How Brain Pacemakers Treat Parkinson's Disease

the_newsbeagle writes Pharmaceutical research for neuropsychiatric disorders hasn't produced many breakthroughs lately, which may explain why there's so much excitement around "electroceutical" research. That buzzy new field encompasses deep brain stimulation (DBS), in which an implanted stimulator sends little jolts through the neural tissue. DBS has become an accepted therapy for Parkinson's and other motor disorders, even though researchers haven't really understood how it works. Now, new research may have found the mechanism of action in Parkinson's patients: The stimulation reduces an exaggerated synchronization of neuron activity in the motor cortex.

Comments

No new treatments?

[Mycroft-X]

Pharmaceutical research for neuropsychiatric disorders hasn't produced many breakthroughs lately,

What, you mean like this Parkinson's treatment just approved in January?

https://www.michaeljfox.org/foundation/news-detail.php?fda-approves-duopa-levodopa-carbidopa-intestinal-gel-delivery-method-new-to-market

I've seen patients with it and without it and it's a stunning difference.

Re:No new treatments?

[sjames]

That is an improvement, but it's not a fundamentally new treatment so much as it is an improvement on the administration of an old treatment.

Re:No new treatments?

[Jason Levine]

My wife's grandfather passed away due to complications from Parkinson's. I never got to meet him before the disease started, but it was heartbreaking to see him go from able to walk on his own using a walker to being unable to move a leg without help. He would fall down and being unable to help you life him back up. (FYI, it can really hurt your back trying to lift up a 150 or so pound man who can't help by supporting his own weight at all.) In the end, he couldn't even get out of bed.

I'm not sure which is worse, Parkinson's or Alzheimer's (where you slowly lose chunks of your memory/yourself until there's just an empty shell left). Any progress towards treating these disorders is fantastic.

Re:No new treatments?

[Anonymous Coward]

In the mean time, there's always Dignitas*: http://en.wikipedia.org/wiki/Dignitas_%28assisted_dying_organisation%29

I suppose one could never know whether they would choose this route until they're face-to-face with the stark reality of an affliction which has already progressed beyond the point of no return. Neurological disorders like Parkinson's and, especially, Alzheimer's are a doubly whammy: you have to make up your mind much sooner than, e.g., somebody with terminal cancer. (I suppose with Parkinson's as long as you can swallow you could still do it in some locales. In others that might be too late for it to be legal because somebody would have to actually place the pills or straw into your mouth.)

* Some US states have legalized assisted suicide, but you have to be a resident. Montana might be an exception given that it was a judicial decision that effectively legalized it. But in any event, Dignitas is the last resort of last resorts.

Re:No new treatments?

[demonlapin]

That's improving delivery, not improving the drug. It's still an ugly hack of a drug - one that I'm glad we have, but an ugly hack. Pyridostigmine for myasthenia gravis falls in the same category. If you want to see a synaptic-effect drug that is a real advance, look at sugammadex for reversal of aminosteroid paralytics.

Re:No new treatments?

[mindwhip]

Parkinsons is worse having had experience of both in close family members. For the most part Alzheimer's sufferers are in themselves fairly unaware or unconcerned with their disease. Parkinsons the individual is usually fully aware of the disease and what they can no longer do for themselves, what they can't recall and what they have lost causing additional stress to both the sufferer and their family, along with depression and related mental health issues. Also the commonly perceived symptoms (shakes and immobility) in Parkinsons are not the only symptoms and there can often be significant (bad) personality changes that can break entire families apart.

My dad was one of the first in the area to have the implant and it worked well initially and gave my Dad 3 years of reduced symptoms while it was effective. Turning the implant on and off was literally like a switch on his tremor. Unfortunately there were complications with the placement of the probe (which was still "experimental" when it was done and we all knew the risks) that resulted in "mild" brain damage, him requiring full time professional care after 5 years and ultimately accelerated the progression of symptoms.

As for the "new" treatment this is just a new way to administer more or less the same concoction of drugs my Dad was on five years ago but back then was an endless array of tablets that all had different schedules of administration which is not easy for someone with advanced Parkinsons to manage...

Re:No new treatments?

[NigelTheFrog]

If you want to see a synaptic-effect drug that is a real advance, look at sugammadex for reversal of aminosteroid paralytics.

It'd be a lot easier to take a look at Sugammadex if it ever got FDA approval...

Re:No new treatments?

[demonlapin]

Don't get me started on that subject.

Re:No new treatments?

[StikyPad]

Not even. "This treatment has been approved in Europe under the name Duodopa since 2004."

Job Opportunities for Engineers

[damn_registrars]

The medical device companies (Medtronic, Boston Scientific, et al) have been putting a lot of effort in to this field. Engineers - Biomedical, Electric, and others - have lots of good opportunities from this right now.

Optogenetics

[jihema]

Another approach called optogenetics is developed at the University of Otago: http://www.scoop.co.nz/stories...

Re:Not to be overly paranoid here but...

[HornWumpus]

20 years? Try 70.

After WWII England, Australian and America cut a deal. Their intelligence services were banned from domestic spying. So they all spy for each other. See also 'Echelon'.

In the 80s there was quite buzz about the worlds largest database. It tracked every phone # you had ever made a pattern of calling. Today we call it metadata.

Re:Not to be overly paranoid here but...

[ColdWetDog]

"OK, hold it guys, Citizen 23408387387 just activated their vagus nerve. Something's happening. Get the team ready.,,,,"

"Ah, it's OK. He just burped."

I think not.

Wouldn't work for my boss

[reboot246]

He has Parkinson's, but to stimulate a brain you first have to find it.

treatment a variation on ECT?

[whodat54321]

This treatment, while promising, sounds like a finer targeted version of what used to be used in hard to treat and violent psych. patients years ago. What bugs me about this is it's like jump starting a car with a dying battery. There is nothing organic that is happening that will improve with time, and eventually the circuits eventually burn out and the disease continues it's progress. Degenerating tissue cannot sustain the signals needed for functioning indefinitely, despite numerous kick starts. It's not realistic to think of this like a pacemaker, which is effective on heart tissue which is fairly simple in nature to keep alive and contracting versus brain tissue which is still not fully understood at the macro functioning levels. Sort of like pushing more and more power down a failing speaker wire that needs replacement or repair instead of hooking it to the wall socket from time to time to clear the signal path. That's the real challenge facing research into brain disorders. First discover how the circuitry works, then see if treatment at the organic level is possible. I am not sure if that'll happen in my lifetime, but it's a start...

Re:Brain Pacemakers

[davester666]

Everywhere I go...it smells like toast.

Re: essential tremor

[Anonymous Coward]

They are doing surgery for tremor now. They basically short the wires. It's done while you are awake and talking or singing. This helps them keep from cutting the wrong wires