Real-Time Treatment Could Be a Game-Changer in Parkinson's

For years, brain stimulation has helped people with Parkinson's disease manage their symptoms. But now, researchers say they've discovered major improvements can come from adjusting brain stimulation to an individual's needs. With conventional deep brain stimulation (DBS), implanted electrodes deliver a constant electrical pulse to areas of the brain controlling movement. The one-size-fits-all approach means patients can experience understimulation, in which case tremors and stiffness still occur, or overstimulation, marked by erratic movements, per the Guardian. In this pilot study, researchers gave four men with Parkinson's DBS devices that delivered pulses based on the individual's changing brain activity.

Over two months, patients lived with DBS devices that changed to deliver either consistent stimulation or adaptive stimulation, based on algorithms tailored to each individual and their most troublesome symptom. "Neither the patients nor most of the research team knew which type of stimulation was being delivered when," reports the New York Times. Under the adaptive system, which delivered more stimulation in response to stiffness and less in response to involuntary movement, patients spent 50% less waking time dealing with their worst symptom (12% of their day, down from 25%) and three of the four reported having a better quality of life, per the Times and Guardian. Symptom severity also decreased, according to the study published Monday in Nature Medicine.

Participant Shawn Connolly, 48, says he "instantly" noticed improvements with adaptive DBS, with longer periods of "feeling good and having that get-up-and-go," per the Times. "The brain changes in its needs moment to moment," senior study author Dr. Philip Starr of the University of California, San Francisco, tells the outlet. "So it's been a dream to make these stimulators self-regulating." Researchers say larger clinical trials are needed to confirm effectiveness, but it's possible patients using adaptive DBS may be able to lower their medication doses. "Medications are needed often to support mood as well as movement in Parkinson's disease, and so shouldn't be stopped completely," says study co-author Dr. Simon Little, also of UCSF. (DBS may also help with depression and chronic pain.)