Episode Transcript
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Lisa Skinner (00:00):
Lisa, hello everybody. Welcome to another brand new episode of the truth, lies and Alzheimer's Show. I'm your host, Lisa Skinner, and I am so excited to be doing this episode today, because I have some game changing, life changing information to share with everybody today. This article just came out recently, like in the last week in the San Francisco Chronicle, and this has to do with a device that the FDA just approved in February, that's going to literally change the lives of people who live with Parkinson's disease. So I think the easiest way to present the information is just to go ahead and read the article again. It was published in the San Francisco Chronicle very recently, the story is by a gentleman by the name of Jack Lee, and the headline says, Bay Area patients among First in us to receive life changing Parkinson's treatment. And it starts off saying at first Deb zaion, age 77 had trouble opening and closing her left hand as she spoke with UCSF neurologist Simon little on March 24 but as a nurse practitioner tapped on a tablet atop a nearby table, then movements sharpened and sped up, her voice also grew louder. The tablet was wirelessly connected to a medical device implanted near her collarbone, wires from the device, a flat oval that fits in the palm of a hand extended to her brain, both for monitoring signals and sending electrical impulses. This was a brain stimulation device, and it was approved for treating Parkinson's disease just this past February by the US Food and Drug Administration, or also known as the FDA. Now this woman and two others were treated at Stanford Medical Center in late March, and they were among the first in the US to begin adaptive deep brain stimulation as part of their regular care for Parkinson's disease. And until now, this treatment has only been used in clinical trials. Scientists are continuing to improve the technology, which, while not a cure for the disease, does and can provide dramatic improvements. Mrs. Zayin says it literally gave me my life back. Experts estimate that about 1 million Americans live with Parkinson's disease, which is, as we know, a disorder characterized by uncontrollable movements as a result of abnormal brain activity. Those with Parkinson's experience the loss of certain neurons which result in irregular electrical signals in the brain. Helen Bronte Stewart, who is a Stanford neurologist, she headed the global adaptive Deep Brain Stimulation clinical trial that led to the FDA approval. So what it does, and this is the explanation, Deep Brain Stimulation disrupts the jamming pattern that happens with Parkinson's disease in the brain. Earlier versions of treatment provided a continuous signal to the brain, but the newer, adaptive method is personalized to each patient's needs the end of the wires implanted in the brain serve to roll, both delivering electrical impulses into brain tissue and also reading in brain activity, so stimulation can be modulated as needed. So what they. Found was that providing too much stimulation can cause fidgeting and involuntary movements. This is what neurologist at the University of Minnesota by the name of Leo Almada. He's also the Division Chief of the movement disorders group, but he also says that not providing enough stimulation can cause symptoms of Parkinson's disease to reappear. So what they discovered was that they're just getting to the point where Deep Brain Stimulation acts like a brain pacemaker. Referring to the medical device used to regulate irregular heartbeats. While the adaptive treatment is promising, it does, however, carry some risks. The surgery required for Deep Brain Stimulation therapy can cause some bleeding within the brain, for example, and there can be side effects before experts make the adjustments for the individual person, such as tingling sensations. Adaptive Deep Brain Stimulation currently requires specialized staff to set it up and fine tune it, according to Karina or a UC Davis Assistant Professor of Neurology search neurological surgery, who was previously at UCSF, now this adaptive treatment may not be more effective for all people with Parkinson's disease, but it could optimize symptom management for some and deep brain stimulation trial is touted to be always a good thing to have a new tool to offer to patients. Now, this particular stimulation device was produced by Medtronic who's a global medical device company. The system marks the company's first foray into brain computer interfaces. The approach of reading signals and adapting therapy could have broader uses, like pain management. And just to add to that, after I came across this article, I actually saw a story that was featured on my local news channel just a couple nights ago talking about this new procedure, this new device, and the miracles that it is providing for people living with Parkinson's disease. And then at the end of the feature about it being a life changing discovery for people living with Parkinson's disease, they actually said the next clinical trial that they're going to test this on is going to involve people living with epilepsy. That is so exciting, but it again, it has recently, just since this past February, two months ago, been approved by the FDA for people living with Parkinson's disease. Now this gentleman by the name of Ken Washington, who is a Medtronic Chief Technology technician and Innovation Officer for the company that created this device. Says we are just getting started. Adaptive deep brain stimulation has meant that people have been able to take less medication. He cited a man by the name of Keith, who was diagnosed with Parkinson's disease in 1997 when he was only 42 years old. What started as pain in his hand ultimately progressed to his entire arm, shaking. The medicines for managing these symptoms have nasty side effects for him, especially like mental fog and extreme nausea. And this gentleman had to take even more medications to deal with the side effects and complications from the medications. So after starting treatment with deep brain stimulation, he was able to have his daily dosage of these medications and switch to the adaptive version of the treatment, allowing him to have that dosage again.
(09:55):
And he says, as part of his interview, I just. Wake up every morning feeling so much better. The Deep Brain Stimulation also greatly improved the symptoms that another gentleman by the name of John, age 59 faced due to his Parkinson's disease. His most pronounced symptom was painful muscle cramping, but he says with this new Deep Brain Stimulation device that discomfort disappeared almost instantaneously. He says the stiffness just kind of melted away. He has been able to resume running, and even completed the New York City marathon last year. Now don't forget, he was part of the clinical trials, something he never would have thought possible before this treatment. Now he's training for the race this year as well. On March 27 John alternated between sitting patiently and taking laps around a small room as Stanford neurologist Gareth chat tree tweaked settings on his touch screen, he was getting some involuntary movements since the last time I saw him, and that's a sign of disease progression. Doctor Shari explained, so what he was trying to do was adjust the adaptive settings so that John's getting enough stimulation. He had to find the right balance. It's similar to what little of UCSF was doing with Mrs. Zayn altering thresholds and inputs to find the right combination to manage her symptoms. Researchers are working to use machine learning and artificial intelligence to find the best settings more quickly for each individual patient. Dr little said, scientists are exploring if adaptive brain stimulation could treat other symptoms of Parkinson's, beyond those related to movement. Individuals with disease often experience problems with sleep and mood. Parkinson's disease is complicated, said UCSF neurologist Jill Ostrom, who is also a medical director at the UCSF movement disorders and neuromodulation center, it's not just one symptom. She says it's a combination of many symptoms, as any of us who have had any relationship with anybody living with Parkinson's disease, well known researchers are also working to address a technical challenge of the treatment, wallet device both delivers electrical impulses and reads brain activity. Trying to accomplish both tasks in the same brain region can create issues. The signals that you're recording are about a million times smaller than the brain stimulation that you're giving just next door little explain you're trying to listen to what would be considered a whisper at the same time. It's like a cannon is going on. But for now, the Medtronic device monitors just one brain region that's known to be connected to Parkinson's symptoms, scientists are exploring if the other parts of the brain could also play a role in Parkinson's considering additional signals from different areas could make adaptive deep brain stimulation and even more promising treatment for patients, and they conclude this article with, I think it's the future, says Dr Orrin of UC Davis, so that's really revolutionary information. It's going to change the landscape for most people living with Parkinson's disease. So I would say, with this information now being publicized, go talk to your doctors and see if you are a candidate for this new treatment, and don't forget to ask about the risks that are stated in this article. So I'm so excited to have been able to share this brand new breakthrough treatment that was just announced in the last couple weeks for you. To be aware of. So thanks again for spending part of your day with us here at the truth lies and Alzheimer show. I'm Lisa Skinner, your host, and as always, I will be bringing you updates and new content information every week with every new episode that we produce for you to keep informed about any and all of these neurodegenerative diseases that we are living with today. Thanks again for being here, and we'll be back next week with another new episode. Have a great week. Bye. Bye.