search
Back to results

Adaptive DBS Algorithm for Personalized Therapy in Parkinson's Disease (ADAPT-PD)

Primary Purpose

Parkinson Disease

Status
Active
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
Adaptive DBS
Sponsored by
MedtronicNeuro
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Parkinson Disease focused on measuring Deep Brain Stimulation, Parkinson's Disease

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

General

  1. Subject has idiopathic Parkinson's disease
  2. Subject is implanted with Percept PC (Model B35200) and Medtronic DBS leads (Model 3387, 3389, B33005 or B33015) and extensions (Model 37085, 37086, or B34000) bilaterally in the same target (physician confirmed), STN or GPi
  3. In the opinion of the investigator, the subject responds to DBS Therapy.
  4. Based on the opinion of the investigator, the subject's cDBS parameters and PD medications are stable and expected to remain stable from enrollment through the end of the aDBS Evaluation phase
  5. (Primary Cohort) Subject is configured to ring mode monopolar or dual monopolar stimulation using contacts 1 and/or 2 (9 and/or 10) on at least one side.

5. (Directional Stimulation Cohort) Subject is configured to directional monopolar or dual monopolar stimulation using contacts 1 and/or 2 (9 and/or 10) 6. Subject is willing and able to attend all study-required visits and complete the study procedures (e.g. 1-month recall questionnaires, MDS-UPDRS III) 7. Subject has the ability to understand and provide written informed consent for participation in the study prior to the study-related procedures being conducted 8. Subject is a male or non-pregnant female. If female of child-bearing potential, and if sexually active, must be using, or agree to use, a medically-acceptable method of birth control as confirmed by the investigator 9. For subjects with the SenSight system: Subject is configured to the following stimulation rates: 55, 85, 110, 125, 145, 164 or 180 Hz (as required for sensing/aDBS)

LFP Screening Inclusion Criteria

1. Subject has required Beta band (8-30 Hz) amplitude detected on either left and/or right DBS leads

Exclusion Criteria:

  1. Subject and/or caregiver is unable to utilize the patient programmer
  2. Subject has more than one lead in each hemisphere of the brain
  3. Subject has cortical leads or additional unapproved hardware implanted in the brain
  4. Subject has more than one INS
  5. At enrollment, the subject's INS has a predicted battery life of <1 year
  6. Subject has Beck Depression Inventory II (BDI-II) > 25
  7. Subject requires diathermy, transcranial magnetic stimulation (TMS), or electroconvulsive therapy (ECT)
  8. Subject has a metallic implant in the head, (eg, aneurysm clip, cochlear implant)
  9. Subject has, or plans to obtain, an implanted electrical stimulation medical device anywhere in the body (eg, cardiac pacemaker, defibrillator, spinal cord stimulator)
  10. Subject has, or plans to obtain, an implanted medication pump for the treatment of Parkinson's disease (eg, DUOPATM infusion pump) and/or portable infusion pump
  11. Based on the opinion of the investigator, the subject has an abnormal neurological examination that would preclude them from study participation
  12. Subject is breast feeding
  13. Subject is under the age of 18 years
  14. Subject is currently enrolled in or plans to enroll in any concurrent drug and/or device study that may confound the results of this study as determined by the Medtronic study team
  15. Subject is unable to use or tolerate wearable
  16. Subjects with signal artifact on all 6 aDBS sense pathways (3 each on both DBS leads) which preclude the clinician from setting thresholds

Sites / Locations

  • University of California San Francisco
  • Stanford University Medical Center
  • University of Florida
  • Massachusetts General Hospital
  • Duke University
  • Cleveland Clinic
  • Vanderbilt University Medical Center
  • Toronto Western Hospital
  • UJF Grenoble
  • Amsterdam UMC, location AMC

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

aDBS Single Threshold

aDBS Dual Threshold

Arm Description

Adaptive DBS Single Threshold Mode

Adaptive DBS DualThreshold Mode

Outcomes

Primary Outcome Measures

On time without troublesome dyskinesia
Proportion of aDBS subjects with "On" time without troublesome dyskinesia exceeding the threshold (aDBS is no worse than one standard deviation less than cDBS).

Secondary Outcome Measures

Stimulation energy use
Total electrical energy delivered (TEED) for aDBS as compared with cDBS.

Full Information

First Posted
August 20, 2020
Last Updated
March 7, 2023
Sponsor
MedtronicNeuro
search

1. Study Identification

Unique Protocol Identification Number
NCT04547712
Brief Title
Adaptive DBS Algorithm for Personalized Therapy in Parkinson's Disease
Acronym
ADAPT-PD
Official Title
Adaptive DBS Algorithm for Personalized Therapy in Parkinson's Disease
Study Type
Interventional

2. Study Status

Record Verification Date
March 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
December 14, 2020 (Actual)
Primary Completion Date
January 12, 2023 (Actual)
Study Completion Date
May 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
MedtronicNeuro

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Device Product Not Approved or Cleared by U.S. FDA
Yes
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of the study is to demonstrate the safety and effectiveness of adaptive DBS (aDBS) for Parkinson's disease.
Detailed Description
Prospective single-blind, randomized crossover, multi-center study of aDBS in subjects with Parkinson's disease.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Parkinson Disease
Keywords
Deep Brain Stimulation, Parkinson's Disease

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Crossover Assignment
Model Description
Randomization to a crossover sequence of aDBS single threshold and aDBS dual threshold modes
Masking
Participant
Allocation
Randomized
Enrollment
100 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
aDBS Single Threshold
Arm Type
Experimental
Arm Description
Adaptive DBS Single Threshold Mode
Arm Title
aDBS Dual Threshold
Arm Type
Experimental
Arm Description
Adaptive DBS DualThreshold Mode
Intervention Type
Device
Intervention Name(s)
Adaptive DBS
Other Intervention Name(s)
aDBS
Intervention Description
Subjects for whom both aDBS modes are acceptable will receive Dual and Single Threshold aDBS
Primary Outcome Measure Information:
Title
On time without troublesome dyskinesia
Description
Proportion of aDBS subjects with "On" time without troublesome dyskinesia exceeding the threshold (aDBS is no worse than one standard deviation less than cDBS).
Time Frame
Change from Baseline at 1 and 2 months post-randomization
Secondary Outcome Measure Information:
Title
Stimulation energy use
Description
Total electrical energy delivered (TEED) for aDBS as compared with cDBS.
Time Frame
Change from Baseline at 1 and 2 months post-randomization
Other Pre-specified Outcome Measures:
Title
Safety (Stimulation-related AEs)
Description
To characterize stimulation-related adverse events
Time Frame
Up to 45 days per mode (average of 30 days)
Title
Safety (SAEs, AEs and DDs)
Description
To characterize serious adverse events, adverse events and device deficiencies
Time Frame
Through study completion, approximately 1.5 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: General Subject has idiopathic Parkinson's disease Subject is implanted with Percept PC (Model B35200) and Medtronic DBS leads (Model 3387, 3389, B33005 or B33015) and extensions (Model 37085, 37086, or B34000) bilaterally in the same target (physician confirmed), STN or GPi In the opinion of the investigator, the subject responds to DBS Therapy. Based on the opinion of the investigator, the subject's cDBS parameters and PD medications are stable and expected to remain stable from enrollment through the end of the aDBS Evaluation phase (Primary Cohort) Subject is configured to ring mode monopolar or dual monopolar stimulation using contacts 1 and/or 2 (9 and/or 10) on at least one side. 5. (Directional Stimulation Cohort) Subject is configured to directional monopolar or dual monopolar stimulation using contacts 1 and/or 2 (9 and/or 10) 6. Subject is willing and able to attend all study-required visits and complete the study procedures (e.g. 1-month recall questionnaires, MDS-UPDRS III) 7. Subject has the ability to understand and provide written informed consent for participation in the study prior to the study-related procedures being conducted 8. Subject is a male or non-pregnant female. If female of child-bearing potential, and if sexually active, must be using, or agree to use, a medically-acceptable method of birth control as confirmed by the investigator 9. For subjects with the SenSight system: Subject is configured to the following stimulation rates: 55, 85, 110, 125, 145, 164 or 180 Hz (as required for sensing/aDBS) LFP Screening Inclusion Criteria 1. Subject has required Beta band (8-30 Hz) amplitude detected on either left and/or right DBS leads Exclusion Criteria: Subject and/or caregiver is unable to utilize the patient programmer Subject has more than one lead in each hemisphere of the brain Subject has cortical leads or additional unapproved hardware implanted in the brain Subject has more than one INS At enrollment, the subject's INS has a predicted battery life of <1 year Subject has Beck Depression Inventory II (BDI-II) > 25 Subject requires diathermy, transcranial magnetic stimulation (TMS), or electroconvulsive therapy (ECT) Subject has a metallic implant in the head, (eg, aneurysm clip, cochlear implant) Subject has, or plans to obtain, an implanted electrical stimulation medical device anywhere in the body (eg, cardiac pacemaker, defibrillator, spinal cord stimulator) Subject has, or plans to obtain, an implanted medication pump for the treatment of Parkinson's disease (eg, DUOPATM infusion pump) and/or portable infusion pump Based on the opinion of the investigator, the subject has an abnormal neurological examination that would preclude them from study participation Subject is breast feeding Subject is under the age of 18 years Subject is currently enrolled in or plans to enroll in any concurrent drug and/or device study that may confound the results of this study as determined by the Medtronic study team Subject is unable to use or tolerate wearable Subjects with signal artifact on all 6 aDBS sense pathways (3 each on both DBS leads) which preclude the clinician from setting thresholds
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Helen Bronte-Stewart, MD, MSE
Organizational Affiliation
Stanford University
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of California San Francisco
City
San Francisco
State/Province
California
ZIP/Postal Code
94115
Country
United States
Facility Name
Stanford University Medical Center
City
Stanford
State/Province
California
ZIP/Postal Code
94305
Country
United States
Facility Name
University of Florida
City
Gainesville
State/Province
Florida
ZIP/Postal Code
32608
Country
United States
Facility Name
Massachusetts General Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Facility Name
Duke University
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27710
Country
United States
Facility Name
Cleveland Clinic
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44195
Country
United States
Facility Name
Vanderbilt University Medical Center
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37232
Country
United States
Facility Name
Toronto Western Hospital
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5T 25B
Country
Canada
Facility Name
UJF Grenoble
City
Grenoble
Country
France
Facility Name
Amsterdam UMC, location AMC
City
Amsterdam
ZIP/Postal Code
1105 AZ
Country
Netherlands

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
35346837
Citation
Swinnen BEKS, Buijink AW, Pina-Fuentes D, de Bie RMA, Beudel M. Diving into the subcortex: The potential of chronic subcortical sensing for unravelling basal ganglia function and optimization of deep brain stimulation. Neuroimage. 2022 Jul 1;254:119147. doi: 10.1016/j.neuroimage.2022.119147. Epub 2022 Mar 27.
Results Reference
derived

Learn more about this trial

Adaptive DBS Algorithm for Personalized Therapy in Parkinson's Disease

We'll reach out to this number within 24 hrs