A major obstacle to programming in deep brain stimulation (DBS) for Parkinson's disease (PD) is lack of understanding of the temporal evolution of the motor symptoms and side effects in response to changes in stimulation condition. After DBS is switched OFF, tremor returns within minutes while bradykinesia and rigidity take up to 90 minutes to return to their maximum levels, and recent studies by Cooper et al. demonstrated that the washout rate of bradykinesia increased with both the duration of the disease and the laterality of the electrode location. However, it is unknown if the washout rates of symptoms and side effects are dependent on the preceding DBS ON time. During clinical parameter adjustment sessions and in clinical research, carry-over effects of the previous setting may prohibit accurate measurements making it difficult to determine which DBS parameters are most effective. Rigidity is one of the cardinal symptoms of PD and is often assessed as an indicator of the effectiveness of DBS, but there are currently no data that quantify the return of rigidity within the first 15 minutes after DBS is turned OFF. Finally, there are no data on the temporal evolution of cognitive decline associated with bilateral DBS. Recent studies have shown that a side effect of bilateral subthalamic nucleus (STN) DBS is impaired cognition, with complex dual cognitive/motor tasks resulting in motor performance with STN DBS ON similar to performance without STN DBS. The goals of this proposal are 1) to quantify how bradykinesia and rigidity change over time after DBS is turned OFF and to determine if the rate of change and/or time to washout is dependent on the previous STN DBS ON time and 2) to determine if a change in cognitive performance can be detected 90 minutes after DBS has been turned ON.
|Effective start/end date||1/1/14 → 12/31/15|
- Northwestern Memorial Hospital (Exhibit B11)