One-Year Effect on Levodopa Equivalent Daily Dose of Thalamic VIM Nucleus Stimulation Compared to Subthalamic Nucleus Stimulation in Patients With Parkinson's Disease

N/ANot Yet RecruitingNCT06936254

Central Hospital, Nancy, France94 enrolled

Overview

This study compares the effects of deep brain stimulation (DBS) of the thalamic VIM nucleus versus the subthalamic nucleus (STN) on the levodopa equivalent daily dose (LEDD) in patients with Parkinson's disease. The goal is to determine whether VIM stimulation, typically used for tremor, can also reduce medication needs. It hypothesizes that STN stimulation leads to greater LEDD reduction, but VIM may offer moderate benefits in selected case

Thesis Summary: Deep brain stimulation (DBS) is a well-established therapeutic option for patients with advanced Parkinson's disease. The two most commonly targeted structures are the subthalamic nucleus (STN) and the ventral intermediate nucleus (VIM) of the thalamus. While STN stimulation is known to allow a significant reduction in the levodopa equivalent daily dose (LEDD), the effects of VIM stimulation on medication dosage remain less clear, particularly in patients selected for predominant tremor. Objectives: To compare the evolution of LEDD one year after DBS targeting the VIM versus the STN in patients with Parkinson's disease. To assess whether VIM stimulation also enables a meaningful reduction in dopaminergic medication. To contribute to refining surgical indications based on the patient's clinical profile. Hypotheses: STN stimulation leads to a greater reduction in LEDD compared to VIM stimulation. VIM stimulation, though primarily used for tremor control, may result in moderate LEDD reduction in specific patient profiles. Surgical target selection should be personalized, considering not only motor symptom control but also the impact on medication requirements.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Parkinson Disease (PD)Deep Brain Stimulation

Eligibility

Sex: ALL

Medical Language ↔ Plain English

Inclusion Criteria: * Clinical diagnosis of Parkinson's disease * Underwent surgery for subthalamic nucleus (STN) or ventral intermediate nucleus (VIM) deep brain stimulation * Surgery performed at CHRU of Nancy * Surgery performed between 2014 (DxCare implementation) and 2024 Exclusion Criteria: * No clinical diagnosis of Parkinson's disease * No initial dopaminergic treatment * Surgery not performed at CHRU of Nancy * Death within 1 year following surgery

Outcomes

Primary Outcomes

Change in the levodopa equivalent daily dose (LEDD) between Parkinson's disease patients undergoing deep brain stimulation (DBS) targeting the VIM thalamic nucleus versus the STN.

To compare the one-year change in the levodopa equivalent daily dose (LEDD) between Parkinson's disease patients undergoing deep brain stimulation (DBS) targeting the VIM thalamic nucleus versus the STN.

Time frame: The primary endpoint, which is the change in levodopa equivalent daily dose (LEDD), will be measured one year post-surgery in both the VIM and STN DBS groups.