Deep brain stimulation (DBS) has demonstrated potential as a viable treatment for certain symptoms associated with Parkinson’s disease (PD). However, it is not equally effective in alleviating all symptoms of the disease. A deeper understanding of how various sites of electrical stimulation impact the wide array of motor symptoms associated with PD could help in refining treatment methods. Researchers conducted a study involving PD patients treated with DBS at five different centers, which led to the creation of an atlas mapping four major symptoms of PD to different brain regions. Based on these findings, the team developed an algorithm capable of generating personalized DBS treatment plans tailored to specific symptoms, with promising initial results.
Deep brain stimulation (DBS) has demonstrated potential as a therapy for certain symptoms of Parkinson’s disease (PD). However, not all symptoms respond equally to DBS treatment. Having a clearer understanding of how various sites of electrical stimulation affect the wide range of motor symptoms associated with PD could improve treatment accuracy. Researchers from Mass General Brigham studied PD patients at five different centers who were undergoing DBS treatment, and developed an “atlas” that linked four major PD symptoms to specific brain regions. Using this information, the team devised an algorithm.The researchers have developed a system that can create personalized treatment plans for deep brain stimulation (DBS) based on individual symptoms. They tested this system on five patients and found that it has the potential to improve symptoms beyond the standard approaches currently used. The study was published in Nature Communications. Senior author Andreas Horn, MD, PhD, a neurologist at Mass General Brigham, stated that while there is evidence of improved quality of life in patients with Parkinson’s disease treated with DBS, the current approach to treatment is not personalized.Researchers from Brigham and Women’s Hospital and the Center for Neurotechnology and Neurorecovery at Massachusetts General Hospital have developed techniques to tailor deep brain stimulation (DBS) to the specific needs of each patient in order to improve the treatment even further. The team studied 237 patients with Parkinson’s disease (PD) who were treated with DBS to identify tracts associated with four major PD symptoms: tremor, bradykinesia, rigidity, and axial symptoms. The software developed by Horn’s team was used to analyze the data from the study.The researchers accurately located the DBS electrodes in each patient and developed a shared map of the circuits that are linked to the improvement of patients’ symptoms. They found that tremors improved when tracts connected to the primary motor cortex and cerebellum were stimulated, while bradykinesia was associated with the supplementary motor cortex. Stimulation of the premotor cortex improved rigidity in patients.
Axial symptoms, which have not been extensively studied in relation to DBS, improved when tracts connected to the supplementary motor cortex and brainstem were stimulated. This discovery could be particularly important as axial symptoms have not received much attention in relation to DBS.
Problems with walking or maintaining an upright posture, such as gait or postural stability issues, usually do not respond well to deep brain stimulation (DBS) and current dopaminergic treatments like levodopa.
After their research, the scientists developed Cleartune, an algorithm that recommends the best stimulation settings for DBS. They used Cleartune to guide treatment for five Parkinson’s disease (PD) patients in Germany who were undergoing DBS. In four out of the five patients, Cleartune settings resulted in greater improvements in PD symptoms compared to standard treatment protocols. The fifth patient showed similar improvements with Cleartune as with the standard treatments.
ThResearchers at Mass General Brigham, in partnership with other experts, are receiving funding from the National Institutes of Health to develop personalized treatments for PD and OCD, as well as to map the brain’s circuitry using advanced imaging technologies. According to Nanditha Rajamani, PhD, this interdisciplinary effort aims to create the most precise atlas of symptom-specific pathways possible by utilizing anatomical information from various sources and collaborating with skilled neuroanatomists.and confirm the validity of this study. This could serve as a model for enhancing DBS treatments for various other conditions in the future.”
