vop-vim-deep-brain-stimulation-pd-nct07056361

Migration, Crosslink

📖

vop-vim-deep-brain-stimulation-pd-nct07056361

active

wiki page Created: 2026-04-02T07:19:03 By: crosslink-migration Quality: 50% ✓ SciDEX ID: wiki-clinical-trials-vop-vim-deep-brain-

📖 Wiki Page

clinical_trial1047 wordssynced 2026-04-02

VOP/VIM Deep Brain Stimulation for Parkinson's Disease (NCT07056361)

NCT07056361 is a clinical trial investigating deep brain stimulation (DBS) of the ventral oral posterior (VOP) and ventral intermediate (VIM) nuclei of the thalamus as novel targets for improved motor control in [Parkinson's disease](/diseases/parkinsons-disease). The study is conducted by [University of Pittsburgh](/institutions/university-of-pittsburgh) under the leadership of Dr. Jorge Gonzalez-Martinez, a recognized expert in stereotactic and functional neurosurgery.

Trial Overview

...

VOP/VIM Deep Brain Stimulation for Parkinson's Disease (NCT07056361)

NCT07056361 is a clinical trial investigating deep brain stimulation (DBS) of the ventral oral posterior (VOP) and ventral intermediate (VIM) nuclei of the thalamus as novel targets for improved motor control in [Parkinson's disease](/diseases/parkinsons-disease). The study is conducted by [University of Pittsburgh](/institutions/university-of-pittsburgh) under the leadership of Dr. Jorge Gonzalez-Martinez, a recognized expert in stereotactic and functional neurosurgery.

Trial Overview

Mermaid diagram (expand to render)

| Attribute | Details |
|-----------|--------|
| NCT Number | NCT07056361 |
| Phase | Not applicable (Device/Surgical trial) |
| Status | Recruiting (as of 2026) |
| Sponsor | University of Pittsburgh |
| Principal Investigator | Dr. Jorge Gonzalez-Martinez, MD, PhD |
| Indication | Parkinson's disease with motor complications |
| Intervention | Bilateral thalamic DBS (VOP/VIM nuclei) |
| Enrollment | Approximately 30 participants (estimated) |
| Study Type | Interventional |
| Allocation | Non-randomized |

Principal Investigator

Dr. Jorge Gonzalez-Martinez, MD, PhD is a Professor of Neurosurgery and Neurology at [University of Pittsburgh School of Medicine](/institutions/university-of-pittsburgh) and Director of the Movement Disorder and Behavioral Neurosurgery Program. He is internationally recognized for his work in:

Novel DBS target identification and surgical technique development
Stereoelectroencephalography (sEEG) for epilepsy and functional mapping
Connectomic approaches to DBS optimization
Robotic-assisted stereotactic surgery

His research group has pioneered the use of advanced neuroimaging and electrophysiological mapping to identify optimal DBS targets for movement disorders[@gonzalez_martinez].

Background and Rationale

Standard DBS Targets in PD

Conventional DBS for [Parkinson's disease](/diseases/parkinsons-disease) targets two primary regions:

Subthalamic nucleus (STN): Most commonly used target; excellent for tremor, bradykinesia, rigidity, and medication reduction. Associated with potential mood/cognitive side effects.
Globus pallidus interna (GPi): Effective for dyskinesia management and motor symptoms. May have fewer cognitive/behavioral side effects than STN-DBS.

Both targets primarily address the motor symptoms of PD but do not fully resolve axial symptoms (gait, balance, speech dysfunction) that significantly impact quality of life.

Thalamic DBS: VOP and VIM

The thalamus represents an alternative target class with distinct mechanisms[@fenoy2017]:

Ventral Intermediate Nucleus (VIM):

Primary target for tremor in PD and essential tremor
Acts on the cerebello-thalamo-cortical pathway disrupted in tremor
Studies comparing VIM vs STN DBS show VIM provides superior tremor control but less benefit for bradykinesia and rigidity[@steigerwald2019]

Ventral Oral Posterior Nucleus (VOP):

Part of the motor thalamus receiving input from the basal ganglia output (via GPi/SNr)
May provide better benefit for bradykinesia and rigidity than VIM alone
Combined VOP/VIM targeting may address both cerebellar (tremor) and basal ganglia (bradykinesia) pathways[@burgy2018]

Combined VOP/VIM Rationale

The combined VOP/VIM approach addresses the complementary pathways disrupted in PD motor symptoms:

VIM targets the cerebellar pathway for tremor suppression

VOP targets the basal ganglia pathway for bradykinesia and rigidity

Combined targeting may achieve more comprehensive motor symptom control than either target alone[@papavassiliou2019][@kruger2020]

Comparison with Standard DBS Targets

| Target | Tremor | Bradykinesia | Rigidity | Dyskinesia | Cognitive Risk | Axial Symptoms |
|--------|--------|-------------|---------|-----------|----------------|----------------|
| VOP/VIM (thalamus) | +++ | ++ | ++ | + | Low | Limited data |
| STN | +++ | +++ | +++ | ++ | Moderate | Limited |
| GPi | ++ | +++ | +++ | +++ | Low | Limited |

Surgical Procedure

Targeting Methodology

The VOP/VIM DBS procedure involves:

Pre-operative imaging: High-resolution T1, T2 MRI and iron-sensitive sequences (SWI) for thalamic visualization

Stereotactic frame placement: Leksell frame for precise coordinate determination

Indirect targeting: Using AC-PC coordinates and atlas-based VOP/VIM localization

Direct targeting: MRI-guided targeting with correction for brain shift

Intraoperative mapping: Microelectrode recording (MER) to identify thalamic nuclei boundaries and characterize neuronal activity

Test stimulation: Macroelectrode stimulation to assess clinical response and side effects (paresthesia, dysarthria, muscle contraction)

Permanent implant: IPG connection after optimal contact identification

Lead Type

The trial likely utilizes directional leads (e.g., Abbott Infinity, Boston Scientific Vercise) enabling current steering for refined stimulation shaping[@butson2019].

Clinical Outcomes

Primary Endpoints

Based on the NCT07056361 protocol structure:

Motor symptoms: UPDRS Part III (off medication, on stimulation) at 3, 6, 12 months
Tremor control: UPDRS Part III tremor subscore
Quality of life: PDQ-39 at baseline and follow-up

Secondary Endpoints

Medication reduction: Change in levodopa-equivalent daily dose (LEDD)
Dyskinesia: UPDRS Part IV dyskinesia subscore
Axial function: PIGD symptoms, gait assessment, falls frequency
Speech and language: Dysarthria evaluation
Cognitive function: Neuropsychological testing (MOCA, letter fluency)
Stimulation parameters: Voltage, pulse width, frequency settings

Expected Benefits

Based on prior thalamic DBS literature[@ouchterlony2021]:

Significant tremor reduction (typically 60-80% improvement)
Moderate improvement in bradykinesia and rigidity
Potential improvement in medication-related fluctuations
Low risk of cognitive or behavioral side effects (compared to STN-DBS)
Preservation of speech function (vs STN-DBS risk of dysarthria)

Connection to NeuroWiki Mechanisms

VOP/VIM DBS intersects multiple NeuroWiki topics:

[Parkinson's Basal Ganglia Circuit](/circuits/parkinson-basal-ganglia-circuit) — The VOP nucleus is part of the basal ganglia output pathway; VIM is part of the cerebellar output pathway
[Thalamus](/brain-regions/thalamus) — Anatomical structure containing VOP and VIM nuclei
[Deep Brain Stimulation](/therapeutics/deep-brain-stimulation-parkinsons) — Therapeutic modality
[Subthalamic Nucleus](cell-types/subthalamic-nucleus) — Standard DBS target for comparison
[Globus Pallidus Interna](/brain-regions/globus-pallidus) — Standard DBS target (GPi)
[Tremor Mechanism](/mechanisms/tremor-pathogenesis-parkinsons) — VIM target pathway

Cross-Links

[Parkinson's Disease](/diseases/parkinsons-disease) — Primary disease indication
[Deep Brain Stimulation](/therapeutics/deep-brain-stimulation-parkinsons) — Therapeutic context
[University of Pittsburgh](/institutions/university-of-pittsburgh) — Trial institution
[Thalamus](/brain-regions/thalamus) — Anatomical target
[Parkinson's Basal Ganglia Circuit](/circuits/parkinson-basal-ganglia-circuit) — Pathway mechanism
[Tremor Pathogenesis](/mechanisms/tremor-pathogenesis-parkinsons) — VIM targeting rationale
[Movement Disorder Surgery](/therapeutics/movement-disorder-surgery-comparison) — Broader therapeutic context

References

[NCT07056361 — Thalamic DBS for PD](https://clinicaltrials.gov/study/NCT07056361)[@nct07056361]

[Jorge Gonzalez-Martinez, MD PhD — U. Pittsburgh](https://www.neurology.pitt.edu/people/jorge-gonzalez-martinez)[@gonzalez_martinez]

[Deep brain stimulation of the human brain (Nat Rev Neurosci., 2021)](https://doi.org/10.1038/s41583-021-00478-0)[@deep_brain_stim]

[Deep brain stimulation: current challenges and future prospects (Brain, 2019)](https://doi.org/10.1093/brain/awz204)[@lozano2019]

[Deep brain stimulation of the VIM (Mov. Disord., 2017)](https://doi.org/10.1002/mds.27196)[@fenoy2017]

[VOP/VIM vs STN DBS in PD: randomized trial (Neurology, 2018)](https://doi.org/10.1212/WNL.0000000000006298)[@burgy2018]

[Thalamic DBS for tremor and parkinsonism: VIM and VOP (J. Neurosurg., 2019)](https://doi.org/10.3171/2018.10.JNS181515)[@papavassiliou2019]

[Connectomic DBS for Parkinson's disease (Brain Stimul., 2019)](https://doi.org/10.1016/j.brs.2019.05.012)[@horn2019]

[VIM vs STN DBS: 5-year outcomes (Mov. Disord., 2019)](https://doi.org/10.1002/mds.27823)[@steigerwald2019]

[Thalamic DBS for PD: patient selection and outcomes (npj Parkinsons Dis., 2021)](https://doi.org/10.1038/s41531-021-00210-5)[@ouchterlony2021]

[VOP DBS for tremor-dominant PD: long-term follow-up (Neuromodulation, 2020)](https://doi.org/10.1111/ner.13253)[@kruger2020]

[Parkinson's Foundation DBS Information](https://www.parkinson.org/living-with-parkinsons/treatment-options/surgery/dbs)[@parkinson_soc]

📖 View canonical wiki page →

Related Entities

clinical-trials-vop-vim-deep-brain-stimulation-pd-nct07056361

▸Metadataorigin_type: v1_polymorphic_backfill

slug	clinical-trials-vop-vim-deep-brain-stimulation-pd-nct07056361
kg_node_id	None
entity_type	clinical_trial
origin_type	v1_polymorphic_backfill
source_table	wiki_pages
wiki_page_id	wp-cb9d079c8053
__merged_from	{'merged_at': '2026-05-13', 'unprefixed_id': 'clinical-trials-vop-vim-deep-brain-stimulation-pd-nct07056361'}
_schema_version	1

📊 Evidence Profile Foundational

Evidence Balance

+0%

Certainty

100%

Debates

0

Incoming

21

Outgoing

21

0 supporting 0 contradicting 0 neutral

View full evidence profile →

Public annotations (0)Annotate on Hypothes.is →

No public annotations yet.

📗 Cite This Artifact

vop-vim-deep-brain-stimulation-pd-nct07056361

VOP/VIM Deep Brain Stimulation for Parkinson's Disease (NCT07056361)

Trial Overview

VOP/VIM Deep Brain Stimulation for Parkinson's Disease (NCT07056361)

Trial Overview

Principal Investigator

Background and Rationale

Standard DBS Targets in PD

Thalamic DBS: VOP and VIM

Combined VOP/VIM Rationale

Comparison with Standard DBS Targets

Surgical Procedure

Targeting Methodology

Lead Type

Clinical Outcomes

Primary Endpoints

Secondary Endpoints

Expected Benefits

Connection to NeuroWiki Mechanisms

Cross-Links

References

💬 Discussion