# NIH grant: Subthalamic Deep Brain Stimulation for Resolving Visuo-Vestibular Conflict in Parkinson's Disease (1R01NS143992-01A1) — retained record

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[original source ↗](https://reporter.nih.gov/project-details/1R01NS143992-01A1)

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NIH grant 1R01NS143992-01A1: Subthalamic Deep Brain Stimulation for Resolving Visuo-Vestibular Conflict in Parkinson's Disease
Institute: {'code': 'NS', 'abbreviation': 'NINDS', 'name': 'National Institute of Neurological Disorders and Stroke', 'admin_org_id': '12500053', 'admin_funding_url': ''}. PI: Aasef G Shaikh. Award: $330000.
Start: 2026-08-07T00:00:00.
PROJECT SUMMARY
Parkinson’s disease (PD) affects about 10 million people globally, including 1 million Americans. Beyond motor
symptoms like tremors and rigidity, PD patients often struggle with visuo-spatial navigation, impacting skills such
as pathfinding, spatial memory, and awareness, and affecting gait due to difficulties in resolving visuo-vestibular
conflicts. These deficits are often unresponsive to conventional pharmacotherapy, making deep brain stimulation
(DBS) surgery necessary. Subthalamic nucleus (STN) DBS is preferred for motor symptoms, but its impact on
non-motor symptoms like spatial navigation varies. Our research aims to optimize STN DBS to enhance self-
motion perception and visuo-spatial navigation in PD while maintaining its effectiveness on motor symptoms.
We will investigate visuo-vestibular interactions and how STN DBS improves perception during visual-vestibular
conflicts using psychophysics, virtual reality, motion analysis, neuroimaging, and computational modeling.
Clinical assessments will include functional gait assessment (FGA), gait disorientation task (GDT), gait speed,
and motor symptoms (UPDRS-III). We hypothesize that STN DBS improves heading perception during visual-
vestibular conflict, with favorable effects linked to specific STN regions and pathways. Aim 1 will examine how
the location of tissue activation within the STN affects heading perception during visuo-vestibular conflict. We
will use a motion simulator and virtual reality to study heading perception under synchronized or conflicted visual
and vestibular signals, combined with clinical assessments. We will also test the effects of STN DBS by switching
DBS on and off from different electrode contacts and create a stimulation atlas to identify STN locations linked
to changes in heading perception. Aim 2 will identify which axonal pathways modulated by STN DBS correlate
with changes in heading perception during visuo-vestibular interaction. We will combine patient-specific VTAs
with tractography to pinpoint white-matter pathways that correlate with changes in heading perception. We
hypothesize that hyperdirect pathway stimulation will improve heading perception, while cerebello-thalamic
pathway stimulation will worsen it. This research aims to improve treatment for navigational and balance
impairments in PD, enhancing clinical outcomes and deepening our understanding of the role of basal ganglia
in motion perception.
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