Parkinson's Disease Clinical Trial
Official title:
Mapping and Manipulating the Motor, Emotional and Cognitive Territories of the Subthalamic Area in Deep Brain Stimulation Treated Parkinson Patients
About 300 patients with Parkinson's disease (PD) have been successfully treated by deep
brain stimulation (DBS) during the last 10 years in Hadassah. In most of the patients the
site of stimulation is the subthalamic nucleus (STN). Recent studies by our group and others
have demonstrated that the STN is divided into motor and non-motor areas. The investigators
have recently shown that electrophysiological mapping of the STN during the surgery can
differentiate motor and non-motor areas of the STN. Existing methods of adjustment of DBS
parameters aim at amelioration of the motor signs and therefore with inactivation of the STN
motor territory only. Although the DBS parameter setting is believed to influence the mental
and cognitive states, there is no data that correlates stimulation parameters with mental
and cognitive state. In addition, DBS parameter setting is also believed to influence
important verbal functions which are partially related to motor, mental and cognitive
states, but no data correlates the verbal function with the DBS stimulation parameters.
The investigators hypothesize that the cognitive areas of the STN have distinct
electrophysiological properties similar to our findings with the limbic / mental areas of
the STN. The investigators further hypothesize that specific stimulation of these cognitive
areas can influence the cognitive state and thus treatment with cognitive-adjusted DBS can
improve the cognitive symptoms of PD.
In this project, the investigators intend to map the motor, emotional and cognitive areas of
the STN using neuronal (single units) responses to emotional voices and cognitive tasks and
to identify the emotional and cognitive spectral signature of the STN single unit activity
using spectral analysis and neuronal responses to emotional voices and cognitive tasks. In
addition the investigators intend to find the neuronal signature of speech and to find the
correlation between motor, mental and limbic electrophysiology to speech. The investigators
also intend to investigate the motor, emotional and cognitive processing of PD patients by
manipulating the stimulation of the STN. The proposed study will combine neural recording,
stimulation and psychological and cognitive tests to shed new light on processing in the
basal ganglia, as well as to provide better treatment for PD patients.
n/a
Observational Model: Case-Only, Time Perspective: Prospective
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