease Questionnaire-39 (PDQ-39), a disease-specific measure of health-related quality of life in Parkinson's disease.
Domain scores were standardized to a scale from 0 to 100, with higher scores indicating poorer activities of cognitions-related quality of life.
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Baseline, immediately after 1 and 2 weeks of intervention, 2 weeks, 4 weeks, and 8 weeks after intervention.
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Change From Baseline in the Parkinson's Disease Questionnaire-39 (PDQ-39) Communication Domain Score
Tijdsspanne: Baseline, immediately after 1 and 2 weeks of intervention, 2 weeks, 4 weeks, and 8 weeks after intervention.
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Change from baseline in the communication domain score of the Parkinson's Disease Questionnaire-39 (PDQ-39), a disease-specific measure of health-related quality of life in Parkinson's disease.
Domain scores were standardized to a scale from 0 to 100, with higher scores indicating poorer activities of communication-related quality of life.
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Baseline, immediately after 1 and 2 weeks of intervention, 2 weeks, 4 weeks, and 8 weeks after intervention.
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Change From Baseline in the Parkinson's Disease Questionnaire-39 (PDQ-39) Bodily Discomfort Domain Score
Tijdsspanne: Baseline, immediately after 1 and 2 weeks of intervention, 2 weeks, 4 weeks, and 8 weeks after intervention.
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Change from baseline in the bodily discomfort domain score of the Parkinson's Disease Questionnaire-39 (PDQ-39), a disease-specific measure of health-related quality of life in Parkinson's disease.
Domain scores were standardized to a scale from 0 to 100, with higher scores indicating poorer activities of bodily discomfort-related quality of life.
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Baseline, immediately after 1 and 2 weeks of intervention, 2 weeks, 4 weeks, and 8 weeks after intervention.
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Andere studie-ID-nummers
- 102772024RT146
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