Cycling Deep Brain Stimulation on Parkinson's Disease Gait

NCT ID: NCT04408573

Last Updated: 2020-06-23

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

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-06-19

Study Completion Date

2021-12-29

Brief Summary

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Our hypothesis is that cycling DBS stimulation would be superior or non-inferior to regular DBS stimulation in Parkinson's disease patients with gait impairment. The objective of this study is compare gait disorders in patients with Parkinson's disease and DBS in 4 different scenarios: 1) regular continuous high frequency (\>130Hz) stimulation, 2) cycling high frequency (\>130Hz) stimulation (40sec on, 2sec off), 3) low-frequency (80Hz) continuous stimulation and 4) cycling low frequency (80Hz) stimulation (40sec on, 2sec off)

Detailed Description

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Gait disorders such as falls, freezing of gait, reduction of speed, shuffling, and multi-stepped turning are common in patients with moderate and advanced Parkinson's disease. Compared to appendicular symptoms (bradykinesia, tremor, and rigidity), gait disorders tend to be more resistant to medical and regular deep brain stimulation treatment, and greatly impairs patients' quality of life and daily living activities. Some stimulation strategies have been tried to improve gait in Parkinson's disease patients, but so far most of them resulted in concomitant worsening of appendicular symptoms. However, new stimulation strategies such as cycling stimulation can potentially improve gait disorders without impairment of appendicular symptoms.

Conditions

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Parkinson Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

2 weeks of regular continuous high frequency (\>130Hz) stimulation, 2 weeks of cycling high frequency (\>130Hz) stimulation (40sec on, 2sec off), 2 weeks of low-frequency (80Hz) continuous stimulation and 2 weeks of cycling low frequency (80Hz) stimulation (40sec on, 2sec off)
Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Outcome Assessors

Study Groups

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Regular Continuous High Frequency

Patient remains 2 weeks in the currently chosen stimulation protocol.

Group Type NO_INTERVENTION

No interventions assigned to this group

Cycling High Frequency

Patient is stimulated with the same polarity, voltage/current, pulse width and frequency as the currently chosen stimulation protocol, but with cycling stimulation: 40sec On - 02 sec OFF

Group Type EXPERIMENTAL

Cycling deep brain stimulation

Intervention Type OTHER

Deep Brain Stimulation applied in cycling - periods of stimulation ON intercalated with periods of stimulation OFF

Continuous Low Frequency

Patient is stimulated with the same polarity and pulse width as the currently chosen stimulation protocol, but with low frequency (80Hz). Voltage/current will be adjusted to maintain TEED similar to that on the regular stimulation protocol.

Group Type EXPERIMENTAL

Cycling deep brain stimulation

Intervention Type OTHER

Deep Brain Stimulation applied in cycling - periods of stimulation ON intercalated with periods of stimulation OFF

Cycling Low Frequency

Patient is stimulated with the same polarity and pulse width as the currently chosen stimulation protocol, but with low frequency (80Hz) and cycling stimulation: 40sec On - 02 sec OFF. Voltage/current will be adjusted to maintain TEED similar to that on the regular stimulation protocol.

Group Type EXPERIMENTAL

Cycling deep brain stimulation

Intervention Type OTHER

Deep Brain Stimulation applied in cycling - periods of stimulation ON intercalated with periods of stimulation OFF

Interventions

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Cycling deep brain stimulation

Deep Brain Stimulation applied in cycling - periods of stimulation ON intercalated with periods of stimulation OFF

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Diagnosis of idiopathic Parkinson's disease
* Currently receiving Deep Brain Stimulation as a Parkinson's disease treatment
* Hoehn \& Yahr stage between 2-4 during off-medication
* Underlying gait disorders despite optimal medical and stimulation treatment: score over or equal to 1 in the subitem 2.12 of the MDS-UPDRS scale
* Willingness to comply with all study procedures

Exclusion Criteria

* Active moderate/severe psychiatric condition
* Active infection or other uncontrolled moderate/grave comorbidities
* Treatment with experimental drug
* Pregnancy or breast-feeding
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Sao Paulo General Hospital

OTHER

Sponsor Role lead

Responsible Party

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Rubens Gisbert Cury

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Rubens G Cury, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Sao Paulo General Hospital

Locations

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Hospital das Clínicas da Faculdade de Medicina da USP

São Paulo, São Paulo, Brazil

Site Status RECRUITING

Countries

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Brazil

Central Contacts

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Rubens G Cury, MD, PhD

Role: CONTACT

55 11 26617877

Carina C França, MD

Role: CONTACT

55 11 26617877

Facility Contacts

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Rubens G Cury, MD PhD

Role: primary

55 11 26617877

Other Identifiers

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67914017.6.0000.0068

Identifier Type: -

Identifier Source: org_study_id

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