Impact of Subthalamic Nucleus Deep Brain Stimulation on Pain in Parkinson Disease

Study Overview
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Brief Summary
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Pain is a common symptom of Parkinson's disease (PD) but the physiology remains poorly understood. Recent work suggests that subthalamic nucleus deep brain stimulation (STN-DBS) could make a profit on the pain in PD. The investigator would drive a study with a follow up of PD patients before and after STN-DBS. The pain will be clinically explored by targeted questionnaires and electrophysiological through laser evoked potentials. The questionnaires are designed to quantify and characterize the pain in these patients. Laser evoked potentials will, through repetitive stimulation, study both the functional status of the afferent nociceptive pathways, their habituation to repetitive nociceptive stimuli, and so better understand any abnormalities of the central processing of nociceptive information.

Official Title
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Impact of Subthalamic Nucleus Deep Brain Stimulation on Pain in Parkinson Disease : Clinical and Neurophysiological Study

Conditions
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Parkinson Disease

Intervention / Treatment
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* Other: Laser-Evoked potential


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: A patient with idiopathic Parkinson's disease Age between 30 and 70 inclusive. No cognitive decline (MMS greater than or equal to 24) Normal brain MRI Informed consent signed With or without pain sensation Exclusion Criteria: Presence of other neurological pathology that could explain the pain. MMS less than 24 Pregnant or breastfeeding women

Ages Eligible for Study
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Minimum Age: 30 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Basic Science
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Patients who underwent Deep Brain Stimulation (DBS)<br>Patients who underwent Subthalamic Nucleus (STN)-DBS at Lyon | Other: Laser-Evoked potential<br>* Laser-Evoked potential can document lesions of spinothalamic tract and lateral brainstem and of thalamo-cortical projections conducting nociceptive signals. The rapid heating of skin by infrared laser pulses stimulate small fibers sensory pathways. The main cortical laser evoked potential is a complex of components N2-P2. Evaluation of the registered potentials includes shape, latency and amplitude.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Modification of habituation in percentage, between tests performed before and after DBS | The habituation is the change of amplitude between the first and the second response of the double stimulation during the laser evoked potential. We calculated a percentage | After the second laser evoked potential which occurred around 3 months after STN-DBS | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in latency of laser evoked potential responses before and after DBS | latency is calculated in millisecond | After the second laser evoked potential which occurred around 3 months after STN-DBS | 
| Change in amplitude of laser evoked potential responses before and after DBS | amplitude is calculated in microvolts | After the second laser evoked potential which occurred around 3 months after STN-DBS | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Parkinson Disease, Pain, Deep Brain Stimulation, Laser-Evoked Potentials