Parkinson’s Disease and Deep Brain Stimulation: A Revolutionary Approach in Neurology
Shawn Connolly, a professional skateboarder known for his daring stunts and athletic prowess, faced an unexpected turn in his life when he was diagnosed with Parkinson’s disease at the age of 39. Before his diagnosis, Shawn was a vibrant figure in the skateboarding community, frequently appearing in videos and magazines, sponsored by top skateboard makers and shops. However, over time, he began to notice subtle yet concerning changes in his body. His hand would involuntarily cup, and his balance and alignment seemed off. These symptoms gradually intensified, leading to a pattern common in Parkinson’s patients: rapid involuntary movements followed by periods of slowness.
In an effort to manage his symptoms, Shawn became a participant in a groundbreaking study exploring a new approach to deep brain stimulation (DBS), a treatment that has been used for Parkinson’s disease but often with inconsistent results. This study, published in the journal Nature Medicine, introduced an adaptive deep brain stimulation (ADBS) system that tailored the amount of electrical stimulation to each individual’s symptoms. This personalized approach was found to cut in half the time that participants experienced their most bothersome symptoms, offering a significant improvement over conventional DBS methods.
The study included four participants, including Shawn, and demonstrated promising outcomes. The adaptive DBS system works by monitoring brain signals and adjusting stimulation levels in real-time, responding to the patient’s needs as they fluctuate throughout the day. This method aims to smooth out the fluctuations in dopamine levels caused by medications like levodopa, which are commonly used to manage Parkinson’s symptoms. The hope is that this technology will lead to more consistent symptom control and an improved quality of life for patients.
Shawn’s journey with Parkinson’s and his participation in the study tested his determination and resilience in new ways. Despite the challenges, he continued to run the San Francisco Skate Club, a program he started with his wife Thuy Nguyen before his diagnosis. The club helps children build confidence and learn life skills through skateboarding, serving about 100 kids a year. Even as his health declined, Shawn remained committed to his mission, demonstrating the same daring spirit that defined his skateboarding career.
The surgery to implant the sensors and devices for the adaptive DBS system was a complex procedure, taking eight hours to complete. Wires were inserted into specific regions of Shawn’s brain, and devices capable of picking up brain activity were implanted over his pectoral muscles. For a year, Shawn struggled with motor fluctuations as the device was not yet capable of sensing his symptoms accurately. However, a dedicated team of researchers, including Dr. Carina Oehrn, Dr. Stephanie Cernera, and Dr. Lauren Hammer, worked tirelessly to analyze Shawn’s brain signals remotely and develop an algorithm tailored to his unique symptoms.
Once the algorithm was implemented, Shawn experienced significant improvements. He had periods of up to eight hours without motor fluctuations, a remarkable achievement considering the challenges he had faced. The technology also showed positive results in other patients, significantly reducing movement symptoms and improving their quality of life. The study’s findings, published in Nature Medicine in 2024, highlighted the potential of adaptive DBS to revolutionize the treatment of Parkinson’s disease.
Adaptive deep brain stimulation represents a significant advancement in neurology, offering a more personalized and responsive treatment option for Parkinson’s patients. Unlike conventional DBS, which provides constant stimulation, adaptive DBS adjusts the stimulation based on real-time brain activity. This approach not only improves symptom control but also reduces side effects and prolongs battery life, making it a more sustainable long-term solution.
The feasibility study funded by the NIH demonstrated that adaptive DBS could be more effective than conventional DBS in treating Parkinson’s disease. Participants in the study reported noticeable improvements in their most bothersome symptoms, with three out of four able to correctly identify when they were receiving adaptive DBS. This success builds on previous work by researchers at the University of California, San Francisco, who developed the adaptive DBS system and recorded brain activity during daily activities.
Despite the promising results, there are still challenges to overcome before adaptive DBS can be widely available. Setting up the device and fine-tuning it requires input from highly trained clinicians, and the goal is to develop a system that can self-manage, reducing the need for frequent clinic visits. This type of automation would make it easier for other groups to test and offer adaptive DBS therapy, potentially expanding access to this innovative treatment.
The study was supported by various institutions and organizations, including the National Institutes of Health (NIH), the Brain Initiative, the Thiemann Foundation, and the Tuyf Charitable Trust Fund. The Brain Initiative, a collaboration of ten NIH institutes and centers, aims to improve our understanding of the human brain through innovative neurotechnologies. This study represents a significant step forward in achieving that goal and highlights the importance of continued research and collaboration in the field of neurology.
As there is currently no cure for Parkinson’s disease, the focus remains on refining treatments and understanding the brain signals that correlate with symptoms. The use of adaptive DBS could lead to more directed and effective treatments, providing hope for millions of people living with Parkinson’s. Continued research and advancements in this area are crucial for improving the quality of life for those affected by this debilitating condition.
Shawn Connolly’s story is a testament to the impact that innovative treatments can have on individuals living with Parkinson’s disease. His participation in the adaptive DBS study not only improved his own symptoms but also contributed to the broader understanding of how personalized approaches can enhance the effectiveness of existing treatments. As researchers continue to refine this technology, the potential for adaptive DBS to become a standard treatment for Parkinson’s disease becomes increasingly promising, offering new hope for patients worldwide.