Physiology, Imaging and Modeling of Essential Tremor

NCT ID: NCT03811405

Last Updated: 2025-06-26

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

COMPLETED

Clinical Phase

NA

Total Enrollment

12 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-04-01

Study Completion Date

2025-06-01

Brief Summary

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This project aims to investigate novel ways to deliver brain stimulation to Essential Tremor (ET) patients by introducing software changes to their existing devices. The study team aims to investigate safety and efficacy of these new stimulation parameters in patients with ET.

Detailed Description

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Deep brain stimulation (DBS) is a neuromodulatory therapy that is effective in a subset of well selected essential tremor (ET) patients. However, as many as 1/5 of patients may initially improve, but then steadily worsen following the operation. The investigators developed a technique to study a variety of alternative stimulation methods without the use of an invasive repeat surgical intervention.

The electrophysiological effects of non-conventional DBS differ from traditional DBS, however the physiological differences in the setting of human tremor remain largely unknown. This study plans to explore gaps in knowledge of neuromodulation and will collect and contribute essential information to the underlying mechanism of action of DBS. The hypothesis of this project centers around active biphasic stimulation providing a wider therapeutic window and a lower adverse event profile as compared to conventional DBS.

Conditions

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Essential Tremor Parkinson Disease Dystonia

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Patients with chronically implanted DBS devices for ET who experience progressive worsening of tremor symptoms over time.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Each of the 3 interventions will be videotaped for blinded motor score assessment by an independent rater.

Study Groups

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Patients with Essential Tremor

Patients with chronically implanted DBS devices for ET who experience progressive worsening of tremor symptoms over time. The DBS implantable pulse generator (IPG) will be loaded with a temporary custom firmware to allow implementation of active biphasic pulse stimulation. The following random conditions will be applied: (1) Home Settings; (2) VIN Biphasic; (3) Stimulator Off. A 30-minute washout period will be applied between each of the random conditions. Therefore, each patient will serve as their own control.

Group Type EXPERIMENTAL

Active biphasic pulse stimulation---Home Settings

Intervention Type DEVICE

During this visit, the DBS implantable pulse generator (IPG) will be loaded with a temporary custom firmware to allow implementation of active biphasic pulse stimulation.

Active biphasic pulse stimulation---VIN Biphasic

Intervention Type DEVICE

During this visit, the DBS implantable pulse generator (IPG) will be loaded with a temporary custom firmware to allow implementation of active biphasic pulse stimulation.

Active biphasic pulse stimulation---Stimulator Off

Intervention Type DEVICE

During this visit, the DBS implantable pulse generator (IPG) will be loaded with a temporary custom firmware to allow implementation of active biphasic pulse stimulation.

Interventions

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Active biphasic pulse stimulation---Home Settings

During this visit, the DBS implantable pulse generator (IPG) will be loaded with a temporary custom firmware to allow implementation of active biphasic pulse stimulation.

Intervention Type DEVICE

Active biphasic pulse stimulation---VIN Biphasic

During this visit, the DBS implantable pulse generator (IPG) will be loaded with a temporary custom firmware to allow implementation of active biphasic pulse stimulation.

Intervention Type DEVICE

Active biphasic pulse stimulation---Stimulator Off

During this visit, the DBS implantable pulse generator (IPG) will be loaded with a temporary custom firmware to allow implementation of active biphasic pulse stimulation.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Existing unilateral or bilateral VIN DBS for ET, non-demented (MMSE\>24), and must have a documented suboptimal tremor suppression on two successive visits (compared to the baseline post-operative improvement at 6 months following ET DBS surgery). For bilateral cases, the most affected tremor side will be studied.

Exclusion Criteria

* No diagnosis of Essential Tremor
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute of Neurological Disorders and Stroke (NINDS)

NIH

Sponsor Role collaborator

Medtronic

INDUSTRY

Sponsor Role collaborator

University of Florida

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Joshua K Wong, MD

Role: PRINCIPAL_INVESTIGATOR

Univeristy of Florida

Locations

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UF Health at the University of Florida

Gainesville, Florida, United States

Site Status

McKnight Brain Institute--Fixel Center for Neurological Diseases

Gainesville, Florida, United States

Site Status

Countries

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United States

Other Identifiers

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OCR19607

Identifier Type: OTHER

Identifier Source: secondary_id

5R25NS108939-04

Identifier Type: NIH

Identifier Source: secondary_id

View Link

MEDTRONIC INC

Identifier Type: OTHER

Identifier Source: secondary_id

IRB201802397 -N -A

Identifier Type: -

Identifier Source: org_study_id

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