Study Rationale:
Freezing of gait, an episodic inability to initiate movement, is a leading reason for loss of independence in Parkinson’s disease (PD). Despite its prevalence, we lack an effective treatment. Part of the challenge lies in eliciting this symptom during clinical or research visits. We propose to use the only platform that effectively combines virtual and physical worlds to re-create scenarios that trigger freezing of gait. Monitoring brain activity while patients walk in this virtual world will provide unprecedented insight into the underlying neural signature of this halting movement and provide a clear target for treatment using deep brain stimulation (DBS).
Hypothesis:
We will discover, within the brain region that controls movement, a unique signature of neural activity that triggers an episode of freezing of gait.
Study Design:
We will conduct a Phase I trial of safety and feasibility of our approach at a single site over a period of 36 months. As participants complete the virtual reality task — both on and off antiparkinsonian medication — we will gather biomechanical measurements and monitor the neural activity that will allow us to characterize freezing of gait.
Impact on Diagnosis/Treatment of Parkinson’s Disease:
The proposed project will transform how freezing of gait is treated in PD. We propose to uncover the underlying cause of this symptom, information that can then be used to effectively program DBS to address an unmet need in treating this disabling movement disorder in people with PD.
Next Steps for Development:
Results from this project will be used to create patient-specific DBS protocol for relieving freezing of gait. A Phase II randomized study will then be conducted to compare the effectiveness of using a clinical version of our virtual reality task with a traditional DBS program for treating freezing of gait.