Mapping and Stimulating the Limbic Areas of the Subthalamic Nucleus

NCT ID: NCT01962194

Last Updated: 2013-10-14

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

NA

Total Enrollment

10 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-12-31

Study Completion Date

2015-12-31

Brief Summary

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The investigators hypothesize that the emotional and cognitive areas of the Subthalamic Nucleus (STN) have distinct electrophysiological properties and that specific stimulation of these areas can influence the mental and the emotional state. Parkinson's disease (PD; n=5) and obsessive-compulsive disorder (OCD; n=5) patients that are candidates for treatment with Subthalamic Nucleus (STN) Deep Brain Stimulation (DBS) will be recruited over a period of two years. The patients will be enrolled in a prospective, open label, clinical trial and will be followed for one year. No randomization or blinding will be used in this study.

Detailed Description

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Conditions

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Mapping the Limbic STN Using Neuronal Responses

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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PD and OCD paients for DBS intervention

Parkinson's disease (PD; n=5) and obsessive-compulsive disorder (OCD; n=5) patients that are candidates for treatment with STN DBS will be recruited over a period of two years.

Group Type EXPERIMENTAL

Deep Brain Stimulation

Intervention Type DEVICE

In this study we will use implantable Deep Brain Stimulation (DBS) system with local field potential sensing capability. The Device is the Medtronic, Inc DBS Implantable System, "Activa PC+S", which has therapy equivalent to "Activa PC", and has a new sensing programmer.

Interventions

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Deep Brain Stimulation

In this study we will use implantable Deep Brain Stimulation (DBS) system with local field potential sensing capability. The Device is the Medtronic, Inc DBS Implantable System, "Activa PC+S", which has therapy equivalent to "Activa PC", and has a new sensing programmer.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

1. Patients with PD who meet accepted criteria for DBS surgery:

i. advanced idiopathic PD ii. long-term levodopa use that leads to decreased efficacy and increased incidence of adverse effects iii. normal cognitive function or mild-moderate cognitive decline (Addenbrooke's Cognitive Examination (ACE) \> 75 and the Frontal Assessment Battery (FAB) \> 10.
2. Age 40-75 years
3. Male or female
4. Competent and willing to give written informed consent


1. Obsessive-compulsive disorder (OCD), diagnosed by Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (SCID-IV)
2. Presence of disabling severity, as assessed by a Yale-Brown Obsessive Compulsive Scale (YBOCS) score of at least 25
3. Documented highly treatment refractory OCD; the documentation must demonstrate persistence of severe symptoms and impairment for 5 or more years despite both pharmacological and psychological treatments.
4. Either drug free or on a stable drug regimen for at least 6 weeks before study entry
5. General good overall health
6. Age 20-70 years
7. Male or female
8. Competent and willing to give written informed consent.

Exclusion Criteria

1. A diagnosis of severe major depression disorder (MDD) with psychotic features
2. Significant suicidal risk \[Hamilton Depression scale item 3 (suicide) \>2\]
3. Lifetime history of substance or alcohol dependence or of abuse in the preceding 12 months
4. Significant cognitive decline, as measured by Addenbrooke's Cognitive Examination (ACE) \< 75 and the Frontal Assessment Battery (FAB) \< 10.
5. Significant cognitive impairment that would affect a participant's ability to give informed consent or provide interview or self-report data reliably
6. Any clinically significant abnormality on preoperative MRI
7. Any DBS contraindication, infection, coagulopathy, significant cardiac risk factors, or other medical risk factors for surgery
8. Pregnant and/or woman of childbearing age not using effective forms of birth control


1. A diagnosis of severe major depression disorder (MDD) with psychotic features
2. Significant suicidal risk \[Hamilton Depression scale item 3 (suicide) \>2\].
3. Comorbidity with any primary Psychotic Disorder, Bipolar Disorder, Post Traumatic Stress Disorder (PTSD), Eating Disorder.
4. Lifetime history of substance or alcohol dependence or of abuse in the preceding 12 months
5. Significant cognitive decline, as measured by Addenbrooke's Cognitive Examination (ACE) \< 75 and the Frontal Assessment Battery (FAB) \< 10.
6. Significant cognitive impairment that would affect a participant's ability to give informed consent or provide interview or self-report data reliably
7. Any another current clinically significant neurological disorder or medical illness affecting brain function, other than a tic disorder
8. Any clinically significant abnormality on preoperative MRI
9. Any DBS contraindication, infection, coagulopathy, significant cardiac risk factors, or other medical risk factors for surgery
10. Pregnant and/or woman of childbearing age not using effective forms of birth control
Minimum Eligible Age

20 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hadassah Medical Organization

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Renana Eitan, MD

Role: PRINCIPAL_INVESTIGATOR

Hadassah Medical Organization

Locations

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Hadassah Medical Center

Jerusalem, Israel, Israel

Site Status

Countries

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Israel

Central Contacts

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Renana Eitan, MD

Role: CONTACT

Email: [email protected]

Facility Contacts

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Renana Eitan, MD

Role: primary

Other Identifiers

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RE403-HMO-CTIL

Identifier Type: -

Identifier Source: org_study_id