The goal of this observational study is to identify factors in blood that are associated with response to deep brain stimulation (DBS) surgery in patients with Parkinson's disease. The main questions it aims to answer are: 1. What factors in blood (proteins and RNA) are associated with good vs poor response to DBS? 2. Are these factors able to predict response to DBS? 3. How do these factors change before and after DBS? Blood and leftover brain tissue (which spontaneously adhere to the surgical instruments) will be taken and routine clinical data (including scores from routine assessments) will be collected from consenting participants who undergo DBS.
This is a prospective observational study that investigates the clinical, proteomic, transcriptomic, and genomic profiles that are associated with DBS response with regards to motor symptoms, axial symptoms, non-motor symptoms, change in medications, activities of daily living (ADLs), and quality of life (QOL). The investigators will take blood samples from participants but will not take extra brain tissue; only leftover brain tissue (which is routinely discarded) that spontaneously adheres to surgical instruments will be collected. Study participation will not change the surgical procedure in any way. The investigators also aim to characterize the change in these multiomic profiles before versus after DBS treatment, to evaluate the ability of these multiomic profiles to predict and stratify response to DBS, and to identify modifiable factors to improve response to DBS. Additionally, the investigators will use these multiomic profiles, patient demographics, and clinical presentation to develop a DBS prediction model with advanced explainable AI (XAI) techniques.
Study Type
OBSERVATIONAL
Enrollment
30
Deep brain stimulation surgery
The Hong Kong University of Science and Technology
Hong Kong, Hong Kong
RECRUITINGBlood proteomic profile
Plasma proteins measured using high-throughput ultra-sensitive proteomics platform
Time frame: From pre-operative to 5 years post-operative
Blood transcriptomic profile
Bulk RNA-sequencing of blood cells
Time frame: From pre-operative to 5 years post-operative
Movement Disorder Society - Unified Parkinson's Disease Rating Scale (MDS-UPDRS)
Rating scale that measures non-motor experiences of daily living (part I), motor experiences of daily living (part II), motor function via physical examination (part III), and motor complications (part IV) Higher scores indicate a worse outcome Range: Part I: 0-52 Part II: 0-52 Part III: 0-132 Part IV: 0-24
Time frame: From pre-operative to 5 years post-operative
Hoehn and Yahr (H&Y) stage
Staging of overall functional disability in Parkinson's disease Higher score indicates a worse outcome Range: 0-5 Stage 0: No signs of disease Stage 1: Unilateral disease Stage 1.5: Unilateral plus axial involvement Stage 2: Bilateral disease without impairment of balance Stage 2.5: Mild bilateral disease with recovery on pull test Stage 3: Mild to moderate bilateral disease; some postural instability; physically independent Stage 4: Severe disability; still able to walk / stand unassisted Stage 5: Wheelchair bound or bedridden unless aided
Time frame: From pre-operative to 5 years post-operative
Montreal Cognitive Assessment (MoCA)
Assessment of cognitive function in 8 domains: attention and concentration, executive functions, memory, language, visuospatial skills, abstraction, calculations, and orientation Higher score indicates a better outcome Range: 0-30
Time frame: From pre-operative to 5 years post-operative
Non-Motor Symptoms Scale (NMSS)
Assessment of symptomatic burden of non-motor symptoms Higher score indicates a worse outcome Range: 0-360
Time frame: From pre-operative to 5 years post-operative
Parkinson's Disease Sleep Scale - 2 (PDSS-2)
Rating scale assessing sleep disorders in PD Higher score indicates a worse outcome Range: 0-60
Time frame: From pre-operative to 5 years post-operative
Parkinson's Disease Questionnaire - 39 (PDQ-39)
39-item self-report questionnaire assessing health-related quality of life in 8 domains: mobility, activities of daily living, emotional wellbeing, stigma, social support, cognition, communication, and bodily discomfort Higher score indicates a worse outcome Range: 0-100
Time frame: From pre-operative to 5 years post-operative
Depression, Anxiety, and Stress Scale - 21 (DASS-21)
Self-report scale measuring depression, anxiety, and stress Higher scores indicate a worse outcome Range: Depression: 0-42 Anxiety: 0-42 Stress: 0-42
Time frame: From pre-operative to 5 years post-operative
Schwab and England Activities of Daily Living Scale (S&E ADL scale)
Assessment of ability to accomplish essential activities of daily living Higher score indicates a better outcome Range: 0-100%
Time frame: From pre-operative to 5 years post-operative
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