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Stanford Researchers Making Advancements in Parkinson’s Treatment

By Bruce Goldman, www.sanbrunopatch.com

“We have high hopes that discoveries…will fuel the development of new, personalized treatments for a range of neurological disorders.”

Stanford University School of Medicine investigators have successfully implanted and recorded data from a device that not only generates electrical impulses to tame symptoms of Parkinson’s disease, but also continuously monitors and records brain activity in a key affected structure deep within the patient’s brain.

This second-generation version of an existing deep-brain-stimulation, or DBS, device will allow neuroscientists to noninvasively capture vast amounts of information about the patient’s brain-firing patterns to discern the “neural signatures” characterizing that patient’s symptoms, gain insights about the progression of the disease, and ultimately, it is hoped, develop algorithms for automating the device’s signaling program so that it adjusts in response to changes in brain activity.

“We have high hopes that discoveries made possible by this new DBS system will fuel the development of new, personalized treatments for a range of neurological disorders,” said Helen Bronte-Stewart, MD, professor of neurology and neurological sciences at the medical school and director of the Comprehensive Movement Disorders Center at Stanford Hospital & Clinics, who is leading the effort. “With this ‘brain radio,’ we can study the brain’s signaling patterns at the same time that we’re observing a patient’s precise movements — whether intended or not — with the goal of understanding just which brain rhythms correspond to which specific patterns of movement.”

In the past, brain-activity data has been downloaded from Parkinson’s patients while they’re lying still on an operating table, but such data reflected only brain activity while the patients were at rest.

On Oct. 30, a surgical team led by Jaimie Henderson, MD, professor of neurosurgery at the medical school who treats patients at Stanford Hospital & Clinics, implanted a device called a neurostimulator under the collarbone of Parkinson’s disease patient Frank Donobedian and hooked it up to two fine, insulated electrical filaments, or leads, in Donobedian’s brain. In a surgical procedure a week earlier, the team had threaded the leads into the patient’s brain so that they impinged on twin structures, one on each side of the brain, called the subthalamic nucleus. The subthalamic nucleus has been tied to symptoms of Parkinson’s disease such as tremor, difficulty in initiating movement and a tendency to “freeze” in place mid-motion.

The neurostimulator is analogous to a pacemaker in cardiology; it transmits signals — at frequencies, amplitudes and durations programmed by a neurologist — to the leads, which then fire electrical impulses that counteract the aberrant brain signals producing the physical symptoms. Over time, the neurostimulator’s impulse-transmission pattern is optimized via a trial-and-error process involving extensive patient-neurologist interaction.

What made the Oct. 30 procedure unique wasn’t the surgery itself but rather the nature of the neurostimulator, the first of its type ever implanted in the United States. This new neurostimulator not only transmits signals to the subthalamic nucleus but can sense and store the subthalamic nucleus’ electrical output. (In August, a Parkinson’s patient in Germany received such a next-generation DBS device.) Both the currently marketed and new DBS devices are manufactured by Medtronic Inc.  Read more: http://sanbruno.patch.com/groups/schools/p/stanford-researchers-making-advancements-in-parkinsons-treatment

Information about Stanford’s Department of Neurology and Neurological Sciences, which is also supporting this work, is available at http://neurology.stanford.edu/.

–Stanford News Service


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