Parkinson Disease Clinical Trial
Official title:
Stimulation cérébrale Profonde et Empreinte Tissulaire : Une Nouvelle stratégie Pour la Recherche Biologique in Vivo Dans la Maladie de Parkinson, Les TOC, la Dystonie, le Tremblement Essentiel et le Syndrome Gilles de la Tourette.
This exploratory study aims to validate the collection and analysis of brain tissue imprints
during the DBS by using a CE marked Medical Device in patients presenting one of the
following five disorders: Parkinson's disease (PD), essential tremor (ET), dystonia (DYS),
Obsessive compulsive disorder (OCD) and Tourette Syndrome (TS).
The Brain Tissue Imprint project is focused on the DBS surgical procedure, which constitutes
an appropriate method to collect brain tissue imprints by taking advantage of the direct and
transitory contact at the extremity of the dilator with adjacent brain tissue. Indeed, during
this step, micro-fragments of brain material spontaneously adhere to the dilator tip. It is
this imprinting process that allows to collect what is defined as "brain tissue imprints.
This approach is part of the standard surgical procedure of the SCP without major change or
complications.
Deep brain stimulation (DBS) has become the standard functional neurosurgery treatment for
drug resistant Parkinson's disease (PD) patients. It has also demonstrated its efficacy to
treat various movement disorders as well as neurological and psychiatric disorders. The
subthalamic nucleus (STN), the globus pallidus internal (GPi) or the ventral intermediate
nucleus of the thalamus (VIM) are the major targets of DBS.
Access to pathological brain tissue in living PD patients or other neurological diseases is a
key issue for the discovery of new therapeutic targets and the development of potential
curative therapies. In this context, DBS offers a unique access to the pathological brain. In
the standard surgical procedure, to prepare the way for the final electrode, the surgeon uses
a dilator that is lowered gently through the cerebral parenchyma up to the target. It has
been shown that during this step, brain tissue fragments adhere to the extremity of the
dilator. However, the major drawback of the standard dilator lies in the fact that its end is
in contact with several brain regions before reaching the targeted nucleus. Therefore, it is
difficult to guarantee the origin of the collected tissue micro-fragments. In order to
optimize the specificity of the harvested imprints, the investgator will use a dedicated CE
marked medical device that consists of a guide tube and a stylet instead of the dilator used
in DBS surgical procedure. The objective of this study is to validate brain tissue imprints
collection in PD, ET, DYS, OCD and TS.
The BTI will be specifically collected from the targeted implantation site corresponding to
the STN, the GPi and the VIM. Moreover, the tip of the electrode (and therefore the BTI)
often reaches the substantia negra pars compacta (SNpc) because of its proximity with the
STN. The ability to perform BTI in the SNpc is of highly interest since it is the structure
containing the neurons that degenerate gradually and massively throughout the pathological
process of Parkinson's disease.
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