Study Rationale: Difficulties with walking can significantly impact the quality of life for people with Parkinson’s disease (PD). One of the most serious issues is freezing of gait (FOG), episodes in which individuals are temporarily unable to take a step. Studies using electrodes embedded in the brain, an approach called electrocorticography (ECoG), have shown that abnormal neural activity can be detected in the motor cortex during FOG. In this project, we will use ECoG to detect the neural signatures of FOG and attempt to prevent or treat these episodes via an optimized form of deep brain stimulation.
Hypothesis: We hypothesize that we can design a new brain stimulation system that can detect FOG from brain activity alone and then treat these episodes either before they occur or as they happen by electrically stimulating the brain’s cortex.
Study Design: We will begin by implanting ECoG electrodes on the cortex of people with PD who are already receiving standard-of-care deep brain stimulation. We will record activity in the motor cortex as individuals walk on a treadmill that can be used to reliably trigger FOG, and we will compare the activity during normal walking and FOG. We will then stimulate the motor cortex, and assess what type of stimulation is most effective against FOG. Finally, we’ll use our method for detecting FOG episodes in the brain to determine when best to stimulate the cortex to stop or prevent FOG.
Impact on Diagnosis/Treatment of Parkinson’s Disease: If successful, our brain stimulation method could provide a new proof-of-concept treatment for FOG, an undertreated and serious problem in people with PD.
Next Steps for Development: We hope that our proof-of-concept will guide future studies on treating FOG with cortical brain stimulation and will be integrated together with deep brain stimulation as a more complete treatment for PD and its symptoms.
Trial Phase: Phase 1