# Subthalamic deep brain stimulation to modulate vestibular heading perception in Parkinson’s disease.

> **NIH VA I01** · LOUIS STOKES CLEVELAND VA MEDICAL CENTER · 2022 · —

## Abstract

Parkinson’s Disease (PD) is a common neurodegenerative disorder affecting human movements. PD is not
just a motor disease. It also results in impaired multi-sensory processing that is critical for encoding self-
orientation and self-motion. Ultimately, this leads to abnormal spatial navigation, lateral drifts while walking
(veering), postural instability and falls in about 70% of patients. Conventional pharmacotherapy or deep brain
stimulation (DBS) for PD are variably effective in treating these debilitating symptoms. DBS improves balance
dysfunction in some patients, while in some it does not affect balance or even makes it worse. Defining consistent
therapy requires a proper understanding of the mechanisms of navigational impairments in PD, and to know how
DBS modulates the balance function. A singular vision of our research program is: 1) To reveal the
physiological underpinnings of how DBS modulates the process by which multisensory integrated systems
govern perception of one’s own motion critical for spatial navigation, gait and balance in PD. 2) To be able to
consistently treat navigational impairments such as veering in PD patients with subthalamic nucleus (STN) DBS
while preserving its other benefits of treating tremor and increased muscle tone, and reducing pharmacotherapy
burden with bothersome side effects. With this goal the current Merit Review application focuses on the vestibular
system – the critical system for the perception of one’s own linear motion, i.e. vestibular heading perception –
the task that is has to be accurate for the proper control of balance, navigation, and averting falls. We
hypothesize that effects of STN DBS on vestibular heading perception and veering are dependent upon the
specific location of the active electrode contact within the STN and modulation of the cerebello-thalamic pathway
that is known to carry the vestibular signal and is in physical vicinity of the STN. In order to test this hypothesis
we will objectively measure one’s ability to perceive direction of linear motion (i.e., vestibular heading perception),
lateral drifts while walking (i.e., veering) that is common in PD, and then we will compare these objective
measures among three independent conditions – dorsal STN DBS, ventral STN DBS, and DBS off. The Aim 1
will examine the effects of the location of volume of tissue activation within the STN on the change in vestibular
heading perception and veering in human PD patients. We will collate physical location of the volume of tissue
activation from all patients when the change in vestibular heading perception and veering was found. These
locations, generating the probabilistic stimulation atlas, will provide insights about areas of STN that could
influence balance function in PD. The Aim 2 will examine the recruitment metrics of the axonal pathways
modulated by the STN DBS that correlates with change in vestibular heading perception and veering in PD
patients. It will directly examine the role ...

## Key facts

- **NIH application ID:** 10316153
- **Project number:** 5I01CX002086-02
- **Recipient organization:** LOUIS STOKES CLEVELAND VA MEDICAL CENTER
- **Principal Investigator:** Aasef G Shaikh
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2021-01-01 → 2024-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10316153

## Citation

> US National Institutes of Health, RePORTER application 10316153, Subthalamic deep brain stimulation to modulate vestibular heading perception in Parkinson’s disease. (5I01CX002086-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10316153. Licensed CC0.

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