Circuit-based deep brain stimulation for Parkinson's Disease
This study will test the hypothesis that deep brain stimulation (DBS) targeting specific changes in oscillatory activity at the site of stimulation will prove superior to continuous isochronal DBS thus providing the rationale for development and optimization of closed loop paradigms and determine whether the optimal closed-loop biomarker varies across subcortical targets, is task dependent, or serves to re-establish a default network that removes an underlying disruptive physiological state leading to greater improvement in motor signs and task performance.
Parkinson’s disease (PD) is an incurable, progressive condition affecting over one million people in the United States and 7-10 million worldwide. Deep brain stimulation (DBS) of the Subthalamic nucleus (STN) or of the Globus pallidus pars interna (GPi) improves motor signs and quality of life. Although most studies report significant improvement with DBS, results vary across centers, within centers across patients, and even within patients over time. Multiple factors have been proposed to explain this variation, including differences in lead location, electrophysiological biomarkers, or patient phenotype, but this issue has received little systematic study. If we are to fully develop DBS as a treatment tool for PD and other disorders, we must close this knowledge gap. Our goal is to provide comprehensive longitudinal assessments of a cohort of PD patients before, during, and after DBS surgery, including neurological, neurophysiological, and neuropsychological data. As a core facility of the University of Minnesota NIH/NINDS-P50 Udall Center, the primary role of the Clinical Core is to collect these longitudinal data.