Parkinson's disease (PD) is the second most common neurodegenerative disease after Alzheimer's disease. Motor symptoms include rigidity, bradykinesia, tremor, and postural instability, these motor symptoms can cause gait dysfunction. Non-motor symptoms include depression, dysarthria, cognitive disability, and sleep disturbance. Although these symptoms can be improved through drug treatment, when the course of PD reaches the middle to late stage, it will still face the situation of weakened drug efficacy and the drug side effects increased. When medication can no longer adequately control the motor symptoms of PD, deep brain stimulation (DBS) becomes a powerful option. DBS is a surgical treatment that involves implanting one or more electrodes into specific areas of the brain, which deliver electrical stimulation to regulate or destroy abnormal neural signal patterns in the target area. The effect of DBS has been proven whether it is in improving motor-related symptoms or non-motor-related symptoms, but there are still some areas that have not been compared before and after the surgery, such as: gait variability, executive functions and dual-task walking. In addition, the parameters of electrical stimulation for DBS will also affect the clinical characteristics of patients. Due to the large difference between individual cases, the recommendation of the electrical stimulation frequency still not be established. Therefore, the influence of DBS and its parameters on the symptoms of PD is a topic worthy of discussion. Purposes: (1) To investigate the long-term effects of DBS on the symptoms of PD. (2) To investigate the effects of DBS stimulation frequencies on walking performance and executive function in individuals with PD.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
24
Deep brain stimulation implanted at the patients' Substantia Nigra
Deep brain stimulation implanted at the patients' Substantia Nigra
Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University
Taipei, Taiwan
Dual-task gait performance: Stride length
Using the OPTO gait system to evaluate stride length
Time frame: Three days after frequency adjustment
Dual-task gait performance: Double limb support time
Using the OPTO gait system to evaluate double limb support time
Time frame: Three days after frequency adjustment
Executive function - Inhibition control
Using the Stroop test to evaluate inhibition control
Time frame: Three days after frequency adjustment
Executive function - Shifting attention
Using the Trail Making Test to evaluate shifting attention
Time frame: Three days after frequency adjustment
Executive function - Working memory
Using the Digit span test to evaluate working memory
Time frame: Three days after frequency adjustment
Cognitive function
Using the Montreal Cognitive Assessment (MoCA) to evaluate cognitive function
Time frame: Every 6-month up to 2 years
Non-motor symptoms
Using the Non-motor Symptoms Scale (NMSS) to non-motor symptoms
Time frame: Every 6-month up to 2 years
Usual gait performance: Stride length
Using the OPTO gait system to evaluate stride length
Time frame: Three days after frequency adjustment
Usual gait performance: Double limb support time
Using the OPTO gait system to evaluate double limb support time
Time frame: Three days after frequency adjustment
Brain activity: Prefrontal Cortex
Using Functional near-infrared spectroscopy (fNIRS) to evaluate brain activity of Prefrontal Cortex with the formula: Hb diff=HbO-HbR
Time frame: Three days after frequency adjustment
Brain activity: Supplementary Motor Cortex
Using Functional near-infrared spectroscopy (fNIRS) to evaluate brain activity of Supplementary Motor Area with the formula: Hb diff=HbO-HbR
Time frame: Three days after frequency adjustment
Brain activity: Premotor Cortex
Using Functional near-infrared spectroscopy (fNIRS) to evaluate brain activity of Premotor Cortex with the formula: Hb diff=HbO-HbR
Time frame: Three days after frequency adjustment
Functional activity: Gait and balance performance
Using the Timed up and go test to evaluate functional activity
Time frame: Every 6-month up to 2 years
Functional activity: Lower limb function
Using the 30s Chair Stand Test to evaluate functional activity
Time frame: Every 6-month up to 2 years
Balance performance
Using the Mini-BEST test to evaluate balance performance
Time frame: Every 6-month up to 2 years
Motor symptoms
Using the Unified Parkinson's Disease Rating Scale (UPDRS) part 3 to evaluate motor symptoms
Time frame: Every 6-month up to 2 years
Parkinson's Disease patients' Quality of life
Using the Parkinson's Disease Questionnaire (PDQ-39) evaluate quality of life
Time frame: Every 6-month up to 2 years
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.