Parkinson's Disease Clinical Trial
Official title:
Evaluation of Directional Recording and Stimulation Using the spiderSTN During the Implantation of DBS Leads
The purpose of this study is to provide proof-of-concept that directional stimulation and directional recording, in an intraoperative setting, is perceivable in a subject. The tests will be performed using a dedicated intraoperative lead connected to an external neuro-recorder/stimulator, during a deep brain stimulation implantation surgery.
Deep brain stimulation (DBS) technique involves implanting electrodes using a stereotactic
method and connecting them to a pulse generator to deliver a current in localized areas in
the brain.
The optimum location for DBS electrodes is determined by pre-operative brain imaging, often
combined with an intraoperative microelectrode recording/stimulating (MER) sequence. Current
MER practice involves inserting micro-recording/stimulating electrodes into guide tubes in
the brain and lowering them towards the target, performing recordings at selected steps. The
recordings differ based on the types of neuronal structures they are passing through.Based on
the recordings, some promising locations are further discriminated by stimulation using
macro-electrodes, and the target for final lead placement is chosen.
The spiderSTN lead (Aleva Neurotherapeutics SA, Switzerland) is capable of recording and
stimulating from both its inner and outer surface, allowing the user to steer the direction
of stimulation during the target location phase. This will allow the neurosurgeon greater
flexibility in investigating the balance between therapeutic benefits and stimulation-induced
side effects at a given location.
This feasibility study is designed to explore the effect of directional stimulation and the
ability to differentiate between stimulation induced side effects at a given location, during
the DBS surgery. It will be proposed to patients who suffer from Parkinson disease (PD) or
essential tremor (ET) and for whom DBS is indicated according to standard criteria at the
hospital. It will be restricted to a limited number of patients (10), sufficient to assess
the recording and stimulating capacity of the spiderSTN device. The patient undergoes the
normal DBS surgery until the position for the final lead has been chosen. Then the spiderSTN
test phase takes place. Once test phase is completed, the conventional DBS surgery resumes.
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