Correlation of Tractography and Motor Evoked Potentials in Deep Brain Stimulation

Nova Scotia Health Authority60 enrolled

Overview

The goal is to establish another anatomical referencing system in order to achieve an even higher accuracy when implanting stimulation electrodes.

The main goal is to find out what are the optimal distances to these reference fiber tracts when stimulating and to find the optimal target. This has to be evaluated for each target, such as globus pallidus (Gpi), subthalamic nucleus (STN) and ventral intermediate nucleus of the thalamus (VIM) separately. This is of special importance as the investigators can demonstrate the internal capsule, which is often a generator of stimulation-induced side effects: tetanic muscle contractions, dysarthria and gaze deviations.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Improving Accuracy of Implanting Stimulation Electrodes

Interventions

Deep Brain StimulationPROCEDURE

Deep Brain Stimulation

Eligibility

Sex: ALLHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Patient qualifying for deep brain stimulation on the basis of a movement disorder (Parkinson's Disease, tremor, dystonia) or chronic pain disease. * Informed consent Exclusion Criteria: * Lack of consent * Electrical or other devices that preclude the performance of an MRI

Locations (1)

Queen Elizabeth Health Science Centre

Halifax, Nova Scotia, Canada

RECRUITING

Outcomes

Primary Outcomes

distance between stimulation electrode and motor fibers in mm

Distances between the stimulation electrode and motor fibers as depicted on fiber tracking in millimeters in correlation to the threshold current for eliciting clinical side effects

Time frame: Intraoperative

Secondary Outcomes

Intraoperative intensity of stimulation in milliampere (mA)

Intraoperative intensity of stimulation in milliamp, which elicits an activation of contralateral muscle groups (musculus interosseus dorsalis and the musculus tibialis anterior)

Time frame: Intraoperative

Stimulation thresholds in milliampere (mA)

Threshold of intraoperative stimulation intensity in milliamp, which elicits capsular side effects

Time frame: Intraoperative

Change in disease score units on the UPDRS rating scale

Assessment of therapeutic effects using Unified Parkinson disease rating scale (UPDRS)

Time frame: twelve months

Change in disease score units on the FTRS rating scale

Assessment of therapeutic effects using, Fahn-Tremor Rating Scale (FTRS)

Time frame: twelve months

Change in disease score units on the BFMDRS rating scale

Assessment of therapeutic effects using Burke-Fahn-Marsden dystonia rating scale (BFMDRS)

Time frame: twelve months

Change in disease score units on the TWSTR rating scale

Assessment of therapeutic effects using Toronto Western Spasmodic torticollis rating scale (TWSTR)

Central Contacts

Lutz Weise, MD

CONTACT

902-473-6850 lutz.weise@nshealth.ca

Data from ClinicalTrials.gov

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