Deep Brain Stimulation for Visuomotor Function in Parkinson's Disease

NCT ID: NCT05400499

Last Updated: 2026-01-07

Basic Information

• Recruitment Status: RECRUITING
• Total Enrollment: 40 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2022-10-04
• Study Completion Date: 2026-07-01

Brief Summary

Inability to align and refocus the eyes on the objects at different depths, i.e., vergence impairment, frequently affects the quality of life in patients with Parkinson's disease. Our study aims to understand the location-specific effects of subthalamic region deep brain stimulation on vergence by integrating the patient-specific deep brain stimulation models and high-resolution eye-tracking measures. The knowledge gained will allow us to find the most beneficial stimulation location and parameters for improving binocular coordination and vergence while preserving the ability to treat motor symptoms in Parkinson's disease.

Detailed Description

The victims of very common condition Parkinson's disease (PD) are known to have tremor, rigidity, and slow movements. PD, in addition to its effects on human movements, also affects many other aspect of the brain's function. Impairment of vision is frequently seen in PD. These patients have difficulties with holding their eyes steady at a given point, seamlessly look around and read, and refocus their eyes from one image to the other while looking at objects that are at different depths. About third of the PD patients have problems coordinating the movement of two eyes together, i.e., abnormal vergence. Latter results in disabling double vision and abnormal depth perception. Most treatment options available to PD patients are limited to their effects on tremor, stiffness, and slowness - their effects on visual function is very limited. Eye surgeries are not ideal treatment strategies for these conditions given constantly changing state of the PD brain due to its degenerative nature. Cutting edge deep brain stimulation (DBS) surgery has variable effects on the eye movements and vergence function in PD. The goal of our research program is to identify the best possible therapeutic strategy using DBS to improve vergence eye movements in PD while continuing to offer its other benefits. Our multidisciplinary program has two aspects. One part of the study will examine the effects of DBS on vergence abnormalities affecting their ability to focus at various depths. Using state of art, high-resolution, research grade ophthalmic equipment the investigators will examine fine details of how DBS alters the patients' ability to refocus and how it changes the alignment between the two eyes that can cause double vision and abnormal depth perception. Once the investigators identify these characteristic changes, the investigators will correlate them with the stimulated anatomical location within the same patient's brain determined using combination of novel computer simulations of DBS and the patient's own MRI. The knowledge gained will allow us to find the ideal stimulation locations that is most beneficial to the patient for improvement in vision while continuing to offer benefits for tremor, rigidity, and slow movements.

Conditions

Parkinson's Disease

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: PROSPECTIVE

Study Groups

Parkinson's disease with DBS

This is the only group. The patients in this group will have bilateral subthalamic region deep brain stimulator. They will be recruited after they are therapeutically optimized on stimulation as well as medical therapy.

No interventions assigned to this group

Eligibility Criteria

Inclusion Criteria

• Parkinson's disease with bilateral STN DBS
• Availability of pre-operative MR images (with a T1-weighted, gradient-echo sequence) and ability to get post-operative MRI or CT scans
• Hoehn and Yahr stage 2-4 when off medication, and a stable antiparkinsonian medication regimen and DBS parameter settings

Exclusion Criteria

• Previous surgical therapy for Parkinson's disease (other than DBS)
• Dementia
• Clinically significant untreated depression or anxiety
• Clinical features suggestive of atypical parkinsonism

• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

VA Office of Research and Development

FED

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Aasef G. Shaikh, MD PhD

Role: PRINCIPAL_INVESTIGATOR

Louis Stokes VA Medical Center, Cleveland, OH

Locations

Louis Stokes VA Medical Center, Cleveland, OH

Cleveland, Ohio, United States

Site Status: RECRUITING

Countries

United States

Central Contacts

Aasef G Shaikh, MD PhD

Role: CONTACT

Aasef.Shaikh@va.gov

(216) 791-3800 ext. 60000

Monica O'Loughlin

Role: CONTACT

Monica.O'Loughlin@va.gov

(216) 791-3800

Facility Contacts

Cheryl Dudek

Role: primary

cheryl.dudek@va.gov

216-679-3800

Aasef G Shaikh, MD PhD

Role: backup

Aasef.Shaikh@va.gov

(216) 791-3800 ext. 60000

Other Identifiers

I21RX003878-01A1

Identifier Type: NIH

Identifier Source: secondary_id

View Link

N3878-P

Identifier Type: -

Identifier Source: org_study_id