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Temporally Optimized Patterned Stimulation (TOPS®) Deep Brain Stimulation (DBS) for the Treatment of Parkinson's Disease

Not Applicable
Terminated
Conditions
Parkinson Disease
Interventions
Device: TOPS1 DBS
Device: TOPS2 DBS
Device: TOPS3 DBS
Device: Standard DBS
Registration Number
NCT04390867
Lead Sponsor
Deep Brain Innovations LLC
Brief Summary

This study will test newly developed stimulation settings called Temporally Optimized Patterned Stimulation or TOPS, which can be used with an already implanted deep brain stimulation system. The purpose of this study is to determine if TOPS DBS can improve Parkinson's symptoms compared to Standard DBS.

Detailed Description

Not available

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
6
Inclusion Criteria
  • Diagnosed with Parkinson's disease
  • Implanted with unilateral or bilateral subthalamic DBS System to treat Parkinson's disease at least 6 months prior to the study date
  • Responds to DBS by having demonstrated a minimum improvement in motor score

Key

Exclusion Criteria
  • Score of <24 on the Mini Mental Status Exam
  • Abuses drugs or alcohol
  • Pregnant
  • History of significant cardiovascular, pulmonary, musculoskeletal, metabolic, or other neurological disorders (i.e. epilepsy, stroke)
  • Prisoners, employees that report to investigators

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
TOPS1 DBSTOPS3 DBSParticipants receive TOPS1 for one week if it meets screening criteria, followed by one week each of TOPS2, TOPS3, and Standard in random order.
TOPS1 DBSTOPS1 DBSParticipants receive TOPS1 for one week if it meets screening criteria, followed by one week each of TOPS2, TOPS3, and Standard in random order.
TOPS3 DBSStandard DBSParticipants receive TOPS3 for one week if it meets screening criteria, followed by one week each of TOPS1, TOPS2, and Standard in random order.
TOPS1 DBSStandard DBSParticipants receive TOPS1 for one week if it meets screening criteria, followed by one week each of TOPS2, TOPS3, and Standard in random order.
TOPS2 DBSTOPS2 DBSParticipants receive TOPS2 for one week if it meets screening criteria, followed by one week each of TOPS1, TOPS3, and Standard in random order.
TOPS2 DBSStandard DBSParticipants receive TOPS2 for one week if it meets screening criteria, followed by one week each of TOPS1, TOPS3, and Standard in random order.
TOPS3 DBSTOPS1 DBSParticipants receive TOPS3 for one week if it meets screening criteria, followed by one week each of TOPS1, TOPS2, and Standard in random order.
Standard DBSTOPS2 DBSParticipants receive Standard for one week, followed by one week each of TOPS1, TOPS2, and TOPS3 in random order.
TOPS2 DBSTOPS3 DBSParticipants receive TOPS2 for one week if it meets screening criteria, followed by one week each of TOPS1, TOPS3, and Standard in random order.
TOPS3 DBSTOPS3 DBSParticipants receive TOPS3 for one week if it meets screening criteria, followed by one week each of TOPS1, TOPS2, and Standard in random order.
Standard DBSTOPS3 DBSParticipants receive Standard for one week, followed by one week each of TOPS1, TOPS2, and TOPS3 in random order.
Standard DBSStandard DBSParticipants receive Standard for one week, followed by one week each of TOPS1, TOPS2, and TOPS3 in random order.
TOPS1 DBSTOPS2 DBSParticipants receive TOPS1 for one week if it meets screening criteria, followed by one week each of TOPS2, TOPS3, and Standard in random order.
TOPS2 DBSTOPS1 DBSParticipants receive TOPS2 for one week if it meets screening criteria, followed by one week each of TOPS1, TOPS3, and Standard in random order.
TOPS3 DBSTOPS2 DBSParticipants receive TOPS3 for one week if it meets screening criteria, followed by one week each of TOPS1, TOPS2, and Standard in random order.
Standard DBSTOPS1 DBSParticipants receive Standard for one week, followed by one week each of TOPS1, TOPS2, and TOPS3 in random order.
Primary Outcome Measures
NameTimeMethod
Movement Disorders Society-Unified Parkinson's Disease Rating Scale Part III Motor score - Off medication/On DBSAfter 1 week treatment period using each pattern

Average difference between the best TOPS and Standard. The MDS-UPDRS Part III is the sum of 33 scores evaluating a set of Parkinson's disease motor symptoms on a scale from 0 to 4 points. A score of 0 indicates no symptom is present and a maximum score of 4 indicates the most severe symptom. The total scale range is 0-132, where higher scores indicate more severe symptoms.

Study related adverse device effectsAfter 1 week treatment period using Standard

Reported AEs

Secondary Outcome Measures
NameTimeMethod
Parkinson's Medication UseDuring 1 week treatment period using each pattern

Parkinson's medication usage recorded in home use medication diary. Average difference between the best TOPS and Standard

Patient Global Impression of Improvement RatingAfter 1 week treatment period using each pattern

Average difference in PGII between the best TOPS and Standard. Improvement is scored on a scale of 1 - 7 where 1 is Very Much Improved and 7 is Very Much Worse

Home Use "On Time"During 1 week treatment period using each pattern

Home use Parkinson's disease motor symptom diary recording On Time without dyskinesia, On Time with non-troublesome dyskinesia, On Time with troublesome dyskinesia, Off Time, and Asleep Time. Average "On Time" difference between the best TOPS and Standard

Rest Tremor - Off medication/On DBSAfter 1 week treatment period using each pattern

Measured using Kinesia One system. Average difference between the best TOPS and Standard

Type and severity of side effects of stimulationDuring 1 week treatment period using each pattern

Proportion of participants experiencing side effects recorded in home use motor symptom diary and clinic. Average difference between the best TOPS and Standard

Movement Disorders Society-Unified Parkinson's Disease Rating Scale Part III Motor score - On medication/On DBSAfter 1 week treatment period using each pattern

Average difference between the best TOPS and Standard. The MDS-UPDRS Part III is the sum of 33 scores evaluating a set of Parkinson's disease motor symptoms on a scale from 0 to 4 points. A score of 0 indicates no symptom is present and a maximum score of 4 indicates the most severe symptom. The total scale range is 0-132, where higher scores indicate more severe symptoms.

Postural Tremor - Off medication/On DBSAfter 1 week treatment period using each pattern

Measured using Kinesia One system. Average difference between the best TOPS and Standard.

Bradykinesia - Off medication/On DBSAfter 1 week treatment period using each pattern

Measured using Kinesia One system. Average difference between the best TOPS and Standard.

Clinical Global Impression of Improvement RatingAfter 1 week treatment period using each pattern

Average difference in CGII score between the best TOPS and Standard. Improvement is scored on a scale of 1 - 7 where 1 is Very Much Improved and 7 is Very Much Worse

Test Pattern Use CountAfter 1 week treatment period using each pattern

For each pattern, the number of subjects who go home with it and use it for the entire test period (\~7-14 days) will be counted to evaluate if any patterns are more or less likely to be skipped

Trial Locations

Locations (3)

University of Florida

🇺🇸

Gainesville, Florida, United States

Northwestern University

🇺🇸

Chicago, Illinois, United States

Duke University

🇺🇸

Durham, North Carolina, United States

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