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Podcasts Make It Easier to Stay Informed

podcasts

Living with Parkinson’s disease is a daily battle. It can be difficult to navigate the disease on your own, but the right resources can make staying informed a little easier.

Since many Parkinson’s patients experience tremors on a regular basis, audiobooks and podcasts may be helpful in lieu of books or newspapers. Most podcasts offer quick access to relevant topics and weekly updates about current news and events occurring across the globe. The following talk about the science behind Parkinson’s, but also share personal insights.

The Michael J. Fox Foundation Parkinson’s Podcast

The Michael J. Fox Foundation is known for the work that it does in Parkinson’s research and awareness. This is especially evident in the foundation’s podcast, where you can find interviews with scientists and doctors. There’s also plenty of information about living with Parkinson’s. Interviewees give tips about common ailments associated with the disease and ideas about how to navigate them. One episode features listener questions for doctors. Another discusses the role of inflammation in a Parkie’s day-to-day life. Overall, this podcast is incredibly informative and provides great insight.

When Life Gives You Parkinson’s

In “When Life Gives You Parkinson’s,” Larry Gifford shares his personal journey with the disease. He explores common questions about Parkinson’s, with recent episodes featuring ideas about finding a cure. He also interviews other people who are battling the disease, providing insight from an array of different people. This podcast offers tremendous insight and information about Parkinson’s and what it’s like to live with its challenges. The perspectives make it more personable than your standard news outlet and yet, it can be just as informative.

Trembling EMT: My Parkinson’s Journey

Trembling EMT: My Parkinson’s Journey” discusses the early onset of Parkinson’s and what the process looked like for Eric Aquino, an emergency medical technician who was diagnosed with the disease in 2018 at age 40. The podcast takes listeners through the diagnosis process, treatment, and clinical trials. Clinicians generally don’t have Parkinson’s when they treat the disease, so they may be unable to relate to patients. Listening to a podcast like “Trembling EMT” can provide insight into the journey of another person, who is both a patient and a medical professional.

Substantial Matters: Parkinson’s Podcast

In this podcast, the Parkinson’s Foundation not only provides information about the science behind the disease, it also discusses ways to live with it in a more peaceful away. For example, episodes such as “How Mindful Techniques Impact the Nervous System” talk about the benefits of practicing mindfulness. Focusing on the present moment makes it much easier to navigate mood disorders such as anxiety and depression. This podcast also offers a handful of episodes in Spanish, information about clinical studies, and deep brain stimulation.

Whether you are someone who is navigating the depths of Parkinson’s research or you’re interested in finding personal insights about the disease, podcasts offer a terrific way to access that information. While there is science on some podcasts, others involve casual discussions about the disease. It can help to hear other people’s experiences with the disease — and you don’t have to be a medical professional to host a podcast.

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Note: Parkinson’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Parkinson’s News Today or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to Parkinson’s disease.

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Light-based DBS Method Can Alleviate Motor Symptoms of Parkinson’s, Animal Study Shows

STN neurons and DBS

Scientists have developed a new light-based deep brain stimulation method that when applied to neurons located in the subthalamic nucleus (STN) — a brain region involved in controlling movement — alleviated motor symptoms in a rat model of Parkinson’s disease.

The study detailing that research, “Frequency-Specific Optogenetic Deep Brain Stimulation of Subthalamic Nucleus Improves Parkinsonian Motor Behaviors,” was published in The Journal of Neuroscience.

Deep brain stimulation (DBS) is a surgical treatment for Parkinson’s disease that involves implanting a device to activate specific regions of the brain with electrical signals generated by a battery-operated neurostimulator.

When used to stimulate the STN, DBS can effectively alleviate motor symptoms of the disease. However, up until now, the “true“ therapeutic targets of DBS responsible for its beneficial effects remained unclear.

This was mostly because the electrical signals used in DBS stimulate not only neurons, but also other cell types found in the STN, making the real therapeutic targets of DBS difficult to identify with conventional methods.

“If you think of the area of the brain being treated in deep brain stimulation as a plate of spaghetti, with the meatballs representing nerve cell bodies and the spaghetti representing nerve cell axons [nerve fibers], there’s a longstanding debate about whether the treatment is affecting the spaghetti, the meatballs or some combination of the two,” Warren Grill, PhD, professor of Biomedical Engineering at Duke University and senior author of the study, said in a news story.

“But it’s an impossible question to answer using traditional methods because electrical deep brain stimulation affects them both as well as the peppers, onions and everything else in the dish. Our new light-based method, however, is capable of targeting just a single ingredient, so we can now begin teasing out the individual effects of activating different neural elements,” Grill said.

The new light-based method uses optogenetics, a technique that combines light flashes and genetic engineering to allow researchers to control the activity of specific cells of interest.

In this case, investigators genetically modified STN neurons to make them produce an ultrafast light-sensitive opsin, called Chronos. Opsins are ion channels found on cell membranes that can be activated using specific light flashes. Chronos is an ultrafast opsin that is able to respond to 130 light flashes per second, which is equivalent to the frequency of electrical stimulation normally used in standard DBS.

To assess if STN neurons could be the therapeutic target of DBS, Grill and his team stimulated genetically-modified neurons in the brain of a rat model of Parkinson’s with 130 light flashes per second.

They found that when applied at a high frequency rate, the new light-based DBS method alleviated motor symptoms of Parkinson’s in the animals, mimicking the effects of electrical DBS. However, if applied at a lower frequency rate, the new approach failed to provide significant benefits.

In addition to demonstrating that STN neuron stimulation was sufficient to lessen motor symptoms of the disease, the new study also highlighted the therapeutic potential of the new light-based DBS method.

With the new method, investigators now have the opportunity to use DBS in specific subsets of cells in particular regions of the brain. This will allow them to pinpoint not only which areas of the brain should be stimulated to obtain specific effects, but also to devise personalized therapies to manage Parkinson’s motor symptoms more efficiently.

The team is planning to use the same approach to assess the possible contribution of STN nerve fibers known as the hyperdirect pathway — the “spaghetti” in the dish — in alleviating motor symptoms of the disease.

“This is very important because somewhere in that big bowl of spaghetti are some elements that are responsible for treating symptoms and some elements that generate side effects,” Grill said.

“And if we can figure out which is which, we can design electrode stimulation geometries and patterns to target the elements that suppress symptoms while leaving the others alone,” he added.

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New Brain Pathway Key to Movement Found in PD Patients, Study Reports

new brain pathway

Placing electrodes directly in the brains of people with Parkinson’s disease revealed a “hyperdirect” pathway between two regions of the brain responsible for movement and cognition, a study reported.

This pathway was shown to be important in being able to stop body movements once initiated. Modulating or controlling this pathway may be a therapeutic strategy for treating movement disorders such as Parkinson’s.

The study, “Prefrontal-Subthalamic Hyperdirect Pathway Modulates Movement Inhibition in Humans,” was published in the journal Neuron

Parkinson’s disease is characterized by a progressive loss of coordination and movement leading to involuntary tremors and other motor symptoms.

Stopping a body movement that has already been initiated is important for motor control, which is thought to be mediated by a pathway between two regions in the brain. The pathway connects the subthalamic nucleus (STN), which is involved in many complex motor and non-motor functions, and the inferior frontal gyrus (IFG), associated with cognition.

“This pathway is critical to controlling movement overall,” Witney Chen, a graduate student at the University of California, San Francisco (UCSF) and the study’s first author, said in a news story.

“We’re interested in understanding how the brain controls the ways we can stop movement because when this control isn’t functioning properly, it can result in movement disorders such as Parkinson’s,” Chen said.

“This is more than just being able to quickly stop your step into the street if you see oncoming traffic,” she added.

Evidence suggested that the STN-IFG pathway exists in animals. However, only indirect imaging studies have supported its importance in humans, and in the workings of Parkinson’s disease.

To explore this pathway, Chen and colleagues based at UCSF designed a study involving 21 Parkinson’s patients in which electrodes were placed directly in the brain in both the IFG and STN regions. The goal was to gather as much information as possible about this pathway in humans.

“It’s a wonderful opportunity to study the human brain as an intact system,” said Philip Starr, MD, PhD, co-director of the UCSF Surgical Movement Disorders Center and the study’s senior author.  “And fortunately, Parkinson’s patients are especially eager to volunteer. They’re often people who had normal lives for a long time, and now they have this disorder and they really want to contribute to understanding and treating it.”

“These experiments can really only be done well with invasive electrodes at both ends of the pathway,” Starr added.

The Parkinson’s patients enrolled in the study were already scheduled to have electrodes implanted in the STN region of the brain, a standard procedure for deep brain stimulation (DBS), often used on those with mid-stage disease. As there are no pain receptors in the brain, the participants are awake during surgery and can confirm the placement and function of the DBS implants with physicians. 

During the procedure, electrodes also were placed on the surface of the brain, about five centimeters (2 inches) from the DBS implants. Chen noted that these electrode could easily be removed after the experiments.

The team then recorded high-resolution electrical impulses focusing on location and time. They found the response to STN stimulation was detected very quickly (low latency) in the IFG region, which demonstrated a “hyperdirect” connection between these two parts of the brain. 

A second experiment was conducted to measure the ability to stop a body movement. Here, patients were shown either a right or left arrow on a screen as a “go” signal, to which they responded by pushing a respective right or left button in response. Randomly, they received a “stop” signal after the “go” signal and the time taken to stop movement was measured.

The results showed that the longer the IFG and STN signals were simultaneously activated — representing a higher synchronization between both regions — the faster the participants stopped their action, and that faster initiation of activity was found to be important for successful stopping. These findings, shown across all participants tested, demonstrated a direct synchronization between these two brain regions in movement control.

Although movement inhibition has been found to be impaired in people with Parkinson’s, the team did not find physiological factors or stopping behaviors to be associated with parkinsonian severity, as assessed by the Unified Parkinson’s Disease Rating Scale.

“Our study is the first to show that the hyperdirect circuit co-modulation is linked to stopping behaviors, which has broad implications for stimulation-based therapies to treat maladaptive movement inhibition,” the scientists concluded. 

“These findings may inform therapies to treat disorders featuring perturbed movement inhibition,” they added. 

The next step is to study the role of the IFG and STN pathway in more real-life settings using electrodes that can record brain activity over longer periods of time, the researchers said. 

“Using this technology, we can start to tease apart what this circuit is doing in real life when people are moving, talking, walking, playing music or sports or whatever they want to do,” Chen said. 

“We’re really pursuing these therapeutic aspects, because we think modulation in this circuit can translate to better clinical outcomes,” she concluded.

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Is My Parkinson’s Honeymoon Over?

Parkinson's honeymoon

When I started writing this column, I was having a pity party and was in a bad place. Wanting to reflect positivity, I decided to stop writing until I had a better frame of mind.

Why was I feeling sorry for myself?

More than four years have passed since my Parkinson’s diagnosis. I didn’t realize how good I had it then. I remember that previously, my deteriorating symptoms would cause me to tell myself that if it didn’t get worse, I could handle it. Recently, however, it seems that many of my symptoms, especially the non-motor ones, are worsening.

My balance is worsening such that I feel unsteady when walking in narrow areas with crowds. I frequently cough and choke on my food. I gag when I take pills and supplements. People ask me to repeat myself more often. It seems as though I am slurring my speech. Anxiety frequently visits me, something I never experienced prior to my diagnosis.

I can’t seem to find the right combination of medications, despite working on that for almost two years. Much trial and error have followed, as I test whether it’s better to take my medications before or after a meal, and change or add new medicines. I must be weaned off some drugs, while others must be increased for six to eight weeks to test therapeutic benefit. Another person with Parkinson’s coined the term “tweaking and seeking” to describe this lengthy and frustrating process.

Based on my experiences and what I have heard from others with Parkinson’s, it seems as though we must choose our poison. For example, do I prefer dyskinesia induced by carbidopa-levodopa or bradykinesia, the main symptom for which I take that medication?

About that Parkinson’s honeymoon

A friend mentioned to me that he is considering deep brain stimulation surgery because he feels that his Parkinson’s honeymoon is over. I had never heard the term “honeymoon” related to Parkinson’s, so I did some Googling, wondering if my honeymoon period was also coming to a close.

In general, the first stage of the disease is a honeymoon period that lasts up to eight years, during which patients can live what’s practically a normal life, according to Parkinson Québec. It also is the stage during which treatment is most noticeably effective.

When I started to write about the honeymoon ending for me, I realized that kind of negative thinking wouldn’t help me. Leaving this column unfinished for a few weeks was a good decision. I have come back to it refreshed and with that bad place behind me.

Although my symptoms may be worsening and new ones may be appearing, I refuse to go down without a fight. Speech therapy and an assessment by a therapist certified by Parkinson Wellness Recovery are on my list of next steps. Medical marijuana, which is legal in New York for Parkinson’s patients, is something I also am considering.

It’s therapeutic to have a plan with a course of action, and I now have a renewed sense of hope. My Parkinson’s second honeymoon is just beginning!

Never give up, for that is just the place and time that the tide will turn.” ―Harriet Beecher Stowe

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Note: Parkinson’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Parkinson’s News Today or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to Parkinson’s disease.

The post Is My Parkinson’s Honeymoon Over? appeared first on Parkinson’s News Today.

Taking the Day Off from Parkinson’s

day off

I had a pretty good day recently. It was better than I’d had in a long while. I remember thinking that I could forget I had Parkinson’s disease if every day was like that day.

But every day isn’t like that one. Every other day usually begins with being slow and rigid. If I didn’t have Parkinson’s disease, I would jump out of bed and skip to the bathroom. It would be the beginning of a new day.

If I was taking the day off from having Parkinson’s disease, I would take my morning medicinal cocktail and not feel nauseous at all. But wait — if I didn’t have Parkinson’s, I wouldn’t need a medicinal cocktail.

My shower time would be halved, and I wouldn’t have to worry about being off balance in the shower or falling when stepping out of it. 

I would sit down at my computer, and instead of my fingers seizing up, feeling like popsicle sticks, and refusing to be obedient to my brain, they would begin to type. One word, two words, three words, four — just like the old times. 

What if?

But if it were like “old times,” I would most likely still be working. I would be sitting at my desk taking phone calls, encouraging people, and leading a children’s choir. Or I would be running my business again, making wooden figurines for Christmas, Thanksgiving, and Easter scenes. 

Perhaps I would have retired by now and would be watching my grandkids full-time instead of a few hours, two days a week. And I wouldn’t need a nap (or two) during the day.

If I had escaped the Parkinson’s monster, I would be able to drive myself wherever I wanted to go. I would be able to do laundry anytime and not just when I’m “on.” I could fold clothes and carry out other household chores without any help.

If I didn’t have Parkinson’s disease, I wouldn’t have to deal with my medications being “off” or “on.” I could float through my day. 

Life would be good.

Don’t misunderstand me

My life is good in spite of Parkinson’s disease. I have so much to be thankful for that I once may have taken for granted. Family and friends are so much more precious and valuable to me now.

Daily doses of dopamine may be the norm now, or adjusting deep brain stimulation settings, but I still get those priceless hours with my grandkids, and the medication still works when I take it. So, even if I can’t really take the day off from having Parkinson’s, some days are better than others, and I’ll take what I can get.

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Note: Parkinson’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Parkinson’s News Today or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to Parkinson’s disease.

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Imaging Technique Finds Key Neurons in Brain Interact, May Support More Targeted Treatments

nerve cell communication

Two key types of brain nerves cells affected by Parkinson’s disease — cholinergic neurons and dopaminergic neurons — communicate and interact via signaling systems, researchers were able to “see” using a new imaging approach.

This beneficial neuron-to-neuron interaction, confirmed through the novel approach in a rat model of the disease, also supported further work on targeted treatments for Parkinson’s, including a potential gene therapy.

Their study, DREADD Activation of Pedunculopontine Cholinergic Neurons Reverses Motor Deficits and Restores Striatal Dopamine Signaling in Parkinsonian Rats,” was published in Neurotherapeutics.

Parkinson’s is a progressive neurodegenerative disease, meaning that it steadily worsens as neurons die over time. One of its hallmarks is the loss of dopamine — a neurotransmitter crucial for coordinating movement and regulating mood — that occurs when dopaminergic neurons in a brain structure called the substantia nigra malfunction and die.

Cholinergic neurons — those that produce the neurotransmitter acetylcholine — are nerve cells found in the pedunculopontine nucleus (PPN) of the brain. They are also implicated in Parkinson’s, since in post mortem studies of patients’ brain tissue a significant amount of these cells are found dead.

Researchers had previously used used a harmless virus to deliver a genetic modification to cholinergic neurons in a rat model of Parkinson’s disease. This technique is called designer receptors exclusively activated by designer drugs (DREADDs), and consists of a class of engineered proteins that allow researchers to hijack cell signaling pathways in order to look at cell-to-cell interactions more easily.

The animals were then given a compound designed to activate the genetic ‘switch’ and stimulate the target neurons. After treatment, almost all animals had recovered and were able to move.

Now, this same research team used positron emission tomography (PET), a brain imaging technology, together with DREADDs to selectively activate cholinergic neurons in the brains of diseased rats and look at how other brain cells responded.

They found that stimulating cholinergic neurons led to the activation of dopaminergic neurons in the rat brain, and dopamine was released.

This means that cholinergic activation restored the damaged dopaminergic neurons. The parkinsonian rats appeared to completely recover — they were able to move without problems and their postures returned to normal.

“This is really important as it reveals more about how nerve systems in the brain interact, but also that we can successfully target two major systems which are affected by Parkinson’s disease, in a more precise manner,” Ilse Pienaar, PhD, a researcher at the University of Sussex and Imperial College London and study author, said in a press release.

“While this sort of gene therapy still needs to be tested on humans, our work can provide a solid platform for future bioengineering projects,” Pienaar added.

This new technique has several advantages over deep brain stimulation (DBS), a surgical procedure that sends electrical impulses to the brain to activate the neurons.

Deep brain stimulation can help to relieve some Parkinson’s symptoms, but is invasive and has had mixed results. Some patients show improvements while others experience no changes in symptoms or even a deterioration. This may be due to therapy imprecision, as DBS stimulates all types of brain nerve cells without a specific target.

This study sought to address the selectivity issue by looking at the activation of one type of cell in a specific part of the brain to get a better understanding of how other parts might be influenced.

“[T]he current data could allow for designing medical approaches capable of improving the ratio between desirable and undesirable outcomes and leaving nonimpaired functions intact. For example, specific genetically defined neurons … could be targeted to treat motor symptoms of [Parkinson’s], without inducing a cognitive detriment, and vice versa,” the researchers wrote.

“For the highest chance of recovery, treatments need to be focused and targeted but that requires a lot more research and understanding of exactly how Parkinson’s operates and how our nerve systems work,” Pienaar said. “Discovering that both cholinergic and dopaminergic neurons can be successfully targeted together is a big step forward.”

The researchers concluded, “[t]his study supports the hypothesis that it is the cholinergic neuronal population, projecting from the PPN, which delivers some of the clinical benefits associated with PPN-DBS.”

Pienaar and colleagues collaborated with Invicro, a precision medicine company, for this study. Lisa Wells, PhD, a study co-author on the study and Invicro employee added, “It has been an exciting journey … to combine the two technologies [DREADD and PET] to offer us a powerful molecular approach to modify neuronal signaling and measure neurotransmitter release. We can support the clinical translation of this ‘molecular switch’ … through live imaging technology.”

This work may make possible more selective and more effective treatment alternatives to deep brain stimulation.

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Deep Brain Stimulation May Impair Swimming Ability and Increase Risk of Drowning, Case Studies Suggest

swim DBS

Patients who undergo deep brain stimulation to treat Parkinson’s disease may lose their ability to swim, even if their motor symptoms improve after the treatment or if they were formerly proficient swimmers, a collection of nine case studies has found.

The study, “Beware of deep water after subthalamic deep brain stimulation,” was published in the journal Neurology.

“Until more research is done to determine why some people with deep brain stimulation can no longer swim, it is crucial that people be told now of the potential risk of drowning and the need for a carefully supervised assessment of their swimming skills before going into deep water,” Daniel Waldvogel, MD, researcher at the University of Zurich in Switzerland and lead author of the study, said in a press release.

Deep-brain stimulation (DBS) is an invasive surgical treatment in which fine wires are inserted into the brain and connected to a device placed under the skin in the upper chest. The device controls electrical impulses to stimulates areas responsible for movement control, such as the subthalamic nucleus.

DBS is usually used on Parkinson’s patients whose motor symptoms do not respond well to standard medications, and studies have shown long-term improvements in motor symptoms, quality of life, ability to perform regular daily activities, and a significant reduction in the need for levodopa.

However, researchers now say that despite a successful surgical procedure and improvement in motor symptoms, some patients can lose their ability to swim.

The nine patients described in the study had received deep brain stimulation of the subthalamic nucleus, and all were highly satisfied with the treatment’s overall outcome. “However, they were frustrated by their lost ability to coordinate limb movements for swimming,” the researchers said.

The researchers described three of the nine cases in their study.

The first case was a 69-year-old man who lived by a lake and was an experienced and proficient swimmer. Due to his good motor outcomes after undergoing DBS, the man was confident enough to jump into the lake, but he would have drowned if not rescued by a family member.

The second case was of a woman, 59, who was a competitive swimmer and continued to swim even after being diagnosed with Parkinson’s. However, after undergoing DBS, she lost her ability to swim, which never came close to her previous level even after regular swimming practice with a physical therapist.

Finally, researchers reported the case of a 61-year-old woman with a lifesaving diploma, who used to swim in competitions crossing Lake Zurich, which is two miles wide. After the surgical procedure, however, she could barely swim two-tenths of a mile and complained of an awkward posture when trying to swim.

“Swimming is a highly coordinated movement that requires complicated arm and leg coordination,” Waldvogel said. “Exactly how deep brain stimulation is interfering with this ability needs to be determined.”

Three of the nine patients turned off their DBS devices and immediately regained their ability to swim. However, this led to worsening of their other motor symptoms, which made them switch on their devices again.

“Even though these reports affected only a few people, we felt this potential risk was serious enough to alert others with Parkinson’s disease, as well as their families and doctors,” Waldvogel said.

More studies are warranted to better understand the real adverse effects of DBS, including its impact on patients’ ability to swim.

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Glassy Carbon Electrodes Safer Than Metal in MRIs, Study Suggests

glassy carbon electrodes

Implantable electrodes made of glassy carbon may be safer for use in MRI scans than traditional electrodes made of metal for people who undergo deep brain stimulation, a new study shows.

The study, “Glassy carbon microelectrodes minimize induced voltages, mechanical vibrations, and artifacts in magnetic resonance imaging,” was published in Microsystems & Nanoengineering.

In cases where Parkinson’s patients are not responding well to medication, deep brain stimulation (DBS) can be used to treat motor symptoms associated with this neurodegenerative disease. The treatment involves surgically implanting an electrode directly in the brain, then using that electrode to electrically stimulate specific brain regions.

Traditionally, electrodes used for DBS have been made of metal, most typically platinum. But metal electrodes pose a problem when a person needs to undergo an MRI scan. Such scans can be used to image the brain using powerful magnets, but those magnets can interact badly with metal electrodes.

Specifically, the electrodes can lead to large “white spots” on the MRI images themselves, which can limit the utility of the images. Plus, the magnetic fields generated in MRI can cause electrodes to vibrate, or they can generate electrical currents that make the electrode heat up. These circumstances run the risk of causing damage or irritation in the brain.

In the new study, researchers wondered if electrodes made of glassy carbon, instead of metal, would be resistant to these issues. Glassy carbon (GC) is basically a bunch of very thin layers of carbon pressed together.

The researchers previously had created GC-based electrodes designed for DBS, and in a previous study, they showed that these electrodes were more durable than traditional platinum ones.

“Inherently, the carbon thin-film material is homogenous—or one continuous material—so it has very few defective surfaces. Platinum has grains of metal which become the weak spots vulnerable to corrosion,” Sam Kassegne, PhD, a professor at San Diego State University (SDSU) and co-author of both studies, said in a press release.

The researchers tested their GC electrodes in an MRI; but, rather than using actual human brains, they implanted the electrodes in a substance sort of like Jell-O. The researchers demonstrated that, while the metal electrode created a bright white patch on the MRI images themselves, the CG was nearly invisible — suggesting that, in an actual brain, this type of electrode would interfere with imaging far less.

They measured the currents generated in these electrodes during an MRI scan, as well as how much they vibrated, and compared these measurements to similar measurements obtained using traditional metal probes.

They found that the current generated in the GC electrodes was about 10 times lower than that in the metal probes. Similarly, vibrations in the GC electrode were about 40 times weaker than those in the metal ones, Researchers noted, however, that “for both types of microelectrodes, the measurable forces were below the detection limit” — that is, the vibrations were very small for both, even if they were smaller for the GC electrode.

“Our lab testing shows that unlike the metal electrode, the glassy carbon electrode does not get magnetized by the MRI, so it won’t irritate the patient’s brain,” said Surabhi Nimbalkar, study co-author and doctoral candidate at SDSU.

Although the researchers noted that they did not directly assess heating of the electrodes, which may be an avenue for further study, they nonetheless concluded that “GC microelectrodes demonstrate superior behavior with respect to MR safety compared to [platinum]-based electrodes.”

“Since GC has recently been demonstrated to have a compelling advantage over other materials for neural stimulation (…), this MRI compatibility validated in this study offers an additional advantage for long-term in vivo use in clinical settings,” they wrote.

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Activa Patient Programmer for DBS Therapy Available in US, Medtronic Announces

DBS technology

Medtronic, a medical technology company, announced that its Activa patient programmer technology for deep brain stimulation (DBS) therapy is now available to U.S. patients with Parkinson’s disease (PD) and other movement disorders.

The new programmer, approved by the FDA in July, is used with a customized Samsung mobile device to help patients more easily use DBS treatment and in a home setting. The Ireland-based company said that more than 150,000 people have been implanted with its DBS devices globally to manage disease symptoms, particularly those of Parkinson’s, since 1997.

“It is important for patients to have access to advanced technology for user-friendly therapy management at home,” said Sandeep Thakkar, DO, neurologist and movement disorder specialist at Hoag’s Pickup Family Neurosciences Institute, in a press release.

“The new Medtronic DBS Activa Patient Programmer device is an innovative tool that combines familiar consumer technology with medical devices, which facilitates better control for patients in an easier, more accessible way,” Thakkar said.

DBS is a surgical treatment option for people in advanced stages of Parkinson’s, whose movement problems are not being helped by medications. During surgery, one or more wires are inserted deeply into the brain to reach affected areas. These wires are subsequently connected to a pacemaker-like implantable pulse generator that is typically positioned just under the patient’s skin, in the upper thoracic region.

Able to share patient data directly with clinicians, the Patient programmer includes a programmer handset and communicator. When patients wish to modify prescribed therapy settings, check the battery, or activate or deactivate therapy, they hold the communicator above the implanted device and use the programmer to make adjustments.

Clinicians also have the ability to define settings and work with patients to adjust DBS therapy settings when using the therapy away from the clinic.

The system is managed on a Samsung Galaxy Tab S2 tablet with a customized user interface and five-inch touchscreen, and uses Samsung’s security technology to help protect both the device and patient.

Taher Behbehani, head of the Mobile B2B Division, Samsung Electronics America, said the user-friendly therapy marries safety with data control. Medtronic has partnered with Samsung since 2013, expanding into neuromodulation two years later.

“It’s through our open yet secure mobility platform that we can offer this level of customization on our market-leading devices,” he said.

“Medtronic has been the leader in DBS therapy for over 25 years. This launch continues to serve as further evidence of our dedication to our DBS patients,” said Mike Daly, vice president and general manager of the Brain Modulation business, which is part of Medtronic. “With this device, patients gain confidence, as they are able to discreetly manage their DBS therapy no matter where they are.”

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More Years of Schooling Linked to Better Response to DBS in Small Study

DBS and education

The more years of formal education that people with Parkinson’s disease have, the better they seem to respond to deep-brain stimulation — as seen in a greater ability to “dual-task,” or engage in higher-level thought while walking, a study suggests.

Education level affects dual-task gait after deep brain stimulation in Parkinson’s disease” was published in the journal Parkinsonism & Related Disorders.

Dual-tasking (DT) measures an individual’s ability to carry out a cognitive task (such as counting, or naming words that start with a particular letter) while engaging in a motor skill like walking. As such, it can be a helpful proxy for clinically relevant measures of a patient’s ability to perform everyday life tasks, which rarely come one at a time. Cognitive and motor skills are both impacted by Parkinson’s, and having to move while thinking a bit can increase the risk of falls.

Deep brain stimulation (DBS) is a surgical treatment for Parkinson’s that involves implanting a device to stimulate targeted regions of the brain with electrical impulses generated by a battery-operated neurostimulator.

Previous studies on DBS have yielded conflicting results about whether this intervention can improve dual-tasking. The researchers behind this study wondered if this conflict exists because DBS improves dual-tasking in some people with Parkinson’s, but not for others.

They recruited 34 people with Parkinson’s (average age 60.5, 44% female) and measured their DT-related gait changes a few months before DBS and again a year after DBS.

Based on these measurements, participants were divided into two groups: 18 were “responders,” meaning they had significant improvements for four dual-task assignments at the second measurement (i.e., forward and backward counting, and phonemic and semantic fluency); the remaining 16 were “non-responders” who showed no such improvement.

Cognitive reserve — the brain’s ability to improvise and find alternate ways of preforming a task — can account for differences between individuals in “susceptibility to age- or pathology-related brain changes” and has been studied in Alzheimer’s disease. Importantly, in Parkinson’s disease, higher cognitive reserve is associated with milder cognitive and motor deficits.

Education is known to contribute to cognitive reserve. As such, the researchers also divided the participants based on the highest education level they had completed: primary (through 8th grade), secondary (high school), or ‘high level’ (baccalaureate/university studies of up to 12 years).

Among the 16 non-responders, seven had completed a primary education level, four a secondary, and five had a high level. Among the 18 responders, one had completed primary level schooling, eight secondary, and nine had university level.

Responders were more likely to have completed more years of formal education, with further analyses showing that this association was statistically significant.

Other factors analyzed — including levodopa dose, Unified Parkinson Disease Rating Scale (UPDRS) score, and measurements of cognitive function and memory — were not significantly different between the two groups.

“Educational status affects DT-related gait changes one year post-DBS in [Parkinson’s disease],” the researchers concluded, noting that “a high [cognitive reserve] could be considered as a favourable inclusion criterion for future DBS candidates.”

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