Dementia With Lewy Bodies Clinical Trial
Official title:
Double Blind, Randomised, Dual Centre, Crossover, Pilot Trial of Bilateral Nucleus Basalis of Meynert Deep Brain Stimulation to Improve Cognitive Deficits in Patients With Dementia With Lewy Bodies.
This trial aims to collect pilot data to explore whether bilateral deep brain stimulation (DBS) of the Nucleus Basalis of Meynert (NBM) has beneficial effects on memory and thinking impairments among individuals with Dementia with Lewy Bodies (DLB).
We will perform a pilot study to evaluate the effectiveness of human NBM DBS at improving
cognitive deficits in DLB patients. Six patients with DLB with moderate cognitive
impairments (including but not restricted to deficits in attention and working memory) will
have bilateral DBS electrodes implanted to ensure that superficial contacts lie in the motor
Globus Pallidum interna (GPi) target, while the deepest electrical contacts lie in the NBM.
We will place electrodes using our conventional image-guided, stereotactic frame-based
procedure. Once the surgical wounds have healed, patients will be randomised into 2 groups
in a crossover trial design to have 6 week periods of NBM stimulation switched on or
switched off separated by a 2 week washout period, following which the patient will cross
over to have the opposite condition for a further 6 weeks. Outcome measures collected at the
6 weeks and 14 weeks timepoints will be compared according to whether each patient was ON or
OFF stimulation at that timepoint.
At the end of the crossover period, all patients will be invited for continued follow up
with stimulation switched on and will have neuropsychological evaluations at 6 monthly
intervals. Patients will be given the option of receiving additional conventional
stimulation to the motor GPi, through the higher contacts of each electrode, at the end of
the crossover period if required for any coexisting Parkinsonian motor complications of DLB.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Crossover Assignment, Masking: Double Blind (Subject, Caregiver, Outcomes Assessor), Primary Purpose: Treatment
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