Attention and Eye Movement in Parkinson's Disease and Other Movement Disorders
This study is looking at how deep brain stimulation (DBS) affects attention, how your eyes move, and how you understand social cues in people with Parkinson's disease (PD), essential tremor (ET), and dystonia (DT). Researchers want to see if problems with attention and eye movement in PD change how people interpret social cues, and if DBS can improve or worsen these issues. They are also exploring if DBS settings can be adjusted to help with attention while still treating other symptoms. You might receive your usual DBS settings, or DBS with reduced current or reduced frequency. The study will measure facial expression ratings, eye movements, and brain activity during surgery. This study is for people aged 19 to 90 who have been diagnosed with PD, ET, or DT and are able to give informed consent and make perceptual judgments. The current status of this study is unclear, and it plans to enroll 138 participants.
- Study design
- This is an interventional study, meaning participants will receive specific treatments. It plans to enroll 138 participants.
- What's involved
- You will have measurements taken at baseline (before DBS implantation), during the DBS surgery, and 2-3 weeks after surgery once your stimulation is optimized.
- Compensation
- Not stated in the trial record.
- Follow-up
- You will be followed for 2-3 weeks after DBS implantation for post-operative measurements.
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Attention and Eye Movement in Parkinson's Disease
At a glance
Conditions
Where it's being run
1 sites across 1 statesStudy leadership
- Christopher K Kovach, PhD · PRINCIPAL_INVESTIGATOR · University of Nebraska
Who to contact
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Do you actually qualify for this trial?
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Inclusion
Exclusion
What this trial measures
- Facial Expression RatingBaseline (within 2 weeks pre-DBS implantation), intraoperative (Day 0; day of DBS implantation surgery, and post-operative follow-up (2-3 weeks after DBS implantation, following clinical optimization of stimulation parameters).
Participants will rate facial expression along a continuous scale using a computerized slider, following the affective bias task (ABT) of Bijanki et al. (2014). The scale is anchored with three descriptors, "Very Sad" at slider value 0 (left), "Neutral", at position 0.5 (middle), and "Very Happy" at 1.0 (right). Responses are compared between two time points: (1) at the initial pre-surgical testing session and post DBS implantation and (2) at the post-implantation session following clinical optimization of therapeutic parameters, 2-3 weeks after surgery. The comparison will examine both the direction of any bias of the rating, against normative ratings, and the magnitude of average deviation from normative ratings. Finally, the ratings will be incorporated into a generalized linear model of gaze position (Kovach 2014) to identify the association between perceived facial expression and characteristic fixation patterns.
- Eye TrackingBaseline (within 2 weeks pre-DBS implantation), intraoperative (Day 0; day of DBS implantation surgery, and post-operative follow-up (2-3 weeks after DBS implantation, following clinical optimization of stimulation parameters).
The location and duration of gaze fixations will be recorded with a remote eye tracking camera. The location of gaze fixations will be treated as the dependent measure within a generalized linear modeling (GLM) framework for spatial point processes, described in Kovach and Adolphs (2014). Parameter estimates of the model give the log relative risk of fixation at different locations in the visual scene as a function of the independent measures of the model. Independent measures include the main effect of (1) Fourier basis functions encoding scene location and its interactions with (2) image rating in the affective bias task of Bijanki et. al (2014), (3) session and (4) DBS stimulation state. Measures derived from the GLM model will also include the statistical deviation (e.g. Kullback-Leibler divergence) from the average distribution of fixations observed in healthy comparison subjects for each image.
- Intraoperative MicrorecordingsIntraoperative (Day 0; day of DBS implantation surgery).
During the Aim 2 portion of the study, patients undergoing awake DBS surgery as part of standard clinical care will engage in a subset of the face rating tasks during the surgery. Invasive recordings will be obtained from DBS target structures, including STN, VIM, and GPi using microelectrodes that are placed as part of standard clinical practice. Spike sorting will be used to identify firing of individual cells and firing rate will compared to eye movements to identify responses associated with shifts of attention in the targeted deep brain structures . These measures will be compared across movement-disorders populations using mixed-effects linear modeling and other standard statistical procedures.