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NCT03353688

Biomarkers to Guide Directional DBS for Parkinson's Disease

Completed NA Results posted Last updated 19 September 2024
What this trial tests

NA trial testing Boston Scientific Vercise PC IPG with directional DBS lead in Parkinson Disease in 31 participants. Completed in 31 July 2024.

Timeline
3 November 2017
Primary endpoint
15 August 2022
31 July 2024

Quick facts

Lead sponsorUniversity of Alabama at Birmingham
PhaseNA
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designcrossover
Maskingtriple
Primary purposetreatment
Enrollment31
Start date3 November 2017
Primary completion15 August 2022
Estimated completion31 July 2024
Sites1 location across United States

Drugs / interventions tested

Conditions studied

Sponsor

University of Alabama at Birmingham

Who can join

Adults 18 to 70, any sex, with Parkinson Disease. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Change From Preoperative Baseline in Movement Disorders Society Unified Parkinson's Disease Rating Scale Part 3 (MDS-UPDRS Part III) "Off" Medications Primary · 2, 4, and 6 months post op

A blinded examiner will measure Movement Disorders Society Unified Parkinson's Disease Rating Scale Part 3 motor scores "off" medications. MDS-UPDRS Part III is a motor examination consisting of 18 summed items where the investigator rates the severity of Parkinson's motor symptoms based on a scale of 0 - 4. Higher values indicate worse function (possible min score = 0, possible max score = 72). A change between baseline and performance at 2, 4, and 6 months post surgery is reported here. Score calculation is baseline - performance while on directional DBS guided by behavior, baseline - perfo

GroupValue95% CI
Directional DBS Guided by Behavior-16.90322581± 9.253305135
Omnidirectional DBS Guided by Behavior-15.80645161± 9.257139064
Directional DBS Guided by Biomarkers-18.33333333± 9.848274252
Treatment Preference Survey Programming Strategy Preference Primary · 4 months post surgery

Based on overall quality of life, participants will select their preference between directional and omnidirectional DBS.

GroupValue95% CI
Directional DBS Guided by Behavior16
Omnidirectional DBS Guided by Behavior14
Change From Preoperative Baseline in the Beck Depression Inventory-2 (BDI-2) Secondary · 2, 4, and 6 months post op

The Beck Depression Inventory-2 is a 21 question self-report inventory which evaluates a person's severity of depression. Items are answered on a 0 - 3 scale. Higher values indicate worse function (possible min score = 0, possible max score = 63). A change between baseline and performance at 2, 4, and 6 months post surgery is reported here. Score calculation is baseline - performance while on directional DBS guided by behavior, baseline - performance while on omnidirectional DBS guided by behavior, and baseline - performance while on directional DBS guided by biomarkers.

GroupValue95% CI
Directional DBS Guided by Behavior0.965517241± 6.455798936
Omnidirectional DBS Guided by Behavior1.032258065± 5.056242814
Directional DBS Guided by Biomarkers0.692307692± 6.739550316
Change From Preoperative Baseline in the Beck Anxiety Inventory (BAI) Secondary · 2, 4, and 6 months post op

The Beck Anxiety Inventory is a 21 question self-report inventory which evaluates a person's severity of anxiety. Items are answered on a 0 - 3 scale. Higher values indicate worse function (possible min score = 0, possible max score = 63). A change between baseline and performance at 2, 4, and 6 months post surgery is reported here. Score calculation is baseline - performance while on directional DBS guided by behavior, baseline - performance while on omnidirectional DBS guided by behavior, and baseline - performance while on directional DBS guided by biomarkers.

GroupValue95% CI
Directional DBS Guided by Behavior-2.55± 5.689093906
Omnidirectional DBS Guided by Behavior-0.333333333± 6.32455532
Directional DBS Guided by Biomarkers-0.6875± 8.16266909
Change From Preoperative Baseline in the Auditory Verbal Learning Test (AVLT) Delayed Recall Raw Score (Versions AB, CD, CR, GE) Secondary · 2, 4, and 6 months post op

The Auditory Verbal Learning Test (AVLT) delayed recall raw score (versions AB, CD, CR, GE) evaluates a person's ability to encode, consolidate, store, and retrieve verbal information. Participants are read a list of 12 words and later asked to recall the items on the list. Scores indicate the number of items recalled. Higher values indicate better function (possible min score = 0, possible max score = 12). A change between baseline and performance at 2, 4, and 6 months post surgery is reported here. Score calculation is baseline - performance while on directional DBS guided by behavior, base

GroupValue95% CI
Directional DBS Guided by Behavior-0.866666667± 3.785027976
Omnidirectional DBS Guided by Behavior-0.9± 3.39726056
Directional DBS Guided by Biomarkers-0.461538462± 3.776037809
Change From Preoperative Baseline in the Auditory Verbal Learning Test (AVLT) Recognition Raw Score (Versions AB, CD, CR, GE) Secondary · 2, 4, and 6 months post op

The Auditory Verbal Learning Test (AVLT) Recognition Raw Score (versions AB, CD, CR, GE) evaluates a person's ability to encode, consolidate, store, and retrieve verbal information. Participants are given a list of 15 target words. The list is taken away and each is asked to now pick out the 15 target words from a larger list of 30 words. Scores indicate the overall number of target words correctly recognized (minimum = 0, maximum = 15). Higher scores indicate better performance. A change between baseline and performance at 2, 4, and 6 months post surgery is reported here. Score calculation i

GroupValue95% CI
Directional DBS Guided by Behavior-0.5± 1.696853071
Omnidirectional DBS Guided by Behavior-0.433333333± 1.59056124
Directional DBS Guided by Biomarkers-0.961538462± 1.482720991
Change From Preoperative Baseline in the Auditory Verbal Learning Test (AVLT) Learning Raw Score (Versions AB, CD, CR, GE) Secondary · 2, 4, and 6 months post op

The AVLT (versions AB, CD, CR, GE) evaluates a person's ability to encode, consolidate, store, and retrieve verbal information. Participants are read a list of 12 words and asked to immediately recall the items on the list over 6 separate trials. Scores indicate the number of items recalled. Higher values indicate better function (possible min score = 0, possible max score = 72). A change between baseline and performance at 2, 4, and 6 months post surgery is reported here. Score calculation is baseline - performance while on directional DBS guided by behavior, baseline - performance while on

GroupValue95% CI
Directional DBS Guided by Behavior-2.233333333± 9.772174901
Omnidirectional DBS Guided by Behavior-3.3± 9.203260292
Directional DBS Guided by Biomarkers-0.576923077± 8.276100903
Change From Preoperative Baseline in the Letter Fluency Test Raw Score (Version: CFL, FAS) Secondary · 2, 4, and 6 months post op

The Letter Fluency Test (version: CFL, FAS) evaluates the number of words beginning with the letters C, F, L, A, and S that a participant can produce in one minute (minimum = 0, maximum = infinity). Higher scores indicate better function. A change between baseline and performance at 2, 4, and 6 months post surgery is reported here. Score calculation is baseline - performance while on directional DBS guided by behavior, baseline - performance while on omnidirectional DBS guided by behavior, and baseline - performance while on directional DBS guided by biomarkers.

GroupValue95% CI
Directional DBS Guided by Behavior-1.766666667± 8.21975473
Omnidirectional DBS Guided by Behavior-1.935483871± 9.401898687
Directional DBS Guided by Biomarkers-1.230769231± 9.074393389
Change From Preoperative Baseline in the Voice Handicap Index Secondary · 2, 4, and 6 months post op

The Voice Handicap Index evaluates speech function with a 30-item self-administered questionnaire that asks participants to describe their voice and the effects of their voice on their lives. Participants respond on a 0 - 4 scale (minimum = 0, maximum = 120. Higher scores indicate worse functiion. A change between baseline and performance at 2, 4, and 6 months post surgery is reported here. Score calculation is baseline - performance while on directional DBS guided by behavior, baseline - performance while on omnidirectional DBS guided by behavior, and baseline - performance while on directio

GroupValue95% CI
Directional DBS Guided by Behavior-2.709677419± 9.256325939
Omnidirectional DBS Guided by Behavior0.225806452± 7.774786931
Directional DBS Guided by Biomarkers-0.925925926± 12.04135798
Change From Preoperative Baseline in the Communicative Participation Item Bank (CPIB) Secondary · 2, 4, and 6 months post op

The Communicative Participation Item Bank (CPIB) evaluates the extent to which communication disorders interfere with communicative participation. Participants respond on a 0 - 3 scale (minimum = 0, maximum = 30). Higher scores indicate better function. A change between baseline and performance at 2, 4, and 6 months post surgery is reported here. Score calculation is baseline - performance while on directional DBS guided by behavior, baseline - performance while on omnidirectional DBS guided by behavior, and baseline - performance while on directional DBS guided by biomarkers.

GroupValue95% CI
Directional DBS Guided by Behavior-0.387096774± 3.489769996
Omnidirectional DBS Guided by Behavior-0.741935484± 2.920818857
Directional DBS Guided by Biomarkers-0.740740741± 4.927103944
Change From Preoperative Baseline in the 9-Hole Pegboard Test Secondary · 2, 4, and 6 months post op

The 9-Hole Pegboard Test evaluates one's upper extremity motor function. It is a timed test in which participants place 9 pegs in a pegboard and then remove them. Faster times indicate better function. A change between baseline and performance at 2, 4, and 6 months post surgery is reported here. Score calculation is baseline - performance while on directional DBS guided by behavior, baseline - performance while on omnidirectional DBS guided by behavior, and baseline - performance while on directional DBS guided by biomarkers.

GroupValue95% CI
Directional DBS Guided by Behavior-6.15± 10.86369404
Omnidirectional DBS Guided by Behavior-5.242258065± 11.16955019
Directional DBS Guided by Biomarkers-6.755± 11.38578962
Change From Preoperative Baseline in Gait Initiation Test Secondary · 2, 4, and 6 months post op

The gait initiation test evaluates the phase between standing motionless and steady-state locomotion. This is a timed test in which participants are given a go signal and the time until first stride is recorded. Faster times indicate better function. A change between baseline and performance at 2, 4, and 6 months post surgery is reported here. Score calculation is baseline - performance while on directional DBS guided by behavior, baseline - performance while on omnidirectional DBS guided by behavior, and baseline - performance while on directional DBS guided by biomarkers.

GroupValue95% CI
Directional DBS Guided by Behavior5.810333333± 22.17604991
Omnidirectional DBS Guided by Behavior2.491± 22.48954996
Directional DBS Guided by Biomarkers2.282± 27.67356219

Adverse events — posted to ClinicalTrials.gov

Time frame: 1 year. Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Directional DBS Guided by Behavior
Serious: 3/31 (10%)
Deaths: 0/30
Omnidirectional DBS Guided by Behavior
Serious: 4/31 (13%)
Deaths: 0/30
Directional DBS Guided by Biomarkers
Serious: 0/31 (0%)
Deaths: 0/30

Serious adverse events (5 terms)

ReactionSystemDirectional DBS Guided by …Omnidirectional DBS Guided…Directional DBS Guided by …
SAE1Cardiac disorders
SAE2Surgical and medical procedures
SAE3Nervous system disorders
SAE4Psychiatric disorders
SAE5Product Issues
Other adverse events (1 terms — click to expand)

ReactionSystemDirectional DBS Guided by …Omnidirectional DBS Guided…Directional DBS Guided by …
AE1Product Issues

Most-reported serious reactions: SAE1, SAE2, SAE3, SAE4, SAE5.

Data from ClinicalTrials.gov NCT03353688 adverse events section.

Sponsor's own description

The purpose of this study is to investigate the clinical efficacy of directional DBS electrode technology and whether electrophysiology biomarkers can predict effective contact segments for chronic therapy.

Publications & conference data

8 peer-reviewed publications reference this trial (live from Europe PMC):

  1. On the Right Track to Treat Movement Disorders: Promising Therapeutic Approaches for Parkinson's and Huntington's Disease.
    Troncoso-Escudero P, Sepulveda D, Pérez-Arancibia R, Parra AV, et al · · 2020 · cited 22× · PMID 33101007 · DOI 10.3389/fnagi.2020.571185
  2. Differential Cognitive Effects of Unilateral Subthalamic Nucleus Deep Brain Stimulation for Parkinson's Disease.
    Del Bene VA, Martin RC, Brinkerhoff SA, Olson JW, et al · · 2024 · cited 20× · PMID 38501317 · DOI 10.1002/ana.26903
  3. Walking Speed Reliably Measures Clinically Significant Changes in Gait by Directional Deep Brain Stimulation.
    Hurt CP, Kuhman DJ, Guthrie BL, Lima CR, et al · · 2020 · cited 11× · PMID 33584227 · DOI 10.3389/fnhum.2020.618366
  4. Cortical and Subthalamic Nucleus Spectral Changes During Limb Movements in Parkinson's Disease Patients with and Without Dystonia.
    Olson JW, Nakhmani A, Irwin ZT, Edwards LJ, et al · · 2022 · cited 8× · PMID 35702056 · DOI 10.1002/mds.29057
  5. Local anatomy, stimulation site, and time alter directional deep brain stimulation impedances.
    Olson JW, Gonzalez CL, Brinkerhoff S, Boolos M, et al · · 2022 · cited 6× · PMID 35992943 · DOI 10.3389/fnhum.2022.958703
  6. Novel lower-extremity dexterity assessment for Parkinson's disease: validation against measures of arm dexterity and general mobility.
    Kuhman D, Edwards LJ, Walker H, Hurt CP. · · 2023 · cited 4× · PMID 35021926 · DOI 10.1080/09638288.2021.2025273
  7. Pointing in the right direction: Greater motor improvements with directional versus circular subthalamic nucleus deep brain stimulation for Parkinson's disease.
    Hurt CP, Kuhman DJ, Moll A, Guthrie BL, et al · · 2025 · cited 1× · PMID 39973481 · DOI 10.1177/1877718x241301071
  8. Differential contribution of sensorimotor cortex and subthalamic nucleus to unimanual and bimanual hand movements.
    Merrick CM, Doyle ON, Gallegos NE, Irwin ZT, et al · · 2024 · cited 1× · PMID 38124548 · DOI 10.1093/cercor/bhad492

Verify or expand the search:

Other trials of Boston Scientific Vercise PC IPG with directional DBS lead

Trials testing the same drug.

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Other University of Alabama at Birmingham trials

Trials by the same sponsor.

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