Understanding Motivation in Parkinson's Patients Through Neurophysiology (MPPN)

University of California San Francisco (UCSF)

Status: Enrolling

Conditions: Motivation; Parkinson Disease; Deep Brain Stimulation

Treatments: Other: Stimulation off; Other: Stimulation on; Behavioral: Decision Making Task

Study type: Interventional

Funder types: Other

Identifiers

NCT05065151

20-31239

Details and patient eligibility

About

The study aims to better understand motivation and value-based decision-making in Parkinson's patients through neurophysiology using Medtronic's Percept DBS device. By combining behavioral tasks with neural recordings, the study seeks to uncover how DBS affects motivation, particularly in relation to effort, reward, and timing.

Full description

Participants will perform reward-based decision-making tasks designed to assess both self-benefitting and prosocial motivation. The tasks will evaluate how effort and reward influence decision-making, as well as how proximity to a deadline impacts choices. These tasks will be conducted in both clinic and home settings.

Throughout the study, participants will remain on their regular dopaminergic medications. Each participant will complete sessions under two stimulation conditions: their usual DBS settings and with DBS turned off. Neural activity will be recorded using the Percept device, which enables real-time and chronic at-home data streaming. Additionally, participants will wear a device that captures movement, sleep, heart rate variability, and self-reported measures.

The primary outcomes are behavioral: changes in reaction time, acceptance rate, and success rate across different DBS conditions. The secondary outcomes focus on identifying neural oscillatory biomarkers time-locked to specific decision-making events. By linking brain activity to motivational behavior, this study aims to advance our understanding of non-motor symptoms in PD and inform the development of adaptive DBS algorithms targeting these symptoms.

Enrollment: 70 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Has Parkinson's Disease or Dystonia
• Has Medtronic Percept or RC+S DBS device implanted in either GPI or STN
• Has DBS device implanted either bilaterally or unilaterally
• Male or female
• More than 1 month post-DBS surgery

Exclusion criteria

• Severe cognitive impairments
• Has MOCA score below 20
• Pregnancy
• Age less than 18 years old

Trial design

Primary purpose: Basic Science

Allocation: Non-Randomized

Interventional model: Crossover Assignment

Masking: None (Open label)

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70 participants in 2 patient groups

Stimulation

Experimental group

Description:

Patients will be getting standard clinically acceptable stimulation within already safety validated stimulation ranges through their Medtronic Percept device.

Treatment:

Behavioral: Decision Making Task

Other: Stimulation on

No Stimulation

Experimental group

Description:

Patients will have stimulation turned off through their Medtronic Percept device.

Treatment:

Behavioral: Decision Making Task

Other: Stimulation off