Zhongnan Hospital of Wuhan University
Wuhan, Hubei, 430071, China
Location status: Recruiting
NCT Number: NCT07745673
This prospective, randomized, participant- and outcome-assessor-blinded, parallel-group exploratory trial will compare the target-dependent clinical, neuroimaging, and electrophysiological effects of temporal interference stimulation (TIS) targeting the subthalamic nucleus (STN) or globus pallidus internus (GPi) in patients with Parkinson's disease (PD).
Eighteen participants with idiopathic PD will be randomly assigned in a 1:1 ratio to the STN-TIS or GPi-TIS group. Participants will receive one 20-minute TIS session daily for 7 consecutive days. Motor symptoms will be assessed using the MDS-UPDRS Part III immediately before and after each daily stimulation session. Resting-state functional magnetic resonance imaging (fMRI) and 64-channel electroencephalography (EEG) will be performed before the first stimulation session and immediately after completion of the 7-day intervention.
The primary outcomes are: (1) change in MDS-UPDRS Part III score from Day 1 before stimulation to Day 7 after stimulation; and (2) changes in regional spontaneous brain activity and seed-based functional connectivity measured using resting-state fMRI. Secondary outcomes are: (1) daily immediate changes in MDS-UPDRS Part III scores and the proportion of participants achieving at least 30% improvement at Day 7; and (2) changes in resting-state 64-channel EEG relative bandpower.
Safety and tolerability will be evaluated by monitoring adverse events and local skin reactions throughout the intervention. This study aims to provide preliminary evidence regarding target-dependent functional response patterns associated with STN- and GPi-targeted TIS in PD.
Interested in participating?
Request Info40 year and older
All sexes
Interventional
Not applicable
Wuhan, Hubei, 430071, China
Location status: Recruiting
Healthy volunteers accepted: No
Only the study team can determine whether someone qualifies for participation.
Inclusion criteria
Exclusion criteria
TIS stimulation target is the subthalamic nucleus (STN) , with a current intensity of 2 mA, base frequency of 2000 Hz, frequency difference of 130 Hz, and stimulation duration of 20 minutes.
TIS stimulation target is the globus pallidus (GP), with a current intensity of 2 mA, base frequency of 2000 Hz, frequency difference of 130 Hz, and stimulation duration of 20 minutes.
Time frame: Immediately before the first stimulation session on Day 1 and immediately after the final stimulation session on Day 7.
Motor symptoms will be assessed using the Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale Part III (MDS-UPDRS Part III). All assessments will be conducted after withdrawal of antiparkinsonian medications for at least 12 hours. The change score will be calculated as the MDS-UPDRS Part III score immediately after the final stimulation session on Day 7 minus the score immediately before the first stimulation session on Day 1. A negative change value indicates improvement in motor symptoms.
Time frame: Baseline before the first stimulation session and immediately after completion of the 7-day intervention.
Regional spontaneous brain activity and functional connectivity will be assessed using resting-state functional magnetic resonance imaging. Regional spontaneous brain activity will be evaluated primarily using the standardized amplitude of low-frequency fluctuation (zALFF). Seed-based functional connectivity will be calculated using predefined subthalamic nucleus and globus pallidus internus seed regions, and correlation coefficients will be transformed to Fisher z values. For each imaging measure, the change value will be calculated as the post-intervention value minus the baseline value. Within-group changes and between-group differences will be evaluated to characterize stimulation-related and target-dependent brain functional response patterns.
Time frame: Immediately before and immediately after each stimulation session on Days 1 through 7; response rate assessed from immediately before the first stimulation session on Day 1 to immediately after the final stimulation session on Day 7.
MDS-UPDRS Part III will be assessed immediately before and immediately after each daily stimulation session during the 7-day intervention. The immediate within-session change for each treatment day will be calculated as the post-stimulation score minus the corresponding pre-stimulation score, with negative values indicating improvement.
Clinical response will also be evaluated using the percentage change in MDS-UPDRS Part III score from immediately before the first stimulation session on Day 1 to immediately after the final stimulation session on Day 7. Percentage improvement will be calculated as the Day 1 pre-stimulation score minus the Day 7 post-stimulation score, divided by the Day 1 pre-stimulation score and multiplied by 100. Participants with an improvement of at least 30% will be classified as responders, and the response rate will be calculated as the proportion of responders in each stimulation group.
Time frame: Baseline before the first stimulation session and immediately after completion of the 7-day intervention.
Resting-state 64-channel electroencephalography will be recorded under eyes-closed conditions. Relative bandpower will be calculated for predefined frequency bands, including the Parkinsonian tremor-frequency range, theta, alpha, low-beta, high-beta, and total-beta bands, across predefined scalp regions. For each region-by-frequency measure, the change value will be calculated as the post-intervention relative bandpower minus the baseline relative bandpower. Exploratory principal component analysis will be used to characterize multivariate EEG response patterns associated with STN-targeted and GPi-targeted TIS.
Contact information is provided by the study sponsor or research team.
Zhongnan Hospital
Other
Comparative Efficacy of Temporal Interference Stimulation at Different Targets in Parkinson's Disease
Acronym: tTIS
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