Stimulating Brains Podcast | Episode 57

Mallory Hacker is an Assistant Professor for Neurology in the team of David Charles, who is Professor of Neurology, Vice-Chair for Business Development and Strategy, as well as the Medical Director for Telehealth at Vanderbilt University Medical Center in Nashville, Tennessee. In 2006, after a stay at Alim Louis Benabids team in Grenoble, France, David started to investigate the question of whether subthalamic DBS could lead to slowing of motor progression in patients with early stages of Parkinson’s Disease. In a one-of-a kind trial, he collected data on the first patients which were published in 2014.In subsequent follow up trials, many of which were first-authored by Mallory Hacker, Class II evidence that supports this hypothesis could be established. It was a great joy to host Mallory in my lab in Berlin in 2022 and we have looked at the effects of lead locations on patients enrolled in the pilot trial. This is what convinced me that there might be something: The few patients that did not progress at all in their motor symptoms after two years were all precisely stimulated at the optimal location within the STN, while the ones that did progress, were more off target. Indeed, these same optimally placed patients had lower stimulation amplitudes and received less medication – but still had a clearly better outcome. Since the original trial, David and Mallory have been hard at work in trying to secure funding for a phase III pivotal trial, and we discuss how difficult this process has been, but also, that there is hope on the horizon, regarding the next steps!

A man who has been battling Parkinson’s disease for seven years shared a video on TikTok demonstrating the astounding results that deep brain stimulation has had on his ability to use his hands.

Justin Fields, a 35-year-old Knoxville, Tenn., resident, shared a video on TikTok of himself eating cereal with a spoon with the help of his deep brain stimulator, a device that is surgically implanted in the brain and helps people with Parkinson’s control their moments and tremors.

In the video, which was recorded by Fields’ fiancée Emily Norris, he first demonstrates how his body functions without the stimulator. Fields can clearly be seen struggling to pick up the cereal bowl in front of him and raise the spoon to his mouth to take a bite. But after switching the device back on, Fields is able to eat the cereal with relative ease.

Read more on Yahoo!

Among patients with Parkinson disease (PD) aged 60 years and younger with early motor complications, deep brain stimulation (DBS) was found to provide significant improvements in social, occupational, and psychosocial function, according to study findings published in Movement Disorders Clinical Practice.

As the researchers noted, DBS has been shown to improve motor symptoms and quality of life in patients with PD (PwP) and early motor complications. Moreover, the safety of DBS has been indicated in a prior study, with previous concerns of dementia risk found not to be higher than the general PD population who did not undergo the procedure. The implications of these benefits led researchers of the current study to examine whether DBS could be prescribed in the working-age PD population.

Read more at AJMC

Deep brain stimulation (DBS) can decrease the risk for disease progression as well as the need for and complexity of medications in patients with early-stage Parkinson disease (PD) compared with optimal medical therapy alone, according to study results published in Neurology. Previous studies reported the benefits of DBS in mid- and advanced-stage PD, but there are limited data on the long-term safety and efficacy of DBS in early-stage PD.

Read more at Neurology Advisor

Overview of attention for article published in Neurology, June 2020

A pair of ultra-thin electrodes surgically implanted deep into the brain might slow the progression of Parkinson’s disease, according to five-year outcomes from a 30-patient randomized clinical trial conducted by investigators at Vanderbilt University Medical Center. Their report, published in the July 2020, issue of Neurology, presents the latest findings from the world’s first study of deep brain stimulation, or DBS, for early stage Parkinson’s, defined as within four years of disease onset. ….

In other five-year outcomes from the study, the DBS patients required considerably less of the medication used to manage symptoms of Parkinson’s. Also, “Patients receiving only optimal drug therapy had fifteenfold greater odds of needing multiple types of Parkinson’s disease medications,” said project leader Mallory Hacker, PhD, MSCI, assistant professor of Neurology. In a marked but uncertain trend falling just short of statistical significance, Parkinson’s patients receiving drugs alone were more than twice as likely to have clinically significant worsening of their motor symptoms.

Read more at VUMC Reporter

Data from a five-year clinical trial is adding to growing evidence that deep brain stimulation (DBS) can slow the ravages of Parkinson's disease.

Researchers at Vanderbilt University Medical Center in Nashville, Tenn., said that the therapy appears to curb any worsening of tremor and other symptoms, as well as lessening a patient's need for medications.

"Parkinson's is relentless," senior study author Dr. David Charles, Vanderbilt professor and vice-chair of neurology, said in a medical center news release. "There's nothing that slows down its progression."

However, "with this pilot study, we've shown that if DBS is implanted early it's likely to decrease the risk of progression, and if this is borne out in our larger study it would be a landmark achievement in the field of Parkinson's disease," he said.

Read more at US News & World Report

For the first time, a treatment for Parkinson’s disease may actually help stop its progression. In new research presented at the Congress of Neurological Surgeons this month, deep brain stimulation (DBS) was shown to have significant beneficial effects when utilized in people earlier than previously believed.

Read more at Healthline

Larry Clift, 74, of Chattanooga, lies on an operating table with a sheet of plastic draped across his forehead, nearly splitting the room in two. On one side, bright lights illuminate a dime-sized hole in the top of Clift’s skull, surrounded by a white ring of exposed bone and a small ooze of blood. If you look closely, you can see his brain….

For eight years, he has suffered from Parkinson’s disease, a disabling condition that has made his body stiff and weak. Relentless tremors have taken over his right arm, and doctors are certain they will spread to his left if they do not intervene. This operation, as surreal and terrifying as it may sound, is supposed to help. During four hours of surgery, a team of doctors place a tiny electrode deep within Clift’s skull, where electric shocks can stimulate the portion of his brain at the root of his disease. If the procedure works, his symptoms will fade with the flip of a switch. And maybe — just maybe — his tremors will never spread to his left arm at all. “Any time you have tremors,” Clift says, as doctors tinker inside his head, "and the shaking goes away, that’s a miracle.”

Clift was a recipient of deep brain stimulation surgery, which for two decades has been used as a last-resort treatment for patients with Parkinson’s disease, an incurable, degenerative condition that affects millions of people worldwide. But a new decadelong surgery study at Vanderbilt offers a glimmer of hope for younger Parkinson’s patients. Although still far from a cure, the surgery study provides some of the first evidence that any medical treatment can slow the progression of tremors, the signature symptom of the disease.

Read more at the Tennessean

Overview of attention for article published in Neurology, June 2018