Dual Frequency Stimulation in Parkinson's Disease

NCT04650932 | Recruiting DMC FDA Device

• 1 other identifier: 1633883
• Study Type: interventional
• Target: 10
• Locations: 1 country
• Sites: 1

Brief Summary

Deep brain stimulation (DBS) in the dorsal region of the subthalamic nucleus (STN) is very effective for reducing motor symptoms of Parkinson's disease (PD). Modeling studies suggest that this therapy may result in current spread into the ventral STN, causing altered cognitive processes. As a result, current stimulation parameters often lead to worsening in verbal fluency, executive function, and, particularly, cognitive control. There is evidence suggesting that low frequency oscillatory activity occurs across brain circuits important in integrating information for cognition. Preclinical studies and human recording studies indicate these low frequency theta oscillations drive cognitive control during cognitive tasks. Thus, the purpose of this study is to determine the safety, tolerability, and efficacy of low frequency stimulation (LFS) of the ventral STN alongside standard high frequency stimulation (HFS) of the dorsal STN in patients with PD.

Conditions

Parkinson Disease

Keywords

DBS; Deep Brain Stimulation; STN; Subthalamic Nucleus; Parkinson disease; Dual frequency; Dual region; DFDR

Outcome Measures

Primary Outcomes (7)

• Mean Change from Baseline in Depression Scores on the Center for Epidemiologic Studies Depression Scale (CES-D)

  The score of the CES-D will be compared across sessions and a score that rises above 20 (out of 60) will be considered positive for the development of depression.

  Baseline, Week 2, Week 6, Month 3, and Month 6

• Mean Change from Baseline in Impulsiveness Scores on the Barratt Impulsiveness Scale (BIS-11)

  The score of the BIS-11 will be evaluated across sessions and elevated scores indicate greater impulsivity and risk-taking behavior. The scale involves 30 questions with values from 1-4. Overall scores range from 30-120.

  Baseline, Week 2, Week 6, Month 3, and Month 6

• Mean Change from Baseline in Neuropsychiatric Inventory (NPI)

  The NPI assesses frequency, change in severity, and distress over 12 neuropsychiatric domains as evaluated by the caregiver. We will look for a significant score reduction in any domain of the NPI.

  Baseline, Week 2, Week 6, Month 3, and Month 6

• Mean Change from Baseline in Movement Scores on Part III of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS)

  Part III of the MDS-UPDRS consists of 18 areas of motor assessments to assess severity of symptoms. Each score is rated in terms of severity from 0-4, with higher scores indicating higher severity of symptoms. A composite score will be evaluated for changes from baseline.

  Baseline, Week 2, Week 6, Month 3, and Month 6

• Mean Change from Baseline in Cognitive Performance Scores on the Montreal Cognitive Assessment - Blind (MoCA)

  This will be collected via telephone calls. The MoCA-Blind has been validated for telephone administration. We will re-evaluate MoCA-Blind scores during telephone monitoring to assess any changes to cognitive ability. A total score of less than 15 out of a possible 22 indicates greater than mild cognitive impairment.

  Baseline, Hour 24, Week 1, Month 1, Month 2, Month 4, and Month 5

• Mean Change from Baseline in Depression Scores on the CES-D Short Version (CES-D-R10)

  This will be collected via telephone calls. Patients will be given an unmarked form with questions and will be able to follow along the telephone conversation and answer each question (0-4 severity rating scale) for 10 questions focused on patient affect. A total score greater than 10 (out of 30) indicates the development of depression symptoms.

  Baseline, Hour 24, Week 1, Month 1, Month 2, Month 4, and Month 5

• Mean Change from Baseline in Motor and Non-Motor Aspects of Daily Living Scores on Parts I and II of the MDS-UPDRS

  This will be collected via telephone calls. Patients will be asked questions relating to motor and non-motor aspects of daily living and to rate the severity of their symptoms on a scale from 0-4, with higher scores indicating higher severity of symptoms. We will assess for changes in the composite score from baseline.

  Baseline, Hour 24, Week 1, Month 1, Month 2, Month 4, and Month 5

Secondary Outcomes (3)

• Mean Change from Baseline in Decision-Making Scores on Probabilistic Gambling Task

  Baseline, Minute 30, Week 2, Week 6, Month 3, and Month 6

• Mean Change from Baseline in Inter-Temporal Choice Scores on a Temporal Discounting Task

  Baseline, Minute 30, Week 2, Week 6, Month 3, and Month 6

• Mean Change from Baseline in Verbal Fluency Scores on Word Generation Task

  Baseline, Minute 30, Week 2, Week 6, Month 3, and Month 6

Study Arms (1)

Sustained Dual Frequency, Dual Region, Stimulation

EXPERIMENTAL

Device: Deep brain stimulation

Interventions

Deep brain stimulation DEVICE

Patients with idiopathic Parkinson's disease who have previously been implanted with the Boston Scientific VerciseTM DBS system for at least 3 months. These patients will already be receiving high-frequency dorsal STN stimulation as part of the standard of care for PD. Once patients have provided consent and are enrolled in this study, they will receive simultaneous low-frequency stimulation of the ventral STN to examine if there are any effects on cognitive performance.

Also known as: Boston Scientific Vercise DBS

Sustained Dual Frequency, Dual Region, Stimulation

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Individuals who are 18 years and older
• Individuals with idiopathic Parkinson's Disease who previously underwent implantation with the Boston Scientific VerciseTM DBS system
• Individuals who have been implanted with the Boston Scientific VerciseTM DBS system for at least 3 months
• Individuals diagnosed with advanced PD who had bilateral dorsal subthalamic nucleus DBS surgery, as standard of care for motor improvement, with distal contacts of the electrodes implanted into the ventral STN

You may not qualify if:

• Individuals unable to provide consent and/or lack capacity to consent
• Individuals diagnosed with any cognitive or physical impairments that would limit their ability to participate in the cognitive testing
• Individuals who score below 15 on the Montreal Cognitive Assessment Test-Blind
• Individuals who score above 20 on the Center for Epidemiologic Studies Depression Scale
• Pregnant women (note: pregnant women are not candidates for DBS surgery), and prisoners
• Non-English speaking individuals. Cognitive tasks will only be conducted in English.

Sponsors & Collaborators

• University of California, Davis: lead

Study Sites (1)

UC Davis Health

Sacramento, California, 95817, United States

RECRUITING

Related Publications (26)

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  PMID: 24849364 RESULT

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MeSH Terms

Conditions

Parkinson Disease

Interventions

Deep Brain Stimulation

Condition Hierarchy (Ancestors)

Parkinsonian Disorders; Basal Ganglia Diseases; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Movement Disorders; Synucleinopathies; Neurodegenerative Diseases

Intervention Hierarchy (Ancestors)

Electric Stimulation Therapy; Therapeutics; Surgical Procedures, Operative

Study Officials

• Kiarash Shahlaie, MD, PhD

  University of California, Davis

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Kiarash Shahlaie, MD, PhD

CONTACT

916-703-5505; krshahlaie@ucdavis.edu

Janice Wang-Polagruto, PhD, CCRP

CONTACT

916-551-3244; jfwang@ucdavis.edu

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Masking Details: Open-label
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: November 16, 2020
• First Posted: December 3, 2020
• Study Start: October 22, 2022
• Primary Completion (Estimated): June 30, 2026
• Study Completion (Estimated): June 30, 2026
• Last Updated: March 31, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)