A small, early study suggests that rapidly adapting brain stimulation in real time can dramatically reduce Parkinson’s symptoms.
The device in question, described in an article published on Monday (19 August) in the magazine Natural medicine, uses implanted electrodes that automatically respond to brain signals associated with slow movements or spasms in Parkinson’s patients. The device then delivers more or less electrical stimulation as needed.
For comparison: traditional brain stimulation delivers constant electrical stimulation and the level of stimulation must be adjusted by the patient’s physician.
The new adaptive deep brain stimulation (aDBS) system “shortens the duration of their motor symptoms by half and improves their quality of life,” said the lead study author. Carina Oehrna cognitive neuroscientist at the University of California, San Francisco, told Live Science.
Related: New blood test could detect Parkinson’s disease years before first symptoms, study suggests
Parkinson’s disease is a neurodegenerative disease in which certain brain cells that produce dopamine malfunction and gradually die. These cells play a crucial role in movement.
Most Parkinson’s patients take levodopa, a drug that increases dopamine levels in the brain. But as the disease progresses, levodopa is often no longer enough to relieve symptoms.
At this point, many patients complement the medication with constant deep brain stimulation (cDBS), in which surgeons implant electrodes that alter the signals underlying Parkinson’s symptoms. While the treatment is safe and effective, because the stimulation is constant, it can both under- and over-compensate for a person’s symptoms.
To see if there was a better approach, Oehrn and colleagues implanted a device that could switch between continuous and aDBS delivery into four men with Parkinson’s disease. The researchers asked each patient which symptom bothered them most; three answered bradykinesia, or slow movements, while the last reported convulsions. They then focused on the brain signal associated with the problem symptom.
After continuously recording from two brain regions, the team trained algorithms to predict and respond to the course of a patient’s symptoms. The aDBS device responded to a brain signal that marked when a patient’s dopamine levels rose – right after they took their medication – and when they fell as the effects of the drugs wore off.
After the training phase, the patients, some of whom worked full-time, left the clinic and went about their daily lives. The device then delivered either cDBS or aDBS, switching between the two over time. In theory, the patients did not know which type of stimulation was active at any given time.
“But after a while, they could really tell which days they were receiving aDBS, simply because their motor symptoms were so well controlled,” Oehrn said. Patients rated which stimulation they preferred via a phone app and indicated that aDBS was superior to them.
According to Oehrn, there will likely be many patients for whom cDBS alone will be sufficient because their symptoms do not change throughout the day. Those whose symptoms fluctuate are most likely to benefit from the new system, she said.
While researchers focused on one type of symptom at a time in this study, Oehrn hopes future algorithms can respond to more symptoms as well. Next month, they’ll see how the device affects memory and mood problems associated with Parkinson’s, Oehrn said.
The study is notable because it examined a new type of brain signal as a trigger for activating the device, which could open the door to a wider range of applications than previously thought. Martin Beudela neurologist at the University Medical Center Amsterdam, told Live Science in an email.
The new research has “significantly expanded” the therapy’s potential in treating Parkinson’s disease, said Beudel, who was not involved in the study.
This article is for informational purposes only and does not constitute medical advice.
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