A new approach to brain stimulation could help Parkinson’s disease patients better control symptoms and cut the duration of its most bothersome symptoms in half, experts say.
Deep brain stimulation (DBS) is currently the main treatment for Parkinson’s disease patients, and is effective in alleviating symptoms such as stiffness, slowness of movements and tremors.
This method involves implanting thin electrodes in the brain to deliver electrical stimulation to specific areas that control movement.
Currently, this stimulation is set at a fixed level regardless of the patient’s behavior or the severity of their symptoms. As a result, this technology can be either under-stimulated, resulting in a rapid worsening of symptoms, or over-stimulated, leading to erratic movements.
Experts say they have taken a big step towards improving the technology by making it possible to automatically adjust stimulation levels based on real-time signals in the brain according to a patient’s needs. brain.
The team behind the study say further trials are needed to confirm the pilot study findings, and that some fine-tuning is needed to make it viable in routine clinical practice, as well as training clinicians, but they expect the technology, which they call “adaptive” DBS, could be widespread within a few years and that the cost would be comparable to traditional DBS.
“Once these challenges are resolved, I am very optimistic that adaptive DBS will become a highly effective alternative to standard DBS. [Parkinson’s] “This research may have implications for other neurological and psychiatric disorders, allowing for more stable and individualized symptom management and potentially significantly improving patient outcomes,” said the study’s lead author, Dr. Karina Oren of the University of California, San Francisco.
He contributed to Nature Medicine Oren and his colleagues explain how four men with Parkinson’s disease who were implanted with DBS devices provided by a company for research purposes participated in the pilot study.
“The device can sense brain activity and stimulate it at the same time. Our job was to write the software algorithms that would work with the device,” O’Anton said.
The team found that increases in certain types of brain signals were associated with higher dopamine levels and reduced motor symptoms as the subjects’ drugs began to take effect.
Oren said this allowed the team to create an algorithm that could increase DBS stimulation when the signal was low and decrease it when the signal was high.
The team tailored the algorithm to each individual and their most concerning symptoms, resulting in a system that continuously monitored participants’ brain signals and automatically adjusted the electrical stimulation as needed.
Four participants each underwent traditional DBS and this new approach for one month, but were not informed which technology was being used.
Results showed that participants who received adaptive DBS spent approximately 50% less time awake experiencing their most bothersome symptoms compared with those who received traditional DBS, and three in four reported an improved quality of life.
The researchers say drug therapy will also be needed in parallel with adaptive DBS, although potentially at lower doses.
“In Parkinson’s disease, medications are often needed to support mood as well as movement, so they shouldn’t be stopped completely,” said Dr. Simon Little of the University of California, San Francisco, another author of the study.
Claire Vale, associate director of research at Parkinson’s UK, welcomed the study.
“Current DBS can be life-changing, but this major advancement could help manage the fluctuating symptoms people experience and reduce the number of side effects,” she said.
But Baer said the study only included a small number of participants.
“The encouraging results support the need for larger clinical trials to confirm the safety and effectiveness of this treatment and provide the evidence needed for ‘adaptive’ DBS to become a long-awaited approved new treatment for people with Parkinson’s disease,” she added.
