Parkinson's symptoms may be reduced by self-adjusting brain pacemaker

Press release

Tuesday August 20, 2024

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Small NIH-funded trial shows promise for personalized medicine.

The implanted device adjusts stimulation in response to changes in biomarkers in the brain that indicate symptoms of Parkinson's disease. This allows for treatment tailored to each patient in real time.Starr Laboratory

The National Institutes of Health funded a small feasibility study that found that an implanted system controlled by brain activity can provide symptomatic relief of Parkinson's disease (PD) in some patients. The adaptive deep brain stimulator (aDBS) is an improved version of a treatment that has been around for years. This study showed that aDBS is significantly more effective than conventional DBS in controlling PD symptoms.

Megan Frankowski Ph.D. is the director of the NIH DBS program. Brain research through the advancement of innovative neurotechnologies (r) Initiative or The BRAIN Initiative(r)This project was funded by. "Adaptive deep brain stimulation may improve the quality of life of some patients with Parkinson's disease by helping to control residual symptoms without exacerbating others."

Deep brain stimulation is a procedure that involves placing electrodes, or thin wires, at specific points in the brain. The wires transmit electrical signals that can be used to reduce symptoms associated with brain disorders like PD. Conventional deep brain stimulation can cause unwanted side effects because it provides constant stimulation. Adaptive deep brain stimulation, on the other hand, uses data taken directly from a patient’s brain to adjust the level of stimulation in real time as their needs change over time.

First, four people who had previously received conventional deep brain stimulation treatment were asked to identify their greatest complaint that persisted despite treatment. Most commonly, this resulted from involuntary movements or difficulty initiating movements. Participants were primed for adaptive deep brain stimulation therapy alongside existing deep brain stimulation treatment. Participants trained the adaptive deep brain stimulation algorithms for several months before being sent home to complete the comparison tests. Changes were made every 2 to 7 days.

aDBS significantly improved each participant's most bothersome symptom by approximately 50 % compared with conventional DBS. Three of the four participants, even when blinded to their treatment type, were able to accurately guess that they had been treated with aDBS because of notable symptom improvements.

The project continues the work of Dr. Philip Starr, Ph.D., and his colleagues at the University of California, San Francisco. In 2018, the researchers reported a Adaptive DBS systemThey called it a closed-loop system that can adjust itself based on feedback from the brain. In 2021, they will describe their ability to Record brain activity Among people going about their daily business.

These two results were then combined to control aDBS using brain activity recorded during normal activities. DBS therapy changed brain activity to such an extent that it was not possible to detect the expected signal to control aDBS. The researchers had to use a data-driven and computational approach to find a new signal in the brains of people who had received conventional DBS treatment.

Levodopa is often used in the treatment of Parkinson's disease to replenish the dopamine that the disease has deprived the brain of. The amount of the drug in the blood fluctuates, peaking shortly after administration and then gradually decreasing as the body metabolizes it. aDBS can help smooth out these fluctuations by increasing stimulation during high drug levels and vice versa.

These results may be promising, but there are still significant hurdles to overcome before this treatment becomes more widely available. Initial setup of the machine requires significant input from highly trained clinicians. The researchers imagine a world where the majority of the work will be done by the device, reducing the number of visits to clinics for fine-tuning.

There is a need to automate this process for groups wishing to offer aDBS in a clinical setting.

Frankowski said access is a major issue for DBS devices, including those approved to treat Parkinson's disease. That applies both to patients, who need to be able to get them, and to doctors, who need special training to program the device. If a system could find the optimal settings with the push of a button, it would make this treatment more accessible to more people.

NIH The BRAIN InitiativeA multidisciplinary collaboration between Ten NIH Institutes and CentersThe BRAIN Initiative(r) is uniquely positioned to make cross-disciplinary discoveries in neuroscience that will revolutionize how we understand the brain. The BRAIN Initiative(r) accelerates the development and use of neurotechnologies to enable researchers to gain unprecedented insights into the brain in health and disease. This will improve how we prevent and treat brain disorders. The BRAIN Initiative is a network of multidisciplinary federal and non-federal partners whose current research portfolios and missions complement the goals of the BRAIN Initiative.

The National Institutes of Health: The NIH is the medical research agency of the U.S. Department of Health and Human Services. It consists of 27 institutes and centers. The NIH, the nation's medical research agency, is a component of the U.S. Department of Health and Human Services. It is responsible for conducting basic, translational, and clinical medical research and investigating the causes, treatments, and cures. Visit the NIH for more information about its programs. www.nih.gov.

NIH…Transforming Discovery into Healthcare^(r)

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