📗 Cite This Artifact
Circuit-Based DBS for Parkinson's Disease (NCT05658302)
Circuit-Based Deep Brain Stimulation for Parkinson's Disease
Overview
Circuit-Based Deep Brain Stimulation (DBS) represents a paradigm shift in [Parkinson's disease](/diseases/parkinsons-disease) treatment, moving from fixed stimulation patterns to adaptive, closed-loop systems that respond to neural circuit activity. This observational study (NCT05658302) conducted by the University of Minnesota investigates how targeted electrical modulation of specific brain circuits affects motor and cognitive function in Parkinson's disease patients.
Trial Details
| Parameter | Value |
|-----------|-------|
| NCT Number | NCT05658302 |
| Status | Recruiting |
| Study Type | Observational |
| Sponsor | University of Minnesota |
| Enrollment | 30 participants (estimated) |
| Start Date | March 28, 2023 |
| Completion Date | March 1, 2028 |
| Location | Minneapolis, Minnesota, United States |
Mechanism of Action
Circuit-Based DBS Approach
Traditional DBS delivers continuous high-frequency electrical stimulation to brain regions like the [subthalamic nucleus](/cell-types/subthalamic-nucleus) or [globus pallidus internus](/cell-types/globus-pallidus). Circuit-Based DBS advances this by:
Research Objectives
...
Circuit-Based Deep Brain Stimulation for Parkinson's Disease
Overview
Circuit-Based Deep Brain Stimulation (DBS) represents a paradigm shift in [Parkinson's disease](/diseases/parkinsons-disease) treatment, moving from fixed stimulation patterns to adaptive, closed-loop systems that respond to neural circuit activity. This observational study (NCT05658302) conducted by the University of Minnesota investigates how targeted electrical modulation of specific brain circuits affects motor and cognitive function in Parkinson's disease patients.
Trial Details
| Parameter | Value |
|-----------|-------|
| NCT Number | NCT05658302 |
| Status | Recruiting |
| Study Type | Observational |
| Sponsor | University of Minnesota |
| Enrollment | 30 participants (estimated) |
| Start Date | March 28, 2023 |
| Completion Date | March 1, 2028 |
| Location | Minneapolis, Minnesota, United States |
Mechanism of Action
Circuit-Based DBS Approach
Traditional DBS delivers continuous high-frequency electrical stimulation to brain regions like the [subthalamic nucleus](/cell-types/subthalamic-nucleus) or [globus pallidus internus](/cell-types/globus-pallidus). Circuit-Based DBS advances this by:
Research Objectives
The trial focuses on understanding:
- How reach-related neural modulation differs in PD patients with DBS
- The relationship between cognitive task performance (N-back) and motor circuits
- How rigidity and bradykinesia assessments correlate with circuit-level changes
Outcome Measures
Primary Outcomes
- Reach-related modulation — Neural activity changes during reaching movements
- N-back task trials — Cognitive performance assessments
- Rigidity and bradykinesia assessments — Standard motor symptom evaluations
Significance for Parkinson's Disease
Circuit-Based DBS represents the next evolution in [deep brain stimulation](/therapeutics/deep-brain-stimulation) therapy:
Deep Brain Stimulation Background
Evolution of DBS Technology
Deep brain stimulation has evolved significantly since its FDA approval:
First Generation ( Conventional DBS):
- Continuous high-frequency stimulation
- Fixed parameters
- Single brain target
- Responsive to patient state
- Closed-loop systems
- Real-time modulation
- Identifies specific circuits
- Personalized targeting
- Cognitive-motor integration
Circuit Dysfunction in PD
Parkinson's disease involves dysfunction in multiple motor circuits:
Basal Ganglia Circuits:
- Motor selection circuit
- Oculomotor circuit
- Prefrontal circuits
- Motor cortex
- Premotor cortex
- Supplementary motor area
Neural Circuit Mapping
This trial maps circuits using:
Recording Methods:
- Intracranial electrodes
- Surface EMG
- Kinematic tracking
- Reach-related modulation
- N-back cognitive tasks
- Motor assessment correlation
Beta-Band Oscillations in PD
Pathological Synchronization
In Parkinson's disease, the basal ganglia exhibit abnormal oscillatory activity that correlates with motor symptoms:
Beta-Band Activity (13-35 Hz):
- Elevated in the [subthalamic nucleus](/cell-types/subthalamic-nucleus) and [globus pallidus](/cell-types/globus-pallidus)
- Correlates with bradykinesia and rigidity severity
- Suppressed by dopaminergic medication and conventional DBS
- Acts as biomarker for adaptive stimulation systems
- Excessive synchronization of parkinsonian basal ganglia neurons
- Loss of normal rhythmic patterning in motor circuits
- Disrupted information encoding in cortico-basal ganglia loops
- Correlation with akinesia and reduced movement initiation
- Beta-band power serves as control signal for adaptive DBS
- Real-time monitoring enables closed-loop stimulation
- Reduction in beta activity predicts clinical improvement
- Individual beta dynamics inform personalized parameter selection
Alpha-Band Activity
Tremor-Correlated Oscillations:
- Alpha-band (8-12 Hz) oscillations correlate with resting tremor
- Phase-amplitude coupling between alpha and beta bands
- Different frequency bands encode different symptoms
- Multi-band analysis improves symptom tracking
Patient Selection and Surgical Considerations
DBS Candidate Evaluation
Eligibility Assessment:
- Movement disorder neurologist evaluation
- Neuropsychological testing for cognitive function
- Neuroimaging for target planning
- Medical optimization for surgery
| Test | Purpose |
|------|---------|
| MRI brain | Structural assessment, target planning |
| CT brain | Precise electrode trajectory planning |
| DaTscan | Confirm dopaminergic deficit |
| Neuropsych battery | Cognitive baseline, risk assessment |
| Medication review | Optimize pre-surgical therapy |
Surgical Procedure
Electrode Implantation:
- Frame-based or frameless stereotactic systems
- Microelectrode recording for target refinement
- Macro stimulation test for efficacy
- Bilateral or unilateral implantation
- Healing period (2-4 weeks)
- Initial programming (4-8 weeks)
- Optimization phase (3-6 months)
- Long-term maintenance
Programming and Parameter Optimization
Stimulation Paradigms
Conventional High-Frequency Stimulation:
- Frequency: 130-180 Hz
- Pulse width: 60-120 μs
- Amplitude: 1-5 V
- Continuous delivery
- Alternative for speech/gait side effects
- May worsen rigidity in some patients
- Useful for specific symptom profiles
- Intermittent high-frequency bursts
- May reduce side effects
- Under investigation for cognitive symptoms
Adaptive DBS Algorithms
Signal Processing Pipeline:
Control Strategies:
- Threshold-triggered (on/off based on biomarker level)
- Proportional (stimulation intensity scales with biomarker)
- Predictive (anticipate symptom fluctuations)
- Multi-modal (combine multiple biomarkers)
Clinical Outcomes and Quality of Life
Motor Symptom Control
Targeted Outcomes:
- Improvement in MDS-UPDRS Part III scores (typically 40-60%)
- Reduced medication requirements
- Improved motor fluency and timing
- Enhanced movement initiation
- Finger tapping (bradykinesia)
- Finger to nose (coordination)
- Gait and posture evaluation
- Speech and swallowing function
Non-Motor Symptoms
Cognitive Effects:
- Variable effects on executive function
- Potential improvement in processing speed
- Risk of worsening in susceptible individuals
- Importance of preoperative cognitive screening
- Depression management (may improve or worsen)
- Apathy recognition and treatment
- Impulse control monitoring
- Sleep quality assessment
Quality of Life Measures
PDQ-39 Domains:
- Mobility
- Activities of daily living
- Emotional well-being
- Stigma
- Social support
- Communication
- Cognition
- Bodily discomfort
Technical Considerations and Future Directions
Hardware Development
Next-Generation Systems:
- Directional leads (steerable electric fields)
- Chronic recording capabilities
- Rechargeable batteries
- Wireless connectivity
- Fully implantable systems
- Local field potential recording
- Chronic biomarker monitoring
- Closed-loop integration
- Remote programming options
Computational Approaches
Machine Learning Integration:
- Patient-specific symptom clustering
- Optimized parameter prediction
- Long-term outcome modeling
- Biomarker pattern recognition
- Individual circuit mapping
- Customized stimulation protocols
- Genotype-phenotype correlations
- Precision targeting algorithms
Trial Methodology
Observational Design
The observational design allows:
Data Collection:
- Natural variation observation
- Without intervention effects
- Longitudinal tracking
- DBS candidates
- PD diagnosis
- Motor症状 assessment
Neural Recordings
Recording Sites:
- Motor cortex
- Subthalamic nucleus
- Pallidum
- Single-unit activity
- Local field potentials
- Cortical rhythms
Motor Circuit Function
Reach-Related Modulation
The trial studies:
Motor Preparation:
- Movement planning
- Execution initiation
- Movement modulation
- Activity patterns
- Timing relationships
- Synchronization
Cognitive Integration
Motor and cognitive circuits interact:
N-Back Task:
- Working memory assessment
- Cognitive load
- Motor interference
- Cortico-striatal loops
- Prefrontal involvement
- Motor sequencing
Clinical Implications
Personalized Medicine
Circuit-based approaches enable:
Target Selection:
- Individual anatomy
- Symptom profiles
- Circuit mapping
- Stimulation sites
- Frequency selection
- Intensity tuning
Future Directions
Circuit-based DBS may lead to:
Closed-Loop Systems:
- Real-time adaptation
- Automatic adjustment
- Patient-specific settings
- Non-motor symptoms
- Mood effects
- Autonomic function
Safety Considerations
DBS Safety Profile
Established safety considerations:
Surgical Risks:
- Infection
- Hemorrhage
- Hardware complications
- SpeechEffects
- Mood changes
- Gait effects
Monitoring
Patient monitoring includes:
- Motor assessments
- Cognitive testing
- Quality of life
Research Significance
contribution to PD Understanding
This trial advances:
Broader Applications
Circuit-based approaches may apply to:
- Essential tremor
- Dystonia
- Epilepsy
- Psychiatric disorders
Related Pages
- [Parkinson's Disease](/diseases/parkinsons-disease)
- [Deep Brain Stimulation](/therapeutics/deep-brain-stimulation)
- [Dopaminergic Neurons](/cell-types/dopaminergic-neurons)
- [Subthalamic Nucleus](/cell-types/subthalamic-nucleus)
- [Globus Pallidus](/cell-types/globus-pallidus)
- [Motor Cortex](/cell-types/motor-cortex)
- [Clinical Trials in Parkinson's Disease](/clinical-trials/parkinsons-disease)
External Links
- [ClinicalTrials.gov - NCT05658302](https://clinicaltrials.gov/study/NCT05658302)
- [University of Minnesota Medical School](https://med.umn.edu/)
- [Parkinson's Foundation - DBS](https://www.parkinson.org/Life-with-Parkinsons/Treatment-Surgery/Alternatives-to-Levodopa/Deep-Brain-Stimulation)
References
Pathway Diagram
▸Metadataorigin_type: v1_polymorphic_backfill
| slug | clinical-trials-circuit-based-dbs-parkinson |
| kg_node_id | None |
| entity_type | clinical |
| origin_type | v1_polymorphic_backfill |
| source_table | wiki_pages |
| wiki_page_id | wp-395fe9cbd108 |
| __merged_from | {'merged_at': '2026-05-13', 'unprefixed_id': 'clinical-trials-circuit-based-dbs-parkinson'} |
| _schema_version | 1 |
No provenance edges found
Use ?embed=1 to load the artifact without SciDEX chrome — suitable for iframing into wiki pages or external sites.
<iframe src="http://scidex.ai/artifact/wiki-clinical-trials-circuit-based-dbs-parkinson?embed=1" width="100%" height="600" style="border:0;border-radius:8px"></iframe>
[Circuit-Based DBS for Parkinson's Disease (NCT05658302)](http://scidex.ai/artifact/wiki-clinical-trials-circuit-based-dbs-parkinson)
http://scidex.ai/artifact/wiki-clinical-trials-circuit-based-dbs-parkinson