Investigating the Pathophysiological Roles of Cortical, Sub-thalamic Nuclear and Pedunculo-pontine Nuclear Oscillation in Movement Termination of Parkinson Disease Patients

This study has been completed.
Sponsor:
Collaborator:
National Science Council, Taiwan
Information provided by (Responsible Party):
Chon-Haw Tsai, China Medical University Hospital
ClinicalTrials.gov Identifier:
NCT01774383
First received: January 21, 2013
Last updated: January 29, 2014
Last verified: January 2014
  Purpose

The ERD and ERS patterns of coordination between the STN and cortical regions in the termination of volitional movement in PD patients.


Condition
Parkinson's Disease; Deep Brain Stimulation

Study Type: Observational
Study Design: Observational Model: Case-Only
Time Perspective: Prospective

Resource links provided by NLM:


Further study details as provided by China Medical University Hospital:

Primary Outcome Measures:
  • The ERD and ERS patterns of coordination between the STN and cortical regions in the termination of volitional movement in PD patients. [ Time Frame: after deep brain stimulation 4th day ] [ Designated as safety issue: Yes ]
    1. To investigate the functional connectivity between the sub-thalamic nucleus and cerebral cortex on movement initiation and termination in PD patients.
    2. To examine phase leading roles of sub-thalamic nucleus and cerebral cortex in conducting volitional movements and will mainly focus on the movement termination.


Enrollment: 3
Study Start Date: August 2012
Study Completion Date: July 2013
Primary Completion Date: July 2013 (Final data collection date for primary outcome measure)
Detailed Description:

The project will investigate the roles of cortical regions, sub-thalamic nucleus and pedunculo-pontine nucleus in the preparation of volitional movement termination in patients with Parkinson's disease (PD)receiving deep brain stimulation. Currently there are two models of inhibitory preparation of volitional movements. The "withdrawal mechanism" posits the explanation that movement termination is due to the"shutting off" of the activated neuralcircuitry, whereas the "inhibition mechanism" suggests that inhibitory neural structures are activated to terminate the voluntary movement. These hypotheses were deduced from the study of scalp movement-related cortical potential recordings and how the deep structures involved in the execution in movement termination is uncertain. Movement preparation prior to movement onset (Mon) has been addressed in both scalp recordings of MRCP and from recent studies of STN in PD patients. However,the electro-physiologic information concerning the role of STN in the preparation of movement offset (Moff)is less understood. In our pilot study, we have found that high-beta event-related de-synchronization (ERD)appeared earlier (3 seconds prior to Mon) than those of low-beta and alpha for the Mon phasic movement.There was no alpha ERD for the Mon tonic movement. Alpha, low-beta, and high-beta ERD all appeared about 1 second prior to the Moff tonic movement. These findings suggest that STN participates in the preparation of volitional movement termination but via different mechanism from that in movement initiation.Unlike asynchronous ERD frequency bands present in movement initiation, a simultaneous ERD across wide frequency bands in STN may play a pivotal role in terminating volitional movement. Since there is tight connection between the cortical regions and STN, it is intriguing to know the relationship of these oscillatory patterns between the deep and superficial neural structures. In the current proposal, we will examine the patterns of ERD and ERS prior to Mon and Moff of tonic movements in both cortical and STN regions and determine the temporal relationship among them.

  Eligibility

Ages Eligible for Study:   20 Years to 80 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Sampling Method:   Probability Sample
Study Population

PD undergoing deep brain stimulation of the sub-thalamic nucleus.

Criteria

Inclusion Criteria:

Patients with PD undergoing deep brain stimulation. The inclusion criteria for the patient selection will be those with motor complications (wearing off, on-off, drug-induced dyskinesia). Levodopa challenge test will be conducted to ensure good beneficial response of medication in each patient, since this is a reliable indicator to predict the DBS effect.

Exclusion Criteria:

  1. impairment of cognition that leads unable to fully cooperate with the oral commands during operation,
  2. any moderate to severe medical disorders such as poor control of diabetic mellitus, functional III or above congestive heart failure, or cancer with distant metastasis etc.,
  3. severe mood disorders such as major depression.
  Contacts and Locations
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Please refer to this study by its ClinicalTrials.gov identifier: NCT01774383

Locations
Taiwan
China Medical University Hospital/Neuro Depart.
Taichung, Taiwan, 40447
Sponsors and Collaborators
China Medical University Hospital
National Science Council, Taiwan
Investigators
Principal Investigator: Chon-Haw Tsai, MD, PHD Department of Neurology, China Medical University Hospital, Taichung, Taiwan
  More Information

No publications provided

Responsible Party: Chon-Haw Tsai, The Chief, Department of Neurology, China Medical University Hospital
ClinicalTrials.gov Identifier: NCT01774383     History of Changes
Other Study ID Numbers: DMR101-IRB2-005
Study First Received: January 21, 2013
Last Updated: January 29, 2014
Health Authority: Taiwan: Department of Health

Keywords provided by China Medical University Hospital:
Parkinson's disease
sub-thalamic nucleus
oscillation
local field potential

Additional relevant MeSH terms:
Parkinson Disease
Parkinsonian Disorders
Basal Ganglia Diseases
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases
Movement Disorders
Neurodegenerative Diseases

ClinicalTrials.gov processed this record on October 19, 2014