Personalized DBS for Parkinson’s may result from brain study in China
New research lays groundwork for safer, more tailored deep brain stimulation
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The findings from new research in China may enable personalized deep brain stimulation for people with Parkinson's.
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The study's scientists used MRI scans to track brain circuit changes during DBS treatment.
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The researchers say this work allows them to better understand how this type of Parkinson's treatment influences brain biology.
Scientists have demonstrated that it is possible to collect individualized data on how connections among brain circuits change for people with Parkinson’s disease who are undergoing deep brain stimulation (DBS) as a treatment for their symptoms.
These findings lay the groundwork for more individualized approaches for DBS, and also provide a new resource for researchers to better understand how this type of Parkinson’s treatment influences brain biology, according to the team.
The data were described in “Circuit response to neuromodulation characterized with simultaneous deep brain stimulation and precision neuroimaging in humans,” a study published in the journal Nature Neuroscience. The work was funded mainly by the National Key Research and Development Program of China and the National Natural Science Foundation of China.
The senior author of the study, Hesheng Liu, PhD, is the cofounder and chief scientific officer of Galaxy Brain Scientific, a China-based company that is working to advance personalized DBS approaches for Parkinson’s and other neurological disorders.
“Our goal is to redefine the treatment paradigm for brain disorders,” Liu said in a company press release detailing the findings. According to Galaxy, “this study establishes the world’s largest longitudinal … dataset to date” on DBS and MRI brain imaging scans.
“By moving from ‘one-size-fits-all’ to ‘one-person-one-strategy,’ we are now pioneering the application of this technology to treat complex conditions beyond Parkinson’s, including autism and Alzheimer’s disease,” Liu said.
Parkinson’s is a neurological disorder in which certain brain cells sicken and die, leading to disruptions in brain signaling that ultimately give rise to disease symptoms.
DBS is a surgical treatment for Parkinson’s in which tiny electrodes are implanted into the brain to deliver gentle electrical stimulation to specific brain regions. DBS is well-established as an effective approach for managing certain Parkinson’s symptoms.
Nonetheless, there’s often a lot of trial and error involved in finding the exact right settings to ease symptoms for each individual.
Electrodes used in brain in DBS weren’t always compatible with MRI
While the procedure is known to work, researchers still don’t fully understand exactly how DBS affects the person’s brain networks. In theory, better understanding these effects could help guide treatment, helping remove trial and error so that settings could be directly tailored to each person’s unique needs.
Part of the reason DBS’s effect on the brain has been difficult to study is that, in many cases, the metal electrodes used for DBS are not safely compatible with brain imaging technology like MRI scans, which work using powerful magnets. But recent breakthroughs have led to the development of new, cutting-edge electrodes that are safe when used for these scans.
The primary obstacle in conducting neuroimaging studies in DBS-implanted patients is the safety concern associated with the DBS electrodes, which hinders the collection of adequate amounts of data per individual. … The current resource marks a crucial advancement in addressing this challenge.
Now, a team led by researchers in Beijing published a comprehensive dataset from 14 people with Parkinson’s who underwent five functional MRI scans over the course of a year while receiving DBS at various settings. Functional MRI, or fMRI, is a specific type of brain imaging that looks at the connections between different regions within the brain.
fMRI data from patients were compared with those from 27 healthy individuals, who served as controls.
The biggest takeaway from the study, according to its researchers, is that this work has shown that it’s possible to gather detailed data on brain connectivity patterns in people with Parkinson’s undergoing DBS. According to the team, this is a crucial step toward developing more personalized approaches.
“The primary obstacle in conducting neuroimaging studies in DBS-implanted patients is the safety concern associated with the DBS electrodes, which hinders the collection of adequate amounts of data per individual,” the team wrote. “The current resource marks a crucial advancement in addressing this challenge.”
Important conclusions drawn despite small study size
Although the dataset was limited to slightly more than a dozen individuals, the researchers were nonetheless able to draw some notable conclusions from the data.
In particular, the scientists found that a clinical response to DBS was closely associated with a normalization of connectivity in the somato-cognitive action network (SCAN), a specific brain network that helps control movement. Previous work by Liu and colleagues had shown that abnormal functional connectivity within SCAN is linked to Parkinson’s motor symptoms.
Overall, the new “evidence suggests that SCAN may play a central [disease-driving] role in [Parkinson’s] and may be a promising target for optimizing DBS or developing new neuromodulation therapies,” the scientists wrote.
The team has made their fMRI dataset freely available to other scientists in hopes of accelerating research in this area.
