Chronic Effects of DBS in Parkinson's Disease and Dystonia

Inclusion Criteria(both groups):

- Ability to give informed consent for the study

- Movement disorder symptoms that are sufficiently severe, in spite of best medical
therapy, to warrant surgical implantation of deep brain stimulators according to
standard clinical criteria

Inclusion criteria (Isolated dystonia):

- Age 22-75

- Isolated dystonia that is generalized or segmental, that must affect one or - Stable
doses of anti-dystonia medications (such as Artane, Baclofen, or Clonopin) for at
least 30 days prior to baseline assessment

- For patients with craniofacial involvement, prior treatment with botulinum toxin with
failure to adequately control dystonia symptoms.

Inclusion criteria (PD):

- Age 30-75

- Bilateral disease (Hoehn and Yahr stage 2 or greater)

- Has been treated with levodopa/carbidopa, and with a dopamine agonist, at the maximal
tolerated doses as determined by a movement disorders neurologist

- Stable doses of antiParkinsonian medications for at least 30 days prior to their
baseline assessment

- Significant disability in the setting of optimal medical management by a movement
disorders neurologist. Disability may be due to tremor that is unresponsive to
medications, or to motor fluctuations

- UPDRS-III score off medication between 20 and 60

- Improvement of at least 30% in the baseline UPDRS-III on medication score, compared to
the baseline off-medication score.

Exclusion Criteria (both groups):

- Pregnancy or breast feeding

- MRI showing cortical atrophy out of proportion to age

- MRI showing focal brain lesions that could indicate a non-idiopathic movement
disorder,

- Major comorbidity increasing the risk of surgery (prior stroke, severe hypertension,
severe diabetes, or need for chronic anticoagulation other than aspirin)

- Inability to comply with study follow-up visits

- Any prior intracranial surgery

- Mood depression with a Beck depression inventory score of > 17 on baseline screening

- Significant cognitive impairment (MoCA<25).

- History of seizures

- Immunocompromised

- Has an active infection

- Requires diathermy, electroconvulsive therapy (ECT) or transcranial magnetic - Has an
implanted electronic device such as a neurostimulator, cardiac pacemaker or medication
pump.