Efficacy and Safety of Deep Brain Stimulation (DBS) of the Pallidal (GPi) in Patients With Tardive Dystonia

NCT ID: NCT00331669

Last Updated: 2009-03-04

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE2

Total Enrollment

24 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-05-31

Study Completion Date

2010-12-31

Brief Summary

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The purpose of this randomized, double blind, multi-center study is to assess the efficacy and safety of bilateral pallidal deep brain stimulation in patients with tardive dystonia.

Detailed Description

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Deep brain stimulation (DBS) has been established as a new reversible, neurosurgical therapeutic option for patients suffering from disabling neurological movement disorders such as essential tremor and Parkinson´s disease. Recently, deep brain stimulation has been successfully applied in patients with primary generalized and segmental dystonia. Additionally, a number of case reports suggest that pallidal deep brain stimulation may also improve tardive dystonia, which may for instance result from the intake of neuroleptics and which is notoriously difficult to treat medically. The present study will investigate the effects of pallidal DBS using a double blind, randomized design (sham- versus verum-stimulation within a 3-months interval post implantation of the electrodes).

Initially 60 patients had been calculated in a power analysis to assess significant results based on an average improvement of dystonic symptoms of 30%. However, in a recent study (Damier et al., Archives of General Psychiatry, 2007), 10 out of 10 showed a successful outcome of approximately 50% decrease on the extrapyramidal symptoms rating scale score. The exact one- sided lower 95% confidence limit would be 0.794 for this result. If such an approach is chosen for sample size estimation with 18 verum and 18 placebo patients one would obtain a power of 82% against a placebo effect of 30% success rate. For a placebo effect of 25% one needs 16+16 patients and for the placebo effect of 20% one needs 12+12 patients. We thus decided to reduce the sample size to 36- 32- 24 patients. It is expected that the continuous primary outcome measure will preserve even higher power than the binary one used in the study mentioned above. The local ethical committee has approved this.

Conditions

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Dystonia Movement Disorder

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Outcome Assessors

Study Groups

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1

device

Group Type PLACEBO_COMPARATOR

deep brain stimulation

Intervention Type PROCEDURE

high frequency stimulation

Interventions

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deep brain stimulation

high frequency stimulation

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Operational criteria for tardive dystonia for \> 18 months after cessation of neuroleptic exposure
* 18-75 years
* Relevant functional impairment in daily living activities
* BFMDRS \> 8 or AIMS \> 16
* Informed written consent

Exclusion Criteria

* PANNS \>60 (Schizophrenia)
* Hamilton-Score \> 18 (Depression)
* MATTIS-Score \<120 (Dementia)
* Preceding stereotactic neurosurgery
* Pronounced brain atrophy
* Increased bleeding risk
* Decreased immune status
* Botulinum Toxin treatment within the last 3 months
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Humboldt-Universität zu Berlin

OTHER

Sponsor Role collaborator

Ruhr University of Bochum

OTHER

Sponsor Role collaborator

Medical University of Cologne

OTHER

Sponsor Role collaborator

Heinrich-Heine University, Duesseldorf

OTHER

Sponsor Role collaborator

University Hospital Freiburg

OTHER

Sponsor Role collaborator

Medical University of Hannover

OTHER

Sponsor Role collaborator

Medical University Innsbruck

OTHER

Sponsor Role collaborator

University of Kiel

OTHER

Sponsor Role collaborator

Philipps University Marburg

OTHER

Sponsor Role collaborator

Ludwig-Maximilians - University of Munich

OTHER

Sponsor Role collaborator

University of Rostock

OTHER

Sponsor Role collaborator

University of Regensburg

OTHER

Sponsor Role collaborator

University Hospital Tuebingen

OTHER

Sponsor Role collaborator

Medical University of Vienna

OTHER

Sponsor Role collaborator

Medtronic

INDUSTRY

Sponsor Role collaborator

Charite University, Berlin, Germany

OTHER

Sponsor Role lead

Principal Investigators

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Andreas R Kupsch, MD

Role: PRINCIPAL_INVESTIGATOR

Dpt. of Neurology, Augustenburger Platz 1, 13353 Berlin, Charite, Campus Virchow, Germany

Locations

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Andreas Kupsch

Berlin, , Germany

Site Status RECRUITING

Countries

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Germany

Central Contacts

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Andreas R Kupsch, MD, PhD

Role: CONTACT

xx49-30-450-50 ext. 660103

Andrea Kuehn, MD

Role: CONTACT

xx49-30-450-50 ext. 660203

Facility Contacts

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Andreas R Kupsch, MD, PhD

Role: primary

xx49-30-450-50 ext. 660103

Andrea Kuehn, MD

Role: backup

xx49-30-450-50 ext. 660203

References

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Trottenberg T, Volkmann J, Deuschl G, Kuhn AA, Schneider GH, Muller J, Alesch F, Kupsch A. Treatment of severe tardive dystonia with pallidal deep brain stimulation. Neurology. 2005 Jan 25;64(2):344-6. doi: 10.1212/01.WNL.0000149762.80932.55.

Reference Type BACKGROUND
PMID: 15668437 (View on PubMed)

Franzini A, Marras C, Ferroli P, Zorzi G, Bugiani O, Romito L, Broggi G. Long-term high-frequency bilateral pallidal stimulation for neuroleptic-induced tardive dystonia. Report of two cases. J Neurosurg. 2005 Apr;102(4):721-5. doi: 10.3171/jns.2005.102.4.0721.

Reference Type BACKGROUND
PMID: 15871516 (View on PubMed)

Damier P, Thobois S, Witjas T, Cuny E, Derost P, Raoul S, Mertens P, Peragut JC, Lemaire JJ, Burbaud P, Nguyen JM, Llorca PM, Rascol O; French Stimulation for Tardive Dyskinesia (STARDYS) Study Group. Bilateral deep brain stimulation of the globus pallidus to treat tardive dyskinesia. Arch Gen Psychiatry. 2007 Feb;64(2):170-6. doi: 10.1001/archpsyc.64.2.170.

Reference Type BACKGROUND
PMID: 17283284 (View on PubMed)

Gruber D, Sudmeyer M, Deuschl G, Falk D, Krauss JK, Mueller J, Muller JU, Poewe W, Schneider GH, Schrader C, Vesper J, Volkmann J, Winter C, Kupsch A, Schnitzler A; DBS study group for dystonia. Neurostimulation in tardive dystonia/dyskinesia: A delayed start, sham stimulation-controlled randomized trial. Brain Stimul. 2018 Nov-Dec;11(6):1368-1377. doi: 10.1016/j.brs.2018.08.006. Epub 2018 Sep 11.

Reference Type DERIVED
PMID: 30249417 (View on PubMed)

Other Identifiers

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DBS and tardive dystonia

Identifier Type: -

Identifier Source: org_study_id

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