Study Rationale:
Dystonia and Parkinson's disease (PD) are closely related movement disorders. Dystonia is characterized by painful, prolonged muscle contractions that cause involuntary, repetitive twisting and sustained muscle contractions. Some experts estimate that 40 percent of people with PD experience dystonia as an early symptom or complication of treatment. Deep brain stimulation (DBS) is a surgical treatment through which small electrical pulses are delivered to the brain. DBS may soon become a much-needed solution for dystonia in Parkinson's. In DBS, electrodes -- thin wires inserted in the brain during surgery -- can measure brain activity and send electric signals to treat dystonia symptoms. The purpose of this study is to record dystonia-associated brain activity through an electrode and use the recordings to set up the new directional DBS technology for the treatment of dystonia.
Hypothesis:
We hypothesize that dystonia-associated brain activity measured through a DBS electrode will help predict locations in the brain where the electrode should be inserted to improve dystonia and other PD motor symptoms.
Study Design:
Using the directional DBS technology, we will record and evaluate brain activity while a patient is at rest and while moving arms and legs. We will note the type of brain activity associated with dystonia and other PD symptoms and examine whether this brain activity predicts the effectiveness of the DBS therapy. We also will evaluate whether the directional DBS technology can help us better understand and treat resistant motor symptoms in the legs.
Impact on Diagnosis/Treatment of Parkinson's Disease:
This study will help researchers and clinicians better understand dystonia associated with PD, and efficiently use new DBS technology to treat dystonia and other Parkinson's motor symptoms.
Next Steps for Development:
This study may help develop new biomarkers, or objective measures of disease, to improve resistant PD motor symptoms as much as possible. Results also can help experts better understand optimal positioning of the electrode in surgery, avoid unwanted side effects of brain stimulation and develop new neurosurgical treatments.