Electrophysiological Recordings of Deep Brain Stimulation in the Basal Ganglia (DBSMER)
2022年10月26日 更新者：Markey Olson、St. Joseph's Hospital and Medical Center, Phoenix
The pathology of Parkinson's disease (PD) and the mechanism of Deep Brain Stimulation surgery (DBS) are not completely understood.
The recording data that is used routinely as part of the procedure to map the target structures, however, may be analyzed in order to better understand the neural network dynamics in PD.
The purpose of the study is to perform simultaneous neural recordings from sub-cortical structures (e.g.
subthalamic nucleus [STN] or globus pallidus internus [GPi]) and the cerebral cortex.
These simultaneous recordings may provide insight in the pathology of PD and the mechanism of DBS.
The researchers will also study the effects of anesthesia level on neuron synchronization .
Recordings with micro-ECoG grid electrodes in the cortex show improved spatial resolution and these will be used to gain better understanding of cortical network dynamics and the synchronization with subcortical structures.
研究概览
详细说明
Subjects will be identified exclusively from the researchers' clinical practice for evaluation of DBS surgical candidacy for Parkinson's disease.
Once it is determined that a patient is an appropriate candidate for DBS placement (multidisciplinary team consensus) and has met inclusion criteria,the researchers will discuss the study with the subject and explain the rationale for the study as well as the implications the subject's participation has to their treatment.
Informed consent will be obtained prior to study procedures being performed.
Subjects will be in the study from the time of enrollment before surgery until all post-operative visits and tests are completed, usually by 6 months after surgery.
Follow-up during this time will consist of the standard follow-up schedule that all patients who undergo DBS follow.
This includes a clinic visit at 10-14 days, 12 weeks, and 6 months after DBS surgery.
Subjects will also have a follow-up neurocognitive evaluation consisting of the same evaluative tests administered pre-operatively.
These post-operative visits are standard for all patients undergoing DBS for Parkinson's.
研究类型
介入性
注册 (实际的)
34
阶段
- 不适用
联系人和位置
本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。
学习地点
-
-
Arizona
-
Phoenix、Arizona、美国、85013
- St. Joseph's Hospital and Medical Center
-
-
参与标准
研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。
资格标准
适合学习的年龄
18年 至 85年 (成人、年长者)
接受健康志愿者
不
有资格学习的性别
全部
描述
Inclusion Criteria:
- Parkinson's disease per Queens Square criteria
- Appropriate DBS candidate for multi-disciplinary team consensus
- Age 18 - 85 years of age
- Motor skills allowing for capability to complete evaluations
- Medically cleared for undergoing anesthesia and DBS surgery
Exclusion Criteria:
- Dementia per DSM-V criteria
- Medical or other condition precluding MRI
- History of supraspinal CNS disease other than PD
- Alcohol use of more than 4 drinks per day
- Pregnancy
- History of suicide attempt
- Currently uncontrolled clinically significant depression (BDI>20)
- History of schizophrenia, delusions, or currently uncontrolled visual hallucinations
学习计划
本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。
研究是如何设计的？
设计细节
- 主要用途：基础科学
- 分配：不适用
- 介入模型：单组作业
- 屏蔽：无（打开标签）
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
|
其他：Deep Brain Stimulation
After informed consent is obtained, the patients will undergo routine DBS pre-operative evaluation and diagnostic testing.
This includes a pre-operative 3T-MRI with and without gadolinium as well as pre-operative medical clearance by the patient's PCP or general practitioner and/or other medical specialist if necessary.
They will also receive a baseline clinical evaluation including both motor function (Unified Parkinson's Disease Rating Scale on and off anti-parkinsonian medication) quality of life assessment (Parkinson's disease Questionnaire-39) and a full neuropsychological evaluation, if not already completed as part of the routine DBS candidacy evaluation within 2 months of surgery.
Subjects will have medical clearance from their specialists and be be evaluated by an internal medicine physician prior to surgery and cleared to proceed.
|
Subjects will have awake or asleep DBS surgery with STN or GPi placement.
Microelectrode recordings will define the electrophysiological target prior to lead implantation.
Cortical recordings will be done using µECoG grids (2.0 x 0.8 cm) placed over the cortex through the same burr hole used for lead implantation.
Neural recordings will be made continuously throughout the procedure: before, during, and after DBS, and at all levels of anesthesia.
A pulse generator will be connected and implanted either during the operation or within 7-10 days post-operatively.
Subjects will be admitted overnight for observation with anticipated discharge the next morning.
The researchers will also be collecting other routine data points (length of surgery, stereotactic accuracy, length of hospital stay, and post-operative complications).
其他名称：
|
研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Neural Recordings
大体时间：pre-operative; intra-operative ; 10-14 post-operative; 12 week post-operative; 6 months post-operative
|
Simultaneous neural recordings from sub-cortical structures (e.g.
subthalamic nucleus [STN] or globus pallidus internus [GPi]) and the cerebral cortex will be collected.
Recordings include action potentials and local field potentials from sub-cortical structures while subdural microelectrocorticography grids will be used to record local field potential from the cerebral cortex.
Time, frequency, and phase relationships between action potentials and local field potentials will also be studied in the context of the level of anesthesia.
Analysis of these simultaneous recordings, including assessing any changes, may provide insight in the pathology of PD and the mechanism of DBS.
|
pre-operative; intra-operative ; 10-14 post-operative; 12 week post-operative; 6 months post-operative
|
合作者和调查者
在这里您可以找到参与这项研究的人员和组织。
调查人员
- 首席研究员：Francisco A Ponce, MD、Barrow Brain and Spine physician with SJHMC privileges
研究记录日期
这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。
研究主要日期
学习开始 (实际的)
2016年2月1日
初级完成 (实际的)
2022年3月1日
研究完成 (实际的)
2022年3月1日
研究注册日期
首次提交
2017年3月2日
首先提交符合 QC 标准的
2017年3月16日
首次发布 (实际的)
2017年3月23日
研究记录更新
最后更新发布 (实际的)
2022年10月28日
上次提交的符合 QC 标准的更新
2022年10月26日
最后验证
2022年10月1日
更多信息
此信息直接从 clinicaltrials.gov 网站检索，没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求，请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改，我们的网站上也会自动更新.