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

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01774383
Recruitment Status : Completed
First Posted : January 24, 2013
Last Update Posted : January 30, 2014
National Science Council, Taiwan
Information provided by (Responsible Party):
Chon-Haw Tsai, China Medical University Hospital

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

Condition or disease
Parkinson's Disease; Deep Brain Stimulation

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.

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Study Type : Observational
Actual Enrollment : 3 participants
Observational Model: Case-Only
Time Perspective: Prospective
Study Start Date : August 2012
Actual Primary Completion Date : July 2013
Actual Study Completion Date : July 2013

Resource links provided by the National Library of Medicine

Primary Outcome Measures :
  1. 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 ]
    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.

Information from the National Library of Medicine

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Ages Eligible for Study:   20 Years to 80 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Probability Sample
Study Population
PD undergoing deep brain stimulation of the sub-thalamic nucleus.

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.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01774383

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China Medical University Hospital/Neuro Depart.
Taichung, Taiwan, 40447
Sponsors and Collaborators
China Medical University Hospital
National Science Council, Taiwan
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Principal Investigator: Chon-Haw Tsai, MD, PHD Department of Neurology, China Medical University Hospital, Taichung, Taiwan
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Responsible Party: Chon-Haw Tsai, The Chief, Department of Neurology, China Medical University Hospital Identifier: NCT01774383    
Other Study ID Numbers: DMR101-IRB2-005
First Posted: January 24, 2013    Key Record Dates
Last Update Posted: January 30, 2014
Last Verified: January 2014
Keywords provided by Chon-Haw Tsai, China Medical University Hospital:
Parkinson's disease
sub-thalamic nucleus
local field potential
Additional relevant MeSH terms:
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Parkinson Disease
Parkinsonian Disorders
Basal Ganglia Diseases
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases
Movement Disorders
Neurodegenerative Diseases