Pathophysiology of Neuronal Oscillations Within Subthalamo-cortical Loops in Parkinson's Disease

Public Assistance-Hospitals of Marseille (AP-HM)

Status: Completed

Conditions: Pathophysiology of Neuronal Oscillations Within Subthalamo-cortical Loops; Parkinson's Disease

Treatments: Other: subthalamo-cortical loops stimulation in a one-sided and bipolar way

Study type: Interventional

Funder types: Other

Identifiers

NCT01284686

2009-A00913-54

Details and patient eligibility

About

Neuronal activity in circuits between the basal ganglia (BG) and motor cortical areas is abnormally synchronised and rhythmic. The oscillatory activity prevails at 8-30 Hz in untreated Parkinson's Disease (PD) and its amplitude at both subthalamic and cortical levels inversely correlates with motor impairment. Moreover, these different levels in BG-cortical loops are coherent in this frequency band. The 8-30 Hz activity is suppressed by treatment following treatment with dopaminergic drugs and is partially suppressed prior to and during voluntary movements. An unanswered question is how do BG-cortical loops become so prominently engaged in this oscillatory activity? One possible explanation is that the resonance frequencies of the loops fall in the 8-30 Hz band in the untreated state, so that oscillations in this band are transmitted particularly well. This hypothesis was confirmed in a previous series of experiments.The aim is to determine whether the resonance frequency within BG-cortical loops is correlated to the BG-cortical coherence frequency (with 20 subjets during 24 months).

Full description

Methods: Record STN-cortex LFP coherence pattern and then stimulate STN (at 0, 5, 10, 15, 20, 25, 30 Hz) in newly implanted patients at rest and during simple and complex motor tasks while recording the steady state evoked potential over the cortex using EEG. The resonance frequency will be calculated as previously (Eusebio et al, Brain 2009). Experiments will be carried out both in the OFF medication and ON medication condition.

Enrollment: 23 patients

Sex: All

Volunteers: No Healthy Volunteers

Inclusion criteria

• Parkinson's disease idiopathique evolving for more than 5 years
• Dopa-Sensibility superior to 50 %
• Electrodes of stimulation implanted in 2 NST at Timone (Pr PERAGUT)

Exclusion criteria

• Bad tolerance of the condition OFF Dopa and\or OFF stimulation

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Crossover Assignment

Masking: None (Open label)

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23 participants in 2 patient groups

dopamine

Active Comparator group

Description:

ON DOPA:The patient will take his usual treatment with dopamine

Treatment:

Other: subthalamo-cortical loops stimulation in a one-sided and bipolar way

Other: subthalamo-cortical loops stimulation in a one-sided and bipolar way

without dopa

Experimental group

Description:

OFF Dopa: The patient will be deprived of his treatment usual dopaminergique for at least 12 hours

Treatment:

Other: subthalamo-cortical loops stimulation in a one-sided and bipolar way

Other: subthalamo-cortical loops stimulation in a one-sided and bipolar way