BRAIN Initiative Grant to Examine Ethical Issues of Deep Brain Stimulation in Parkinson’s

Two Cleveland Clinic researchers are recipients of the first grants awarded by the National Institute of Health’s BRAIN Initiative in neuroethics, for studies looking ethical issues in brain surgeries intended to treat diseases, with specific attention on Parkinson’s.

“We are thankful the BRAIN Initiative sees the importance of exploring ethical considerations in neuroscience and hope our contributions can help move the field forward,” Paul Ford, interim chair of the Department of Bioethics at the Cleveland Clinic, said in a news release.

The Brain Research through Advancing Innovative Neurotechnologies (BRAIN) program, initiated in 2013, aims to deepen the understanding of the human brain and its disorders like Alzheimer’s, Parkinson’s, and epilepsy.

“As medicine moves forward with technologies that allow us to treat patients in new ways in the field neuroscience, we must have a firm understanding of the ethics surrounding these advances,” Ford said.

The awardees are Lauren Sankary, JD, a neuroethics fellow at the Cleveland Clinic, and Cynthia Kubu, PhD, a neuropsychologist with the Center for Neurological Restoration at the clinic.

Sankary received the three-year Ruth L. Kirschstein National Research Service Award (NRSA) Individual Postdoctoral Fellowship grant. The grant’s value was not announced, but it will be used to study the experiences of patients who have taken part in studies of one of two brain implant treatments: deep brain stimulation (DBS) and closed-loop responsive neurostimulation (RNS).

Besides including data from completed DBS clinical trials, scientists will also take into account data from Cleveland Clinic’s new DBS study (NCT02835443) for stroke recovery, which is currently enrolling patients.

Kubu was awarded $1.6 million from the National Institute of Mental Health under the initiative to study the perspectives of Parkinson’s patients and family members on possible changes in personality over the course of DBS.

Deep brain stimulation is used to treat medication-resistant symptoms of Parkinson’s disease, or patients whose symptoms are responding to pharmaceutical treatments but are having increasing difficulties with them, like off periods.

Although little is known about the effects of DBS on personality, studies report that Parkinson’s patients showed increased impulsivity after DBS treatments.

“We hypothesize that patients will report changes to personality associated with Parkinson’s Disease,” Kubu said. “Conversely, we think that deep brain simulation will result in a return to pre-illness personality and will allow patients to be their more authentic self.”

With this study, researchers intend to understand if existing measures capture changes in valued personality characteristics. Among the questions they want to see answered: Does Parkinson’s cause changes in perceived personality? Does DBS change personal characteristics thought meaningful to an individual patient and family members?