Duke’s innovative device, resembling a pacemaker (left), automatically adjusts stimulation parameters, as seen in the CT scan (right) with four electrodes strategically placed. (Image Credit: Duke University)
In a groundbreaking collaboration between physicians, neuroscientists, and engineers at Duke University, a team has successfully demonstrated two novel strategies for improving the symptoms of Parkinson’s disease through deep brain stimulation (DBS). The research, published online in the journal Brain, introduces a new approach that involves simultaneously targeting two key brain structures and utilizing a self-adjusting device resembling a pacemaker.
For the past two decades, DBS has been a vital therapy for treating advanced Parkinson’s disease symptoms that no longer respond to medication alone. The conventional DBS technique involves using a pacemaker-like device to deliver electric impulses to specific areas within the brain, effectively reducing tremors, stiffness, and involuntary movements associated with the disease.
Simultaneous Targeting of Two Brain Structures
The Duke University team, led by senior author Dennis Turner, aimed to enhance the effectiveness of DBS by targeting both the subthalamic nucleus and the globus pallidus simultaneously. These two brain structures are closely associated with movement, and the researchers believed that stimulating them together could offer complementary benefits, potentially reducing medication doses and side effects.
The innovative approach also introduced the concept of adaptive DBS, which allows for real-time adjustments to stimulation parameters based on the patient’s needs. Unlike traditional DBS, where parameters remain constant for extended periods, the adaptive system can dynamically respond to changes in medication, activity levels, and other factors affecting symptom severity.
Clinical Trial Success and Future Prospects
The team conducted a clinical trial with six patients between the ages of 55 and 65, each exhibiting varying symptoms of Parkinson’s disease. Over two years, they observed the efficacy of dual-target continuous DBS and developed an adaptive DBS system in collaboration with Medtronic.
Results indicated that simultaneous stimulation of the subthalamic nucleus and the globus pallidus significantly improved motor symptoms compared to targeting either region alone. Additionally, the adaptive DBS system applied less stimulation but proved just as effective as continuous DBS in both clinical and home settings.
The success of the trial has prompted the researchers to further optimize adaptive DBS, with plans for additional testing in the next stage of clinical trials. The team is optimistic about the potential of this tailored and elegant therapy, acknowledging the significant contributions of the participants and their families in advancing Parkinson’s disease research.
This engineering breakthrough holds promise for revolutionizing the field of DBS, offering new hope for Parkinson’s patients seeking more effective and personalized treatment options. The Duke University team’s innovative approach may pave the way for a future where adaptive DBS becomes a standard and refined therapy for Parkinson’s disease.
References
Martinez, Michaela 2024, ‘Engineering a more elegant deep brain stimulation therapy for Parkinson’s’, Medical Press, viewed 9th January 2024, <https://medicalxpress.com/news/2024-01-elegant-deep-brain-therapy-parkinson.html>
