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CompletedNCT03409120Updated Nov 10, 2022Results posted

Unlocking Dystonia From Parkinson's Disease With Directional DBS Technology

An interventional study of Boston Scientific Vercise PC IPG with directional DBS lead in Dystonia-Parkinsonism, Adult-Onset and Parkinson Disease, sponsored by University of Alabama at Birmingham. Completed at 1 site in United States. Open to participants aged 18 Years to 70 Years. Per ClinicalTrials.gov, last updated 2022-11-10.

Sponsored by University of Alabama at Birmingham · Not applicable, Interventional, and Basic science

Phase
Not applicable
Study type
Interventional
Enrollment
38
Allocation
Not applicable
Ages
18 Years to 70 Years
Sex
All
01

Study summary

This study occurs during five visits that are already scheduled as part of "Biomarkers to Guide Directional DBS for Parkinson's Disease" (ClinicalTrials.gov Identifier: NCT03353688). If participants have dystonia associated with Parkinson's disease, the investigators will consent and administer one additional rating scale (Burke-Fahn-Marsden Dystonia Rating Scale) to assess the severity of dystonia.

Read the detailed description

To measure the effects of DBS on dystonia, the investigators will measure the change in the Burke-Fahn-Marsden Dystonia Rating Scale at 2, 4, 6, and 12 months after surgery versus preoperative baseline. This will allow them to contrast the effects of omnidirectional versus directional STN DBS on dystonia symptoms in patients with PD.

02

Conditions studied

  • Dystonia-Parkinsonism, Adult-Onset
  • Parkinson Disease

Keywords

  • Dystonia
  • Parkinson's Disease
03

Who can participate

Ages eligible
18 Years to 70 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Enrollment in "Biomarkers to Guide Directional DBS for Parkinson's Disease" (ClinicalTrials.gov Identifier: NCT03353688)
  • Diagnosis of Parkinson's disease with and without dystonia

Exclusion criteria

Exclusion Criteria:

  • Not enrolled in "Biomarkers to Guide Directional DBS for Parkinson's Disease" (ClinicalTrials.gov Identifier: NCT03353688)
04

Study design

Phase
Not applicable
Primary purpose
Basic science
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
38 participants (actual)

Study arms

  • Experimental
    Dystonia Severity Assessment

    We will measure the effects of DBS on dystonia by assessing changes in the Burke-Fahn-Marsden Dystonia Rating Scale at 2, 4, 6, and 12 months after surgery to implant the Boston Scientific Vercise PC IPG with directional DBS lead versus preoperative baseline.

    Device: Boston Scientific Vercise PC IPG with directional DBS lead

Interventions

  • DeviceBoston Scientific Vercise PC IPG with directional DBS lead

    We will contrast the effects of omnidirectional versus directional STN DBS on dystonia symptoms in patients with PD.

05

What researchers measure

Primary outcomes

  1. Burke-Fahn-Marsden Dystonia Rating Scale

    Evaluation of degree of dystonia related symptoms. Domains evaluated include eyes, mouth, speech/swallowing, neck, arms, trunk, and legs. Each domain is scored on degree of provoking factor (0= no dystonia at rest or with action; 4 = dystonia present at rest) and severity factor (0 = no dystonia; 4 = extreme/severe dystonia). Scores are then weighted yielding a total score between 0 and 120. Higher scores on the scale indicate greater disease severity.

    Time frame: 5 minutes

06

Results

Posted Nov 10, 2022
Limitations and caveats
Time and physical constraints during surgery sometimes limit data collection, and acute implant of the DBS lead introduces microlesion effects that could alter electrophysiology.

Participant flow

Participants were recruited and studied prospectively as part of the SUNDIAL (SUbthalamic Nucleus DIrectionAL stimulation) study, a randomized, double-blind crossover study contrasting directional versus circular unilateral STN DBS for PD (FDA Investigational Device Exemption G-170063). Further details on inclusion/exclusion are outlined at https://clinicaltrials.gov/ct2/show/NCT03353688.

Participant flow — Overall Study
MilestoneDystonia Severity Assessment
Started38
Completed38
Not completed0

Outcome measures

PrimaryBurke-Fahn-Marsden Dystonia Rating Scale

Evaluation of degree of dystonia related symptoms. Domains evaluated include eyes, mouth, speech/swallowing, neck, arms, trunk, and legs. Each domain is scored on degree of provoking factor (0= no dystonia at rest or with action; 4 = dystonia present at rest) and severity factor (0 = no dystonia; 4 = extreme/severe dystonia). Scores are then weighted yielding a total score between 0 and 120. Higher scores on the scale indicate greater disease severity.

Time frame:
5 minutes
Reported as:
Mean · units on a scale
Burke-Fahn-Marsden Dystonia Rating Scale
units on a scaleStudy Patients Enrolled in Study
Burke-Fahn-Marsden Dystonia Rating Scale3.5 ± 6.0
Statistical analysis
  • Study Patients Enrolled in Study · linear mixed effects model · p = <0.001

Adverse events

Collected over 1 year from baseline visit. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Dystonia Severity Assessment0/38 (0%)0/38 (0%)0/38 (0%)

Baseline characteristics

Age, Continuous
Age, Continuous(years)Study Patients Enrolled in Study
Mean49.0 ± 13.2
Sex: Female, Male
Sex: Female, Male(Participants)Study Patients Enrolled in Study
Female12
Male26
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Study Patients Enrolled in Study
American Indian or Alaska Native0
Asian2
Native Hawaiian or Other Pacific Islander0
Black or African American2
White34
More than one race0
Unknown or Not Reported0
Burke-Fahn-Marsden Total Dystonia Scale
Burke-Fahn-Marsden Total Dystonia Scale(units on a scale)Study Patients Enrolled in Study
Mean3.5 ± 6.0
07

Study locations

1 site
  • University of Alabama at Birmingham
    Birmingham, Alabama 35294, United States
08

References and documents

Publications

  • Olson JW, Nakhmani A, Irwin ZT, Edwards LJ, Gonzalez CL, Wade MH, Black SD, Awad MZ, Kuhman DJ, Hurt CP, Guthrie BL, Walker HC. Cortical and Subthalamic Nucleus Spectral Changes During Limb Movements in Parkinson's Disease Patients with and Without Dystonia. Mov Disord. 2022 Aug;37(8):1683-1692. doi: 10.1002/mds.29057. Epub 2022 Jun 14. PubMed 35702056 ↗

Study documents

  • Study protocol · Dec 11, 2017
  • Informed consent form · Nov 13, 2019

Documents are hosted by the registry — open the source record to download them.

09

Registry details

Key details

Study ID
NCT03409120
Lead sponsor
University of Alabama at Birmingham
Collaborators
Michael J. Fox Foundation for Parkinson's Research
Responsible party
Harrison Walker, MD (Associate Professor of Neurology, University of Alabama at Birmingham) — Principal investigator
First posted
Jan 24, 2018
Start date
Jan 1, 2018
Primary completion
Jun 30, 2021
Completion
Jun 30, 2022
Results posted
Nov 10, 2022
Last update
Nov 10, 2022

Study contacts

Harrison C Walker, MD
principal investigator · Associate Professor of Neurology

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

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