Comparing Two Deep Brain Stimulation Settings for Parkinsons Disease Focusing on Postural Instability and Gait Disorder Using Neurostimulator Pathway Activation Optimization

What this Trial Is About

Researchers are studying Parkinsons disease PD patients who are receiving standard Deep Brain Stimulation DBS therapy. The trial compares the effects on Parkinsons symptoms of two different DBS settings that target distinct neural pathways between the Globus Pallidus GP and the Pedunculopontine Nucleus PPN. This study builds on previous research by testing these settings over a longer period to observe daily life activities and quality of life, which need extended evaluation beyond short laboratory tests. Participants will receive two different neurostimulator settings designed to maximize activation of either the GP-to-PPN or PPN-to-GP pathways. Each setting is tested over two weeks between lab sessions to capture longer-term effects. The study uses deep brain stimulation devices and requires participants to have bilateral DBS implants in specific brain areas. The research aims to provide data to support a future clinical trial targeting the pathway believed to improve postural instability and gait disorder symptoms. During the study, participants will be evaluated using the Unified Parkinsons Disease Rating Scale Movement Disorders Society revision MDS-UPDRS at one hour and again after two weeks of stimulation. Assessments will include observation of daily activities and quality of life measures. Safety and effectiveness of the DBS settings will be monitored closely, with follow-up visits scheduled to track changes in symptoms and function. The trial is expected to continue until 2030, allowing for detailed long-term observation.

Aim 3 Particle Swarm Optimization PIGD