Investigating Neural Biomarkers for Gait in Parkinson's Patients

NCT ID: NCT05820074

Last Updated: 2024-12-03

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

RECRUITING

Total Enrollment

60 participants

Study Classification

OBSERVATIONAL

Study Start Date

2023-04-13

Study Completion Date

2025-03-31

Brief Summary

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This observational study's main goal is to learn more about the neural mechanisms during movement in Parkinson's disease. Furthermore, it aims to inspire personalised treatment options.

Participants will undergo a protocol that involves walking and gait-related motor tasks, such as seated stepping. During the protocol, brain activity will be recorded.

Detailed Description

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Parkinson's Disease (PD) is the second most common neurodegenerative disease accompanied by motor impairment \[1\]. Although symptomatic treatments like medication with Dopamine equivalents and deep brain stimulation (DBS) are available, the effects are very heterogeneous among patients and often cease over time.

This study aims to generate insights into the neural mechanisms of PD by determining neural biomarkers for gait. The insights of this study may further inspire personalised treatment approaches.

The primary objective is to identify neural biomarkers for gait. It is hypothesised that characteristic neural oscillations are underlying kinematic patterns in healthy participants and PD patients.

The secondary objective is to compare the neural activity during gait and a seated lower limb motor task between healthy participants and PD patients. To this end, the investigators hypothesise that neural correlates of gait and of a seated lower limb motor task differ between healthy participants and PD patients.

60 participants will be included, 30 healthy participants and 30 PD patients. All participants must be older than 18 years and give informed consent. Potential participants will be pre-screened and will be informed about the study via phone call/email. Before any study procedure, participants will give informed consent as documented by signature. Afterwards, inclusion/exclusion criteria, medical history and participant characteristics will be assessed. PD patients must be of postural instability and gait difficulty sub-type.

The study consists of one session of approximately 2.5 hours. During this session, electroencephalography (EEG) in healthy participants and EEG + local field potentials of the subthalamic nucleus from implanted DBS-electrodes in PD patients will be recorded during standardised gait sequences and a seated lower limb motor task. Furthermore, a short-term neuromodulation task will be investigated.

Gait-related parameters will be recorded using motion capture, surface electromyography (EMG) and accelerometers. Gait characteristics, including symmetry, coordination, variability, and resilience will be assessed. All recording devices are approved on the market. The protocol of the session slightly differs between healthy participants and PD patients since no DBS electrodes are implanted in healthy participants, but still allows for comparison between the groups.

Conditions

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Parkinson Disease Gait Disorders, Neurologic

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

CROSS_SECTIONAL

Study Groups

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Young, healthy control

Young healthy participants below 45 years will take part in a gait protocol involving treadmill walking with pertubations and overground walking including obstacle stepping, figure-8-walk and timed-up-and-go test, as well as a seated-stepping section.

During the protocol, neural activity is recorded using EEG.

Neural Activity Recording

Intervention Type DIAGNOSTIC_TEST

Neural Activity is measured using EEG in all groups. Additionally, in Parkinson's patients, local-field-potentials from deep brain stimulation electrodes are recorded.

Movement Parameter Recording

Intervention Type DIAGNOSTIC_TEST

Gait-related movement parameters are non-invasively recorded using motion capture, accelerometers and electromyography.

Age-matched healthy control

Age-matched healthy participants above 45 years will take part in a gait protocol involving treadmill walking with pertubations and overground walking including obstacle stepping, figure-8-walk and timed-up-and-go test, as well as a seated-stepping section.

During the protocol, neural activity is recorded using EEG.

Neural Activity Recording

Intervention Type DIAGNOSTIC_TEST

Neural Activity is measured using EEG in all groups. Additionally, in Parkinson's patients, local-field-potentials from deep brain stimulation electrodes are recorded.

Movement Parameter Recording

Intervention Type DIAGNOSTIC_TEST

Gait-related movement parameters are non-invasively recorded using motion capture, accelerometers and electromyography.

Parkinson's patients

Parkinson's patients will take part in a gait protocol involving treadmill walking with pertubations and overground walking including obstacle stepping, figure-8-walk and timed-up-and-go test, as well as a seated-stepping section. Additionally, a neuromodulation set-up will be tested.

During the protocol, neural activity is recorded using EEG and signals from the DBS-electrodes.

Neural Activity Recording

Intervention Type DIAGNOSTIC_TEST

Neural Activity is measured using EEG in all groups. Additionally, in Parkinson's patients, local-field-potentials from deep brain stimulation electrodes are recorded.

Movement Parameter Recording

Intervention Type DIAGNOSTIC_TEST

Gait-related movement parameters are non-invasively recorded using motion capture, accelerometers and electromyography.

Neuromodulation

Intervention Type OTHER

Neural signals are recorded with the electrodes of the deep brain stimulation device. Parkinson's patients are asked to modulate their neural activity by observing the streamed neural activity and applying mental strategies.

Interventions

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Neural Activity Recording

Neural Activity is measured using EEG in all groups. Additionally, in Parkinson's patients, local-field-potentials from deep brain stimulation electrodes are recorded.

Intervention Type DIAGNOSTIC_TEST

Movement Parameter Recording

Gait-related movement parameters are non-invasively recorded using motion capture, accelerometers and electromyography.

Intervention Type DIAGNOSTIC_TEST

Neuromodulation

Neural signals are recorded with the electrodes of the deep brain stimulation device. Parkinson's patients are asked to modulate their neural activity by observing the streamed neural activity and applying mental strategies.

Intervention Type OTHER

Other Intervention Names

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Electroencephalography (EEG) Local-Field-Potentials with deep brain stimulation electrodes Motion capture Accelerometers Electromyography

Eligibility Criteria

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Inclusion Criteria

All participants

* must have given informed consent as documented by signature
* agree to comply with the study procedures

Healthy control group

* no neurological, orthopedic, or rheumatologic disease history
* no identified sensory impairment.
* no epilepsy and self-diagnosed acute or chronic psychiatric disorders

Parkinson's Patients

* non-tremor dominant idiopathic PD patients
* presence of postural instability (UPDRS \>1 for postural instability \[17\]), gait disturbance, and absence of other causes of reduced balance
* Implanted with Percept™ PC neurostimulator
* Able to be in the stimulation OFF

Exclusion Criteria

* Relevant cognitive impairment, with a score on Montréal Cognitive Assessment (MoCA) \< 20
* History of physical or neurological condition that interferes with study procedures
* Social and/or personal circumstances interfering with the ability to come to the session
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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cereneo center for Neurology and Rehabilitation

UNKNOWN

Sponsor Role collaborator

University of Zurich

OTHER

Sponsor Role collaborator

Swiss Federal Institute of Technology

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Olivier Lambercy, PhD

Role: PRINCIPAL_INVESTIGATOR

RELab, ETH Zürich

Locations

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Cereneo

Vitznau, Canton of Lucerne, Switzerland

Site Status RECRUITING

Countries

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Switzerland

Central Contacts

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Lena Salzmann, MSc

Role: CONTACT

+41788248679

Olivier Lambercy, PhD

Role: CONTACT

Facility Contacts

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Andreas Luft, Professor

Role: primary

+41 44 255 55 11

Lena Salzmann, PhD student

Role: backup

+41 44 510 72 34

References

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Poewe W, Seppi K, Tanner CM, Halliday GM, Brundin P, Volkmann J, Schrag AE, Lang AE. Parkinson disease. Nat Rev Dis Primers. 2017 Mar 23;3:17013. doi: 10.1038/nrdp.2017.13.

Reference Type BACKGROUND
PMID: 28332488 (View on PubMed)

Ravi DK, Gwerder M, Konig Ignasiak N, Baumann CR, Uhl M, van Dieen JH, Taylor WR, Singh NB. Revealing the optimal thresholds for movement performance: A systematic review and meta-analysis to benchmark pathological walking behaviour. Neurosci Biobehav Rev. 2020 Jan;108:24-33. doi: 10.1016/j.neubiorev.2019.10.008. Epub 2019 Oct 19.

Reference Type BACKGROUND
PMID: 31639377 (View on PubMed)

Rodriguez-Oroz MC, Moro E, Krack P. Long-term outcomes of surgical therapies for Parkinson's disease. Mov Disord. 2012 Dec;27(14):1718-28. doi: 10.1002/mds.25214. Epub 2012 Dec 3.

Reference Type BACKGROUND
PMID: 23208668 (View on PubMed)

Bichsel O, Stieglitz LH, Oertel MF, Baumann CR, Gassert R, Imbach LL. Deep brain electrical neurofeedback allows Parkinson patients to control pathological oscillations and quicken movements. Sci Rep. 2021 Apr 12;11(1):7973. doi: 10.1038/s41598-021-87031-2.

Reference Type BACKGROUND
PMID: 33846456 (View on PubMed)

Other Identifiers

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2022-01382 NGB

Identifier Type: -

Identifier Source: org_study_id