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Study of the effect of the subthalamic nucleus DBS on the sleep/wake behavior in healthy and parkinsonian NHP

Objectives

Deep brain stimulation (DBS) will be used to restore the abnormal sleep/wakefulness behavior in parkinsonian NHP.

Collaborations

Clinatec and Medtronic

Study

Study Rationale

Sleep/Wake (S/W) disorders are very common in Parkinson Disease (PD) and are suspected to cause excessive daytime sleepiness as well as cognitive impairment that greatly affect patients' quality of life. As of today, no treatment is available to restore a physiological sleep with its complex organization, characterized mainly by several episodes of slow-wave cortical activity. This project aims to explore the ability of the deep-brain stimulation (DBS) of the subthalamic nucleus to modify the cortical activity in order to restore the sleep disorders encountered in PD. STN-DBS is a functional treatment capable of modulating cortical activity and can be considered an innovative means of restoring sleep disorders in PD.

Study Design

During normal sleep, the cortical activity will be recorded trough epidural leads. Based on these recordings, a new nocturnal paradigm of DBS will be identified and used to drive the cortical activity in an attempt to improve the pathological brain activity encountered during sleep in PD. This paradigm of stimulation will be incorporated into a new generation of brain sensing stimulator. The experiments will be performed on NHP which constitutes a model of choice to reproduce the PD with the occurrence of sleep disturbances and to set up new paradigms of DBS. The effect on wakefulness will be assessed by measuring the number and the quality of sleep episodes, the reaction time and the mental flexibility during the day-time.

Method

Telemetry equipment will be implanted in NHPs to collect polysomnographic data and determine the different stages of S/W. An electrode connected to a sensor/stimulator will be implanted in the STN. Daytime sleepiness will be evaluated by a multiple sleep latency tests. The different sleep stages will be studied in different conditions (healthy, parkinsonian, during DBS).
Conclusion: This proposal aims at improving the W/S disorder, one of the most disabling non-motor disorders, using a new the DBS paradigm of stimulation. About 70% of the nearly 100,000 diagnosed PD patients presenting some sleep disturbances could benefit from this procedure, which could also be offered earlier to all newly implanted patients.

Required skills

Neurophysiology, non human primate experiments, sleep, deep brain stimulation

Mise à jour le 26 août 2021

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Pour les stages (master, licence, 3ème hors sessions décembre et avril), envoyer directement un email au responsable de l'équipe que vous avez identifiée.

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