Study Rationale:
Depression is a common non-motor symptom associated with Parkinson's disease (PD), and impulse control disorders (ICDs) are behaviors that may arise with use of certain PD medications. (Read more about ICDs in Parkinson's.) Both depression and ICDs can significantly affect the quality of life for people with PD and their care partners. It is unknown what changes in the brain cause these, so treatments specifically for these symptoms in PD have not been developed.
Hypothesis/Objective:
The goals of this study are to 1) identify the changes in two brain regions - subthalamic nucleus and prefrontal cortex - that contribute to depression and impulse control disorders in individuals with PD and 2) determine whether electrical stimulation can improve these symptoms.
Study Design:
In this study, we will use Activa PC+S, a type of brain stimulation device that can both stimulate the brain and record its electrical signals. This device will be connected to the prefrontal cortex and the subthalamic nucleus of the brain. First, we will record the electrical signals of these two brain regions while treating symptoms of depression and impulse control with medication. This will allow us to understand how brain signals change as symptoms fluctuate. Then, we will deliver electrical stimulation to the brain to determine whether this can improve symptoms.
Impact on Diagnosis/Treatment of Parkinson's Disease:
We expect this project to lead to the development of new stimulation-based treatments for depression and ICDs associated with PD. Such stimulation would be delivered using stimulators similar to those that are currently used to treat motor symptoms of PD (i.e., deep brain stimulation devices).
Next Steps for Development:
We plan to develop a "smart" stimulator tailored to the patient's needs. It will deliver therapeutic stimulation only when it detects brain signals associated with depression and impulse control disorders, which we will identify in the present study.