Studying Non-invasive and Invasive Brain Stimulation to Improve Freezing of Gait in Parkinsons Disease Using EEG and fMRI

What this Trial Is About

Freezing of gait FOG is a severe symptom experienced by people with Parkinsons disease PD, causing brief moments where walking becomes difficult or impossible. The exact cause of FOG is not fully understood but may involve disturbances in brain areas responsible for movement. This condition often appears more during complex movements like turning rather than straightforward walking. Researchers aim to better understand and measure these walking difficulties using new scientific tools over a three-year study period. The study involves developing an artificial intelligence algorithm to detect and measure FOG episodes using video and foot pressure data collected during walking tests. Researchers will also use brain activity recordings with a 64-channel EEG and motor imagery fMRI to study the brains role in FOG during different walking conditions. Additionally, the study will evaluate the effects of treatments including transcranial direct current stimulation tDCS, magnetic resonance-guided focused ultrasound MRgFUS, and Deep Brain Stimulation DBS on gait and FOG symptoms. The tDCS treatment involves daily stimulation sessions of 2.0 mA for up to 20 minutes over five days. Participants will be monitored through various assessments including EEG and electromyography recordings, brain imaging, and clinical rating scales such as the Unified Parkinsons Disease Rating Scale UPDRS and questionnaires focused on gait and freezing symptoms. These measurements will be taken before treatment and at several time points after treatment, up to four weeks. The study uses a randomized, quadruple-blind design to compare real and sham tDCS stimulation. The total study duration extends up to several weeks, with ongoing safety and effectiveness monitoring to better understand and potentially improve management of FOG in PD patients.

Exploring the Possible Beneficial Impact of Non-invasive and Invasive Neuromodulation on Freezing of Gait in Parkinson's Disease During Different Ambulatory Complexities: An Electrophysiological and fMRI Study