Evaluate the Effectiveness and Safety of Variable Frequency Stimulation Compared With Constant Frequency Stimulation for Patients With Idiopathic Parkinson's Disease(RESTEP Study)
试验速览
- 阶段
- 不适用
- 入组人数
- 106
- 试验地点
- 9
- 主要终点
- Stand-Walk-Sit
研究概览
简要总结
In the VFS paradigm the stimulation frequency was set to alternate between high and low frequencies, where the frequency of stimulation or frequency combinations can be changed instantaneously according to damage of the moment rhythms. Variable frequency stimulation is a novel dynamic therapy which breaks through the existing single high-frequency stimulation paradigms. It is the world's first VFS therapy for the brain.
详细描述
In advanced stages of PD, motor symptoms and dyskinesia are effectively treated by deep brain stimulation (DBS) targeting the subthalamic nucleus (STN) . Traditionally, in this procedure, stimulation is set to a constant frequency electrical stimulation with the physician programming the parameters of stimulation frequency, pulse width and amplitude, and stimulated patients' brain nuclei with single frequency, single pulse width and single amplitude of the electric stimulation. Indeed, high frequency stimulation (HFS) of the STN provides consistent, long-term improvement of the cardinal signs of PD . However, the treatment effects of HFS on the axial symptoms of PD, specifically FOG can be poor often causing further impairment. While this can be alleviated by using relatively low frequency stimulation (LFS) , major concerns in the clinical application of LFS exist in regards to its duration of therapeutic benefit. Previous studies have shown that LFS of the STN improves the axial motor signs in some PD patients, but a loss of therapeutic efficacy is seen in the short term. Thereafter, patients may present increased tremor, rigidity and bradykinesia, which is often intolerable outweighing the initial benefits of LFS therapy for FOG. As such, a suitable treatment strategy for FOG remains to be established.
Based on previous findings on the relationships between stimulation frequency and movement rhythm regulation in the human body, The National Engineering Laboratory for Neuromodulation, Tsinghua University, proposes a method of variable frequency stimulation (VFS) for aiding movement.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Double (Participant, Outcomes Assessor)
盲法说明
Patients and the outcomes assessor are blinded in this study
入排标准
- 年龄范围
- 18 Years 至 —(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients With Idiopathic Parkinson's Disease.
- •≥18 years,both male and female
- •Patients who under deep brain stimulation
- •MMSE score ≥24
- •H-Y≥2.0 under the medicine off/ constant frequency stimulation state
- •The 14 item of UPDRS-II score ≥1
- •The 15 item of UPDRS-II score ≥2
- •Subjects had an ability to walk ≥ 10 meters independently under the medicine off/ constant frequency stimulation state
排除标准
- •Pregnant women or breastfeeding mothers, or woman who cannot take effective measures to prevent pregnancy.
- •Presence of other diseases affecting walking distance, such as joint disease in lower body, spinal disease, neuropathy, serious heart or lung disease.
- •Diseases seriously affecting health and life, such as tumour, serious liver or kidney diseases etc.
- •Patients with epilepsy etc.
- •Presence of mental disorders or dementia.
- •Patients or their families who cannot comprehend the therapy or patients who are unable to give informed consent voluntarily.
- •Patients whom cannot cooperate well with follow-up requirements.
- •Patients excluded based on the researchers judgement for participation in the clinical trial.
研究组 & 干预措施
Variable Frequency Stimulation
Subjects in this group received variable frequency stimulation of deep brain stimulation
干预措施: Variable Frequency Stimulation (Procedure)
Constant Frequency Stimulation
Subjects in this group received constant frequency stimulation of deep brain
干预措施: Variable Frequency Stimulation (Procedure)
结局指标
主要结局
Stand-Walk-Sit
时间窗: at 3 months compare to baseline
The total time of patients who complete the Stand-Walk-Sit task
次要结局
- The Freezing of Gait Questionnaire (FOG-Q) scores(at 3、6 months compare to baseline)
- Gait and Falls Questionnaire (GFQ) scores(at 3、6 months compare to baseline)
- United Parkinson's Disease Rate Scale scores(at 3、6 months compare to baseline)
- The39-item Parkinson's Disease Questionnaire (PDQ-39) scores(at 3、6 months compare to baseline)
