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Hope through DBS

Kay Mixson-Jenkins’ life was turned upside down when she was told she had Parkinson’s disease. Suffering from severe dyskinesias, she couldn’t enjoy simple activities with her family. But after undergoing deep brain stimulation (DBS) surgery at the University of Florida in Gainesville, an NPF Center of Excellence, her life improved dramatically.

“Now I can cut my own food, dress myself and dance with my husband,” she said. “I have a future to look forward to and that is wonderful.”

While DBS has yielded life-changing results for Mixson-Jenkins and others whose medications no longer adequately control symptoms, specialists continue to pursue ways to make the therapy easier, safer and more effective. “Parkinson’s disease affects the brain in very complex ways and we have only so far scratched the surface of the best techniques and approaches for using stimulation to treat this disease,” said Michael Okun, MD, NPF’s National Medical Director. In DBS surgery, a neurosurgeon and interdisciplinary team implants one or alternatively two leads (wires) deep in the brain and wires them to a pacemaker-like device implanted below the collarbone.

Electrodes near the tip of each lead emit electrical pulses, regulating the chaotic brain cell activity that causes motor symptoms. At present, DBS is typically used to treat individuals who are in the advanced stages of the disease. One of the challenges facing people with Parkinson’s is recognizing the most beneficial time to have this therapy.

“The right time for DBS is different for individual patients,” said David Charles, MD, Chief Medical Officer of the vanderbilt Neuroscience Institute, and Director of the Movement Disorders Clinic at vanderbilt University Medical Center, an NPF Center of Excellence. “There is an optimal time that DBS can be particularly helpful. It’s a combination of age and how long a person has had Parkinson’s disease.”

"One way to take advantahe of this therapeutic window is to start learning about DBS as soon as you experience levodopa-associated dyskinesias, Dr.Charles recommends. Once you reach the point where your symptoms no longer have any response to medications, the therapeutic window has probably closed and the therapy won't be very beneficial. 

Currently, researchers are studying the benefits of DBS on patients in earlier stages of the disease. last month, Dr. Charles and the team at vanderbilt received approval from the FDA to conduct a multicenter study to test the safety and tolerability of DBS in early stage Parkinson’s disease. “The hypothesis is that DBS applied early in the course of Parkinson’s will slow the progression of disability,” he said. That would be a major breakthrough.

 

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