Frontosubthalamic Networks in Parkinson's Disease.

  • Research type

    Research Study

  • Full title

    Frontosubthalamic Network Dynamics and their Modulation during Impulse Control and Decision Making in Parkinson’s disease.

  • IRAS ID

    253684

  • Contact name

    Alex Green

  • Contact email

    alex.green@nds.ox.ac.uk

  • Sponsor organisation

    University of Oxford / Clinical Trials and Research Governance

  • Duration of Study in the UK

    1 years, 4 months, 7 days

  • Research summary

    Parkinson’s disease (PD) is severe disease characterised by slowing of movement, rigidity and tremor. Other symptoms may include speech impairment, mood disorders and decline of memory. PD is caused by loss of brain cells that produce a chemical in the brain called dopamine and first-line treatment is therefore dopamine replacement therapy. Unfortunately, this medication becomes less effective over time and patients may suffer very severe relapse of symptoms. Under these circumstances deep brain stimulation (DBS) is offered where appropriate to better control motor symptoms. The most common brain target is a region deep in the brain called the subthalamic nucleus (STN).

    Up to 16% of patients with PD develop impulse control disorders such as compulsive gambling which can be devastating for the patient and their relatives. This project aims to understand why some patients develop new impulse control disorders such as gambling addictions after DBS whilst others with these disorders pre-operatively may get better.

    To do this, patients who have had an operation to implant DBS electrodes into the STN will be recruited and separated into two groups. One group will consist of patients that have high scores on the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease (QUIP) and the other group will consist patients that have low scores. These two groups will then undertake two computerised cognitive tasks under different experimental conditions. During these tasks, the electrical signals of the brain will be recorded using non-invasive methods (electroencephalography (EEG) and magnetoencephalography (MEG)) to correlate brain signatures with task performance and self-reported impulsive behaviour. Informed by previous studies, these three experimental conditions will be (1) no stimulation (2) high-frequency stimulation (3) low-frequency stimulation.

    These experiments will test the hypothesis that there are specific neural networks underlying impulse control disorders in PD and that these can be modulated with STN DBS.

  • REC name

    London - London Bridge Research Ethics Committee

  • REC reference

    21/LO/0275

  • Date of REC Opinion

    7 May 2021

  • REC opinion

    Favourable Opinion