Somato-cognitive Action Network Targeted Epidural Modulation for Parkinson's Disease (STEM-PD): a Prospective Open-label Clinical Trial
The goal of this clinical trial is to learn if epidural modulation targeting the Somato-Cognitive Action Network (SCAN) can improve motor symptoms in adults with idiopathic Parkinson's disease (PD). It will also evaluate the safety of this treatment. The main questions it aims to answer are: * Does epidural modulation targeting SCAN reduce motor symptoms (measured by MDS-UPDRS-III scores) in PD patients after 3 months? * Is SCAN targeted epidural modulation (STEM) a safe and tolerable treatment for PD, with minimal adverse effects? Researchers will compare participants' baseline motor function to their post-treatment results to determine if STEM is effective. Participants will: * First undergo non-invasive brain stimulation (iTBS) to test responsiveness. * If eligible, receive surgical implantation of STEM electrodes in the personalized SCAN target. * Complete follow-up visits for 12 months to monitor symptoms, side effects, and quality of life.
• Diagnosed with idiopathic Parkinson's disease (PD) according to the revised clinical diagnostic criteria of the International Movement Disorder Society (MDS) (2015 version) or the Chinese Parkinson's Disease Diagnostic Criteria (2016 version).
• Age between 40 and 75 years, with a minimum age of 40 years at the time of diagnosis.
• Any gender, including both male and female patients.
• Hoehn-Yahr staging between 2 and 4 (inclusive).
• Disease duration of 5 years or more.
• Responding effectively to levodopa-based drug therapy with a minimum of 30% improvement in the levodopa loading test.
• Presence of motor fluctuations with or without anisocoria despite optimal drug treatment.
• Stable on medication for at least the past 1 month prior to screening and surgery.
• Ability to understand the trial and willingness to sign an informed consent form.