New Hope for Taming the Shake of Parkinson’s
Clinical trials at Vienna’s MedUni show that new forms of Deep Brain Stimulation could change patients’ lives for the better
Treating the debilitating shake of Parkinson’s disease may just have gotten easier, with results from a recent Medical University of Vienna clinical trial in a new and rechargeable technology showed significant patient improvement.
The "Vantage" study looked at 40 subjects at six European centres, given Deep Brain Stimulation (DBS) with the new device. Preliminary results were presented at the 17th International Congress of Parkinson's Disease and Movement Disorders, in June in Sydney, Australia.
DBS can be thought of as a pacemaker for the brain. Once implanted, it sends a fine-tuned electrical signal directly to the sources of the problem – the misbehaving nerves. This off-switch signal causes the shake in most cases to be significantly reduced and can even stop it entirely.
"It’s a completely new system, which comes from bionics, and is a cleverer solution" than the older pacemaker model, study leader Prof. François Alesch told The Vienna Review.
Parkinson’s disease is the second most common neurodegenerative disorder behind Alzheimer’s. The English doctor James Parkinson first described it in 1817 in his publication "An Essay on the Shaking Palsy." As it already showed, the most common symptom of the disease is an uncontrollable tremor. Other symptoms can also include severe depression as well as dementia.
The symptoms of Parkinson are caused by proteins (called alpha-synuclein for the protein savvy), which build up in nerve cells forming protein roadblocks (technically speaking, Lewis bodies). These blockages decrease the ability of nerve cells to communicate and function with one another, eventually leading to cell death and the onset of the associated symptoms.
Parkinson’s is most common in the elderly, with most patients showing early signs in their 50s. However it can start earlier, with some of the most famous cases including boxing champion Muhammad Ali who was diagnosed at 38, and actor Michael J. Fox at only 30.
The exact cause of Parkinson disease remains unknown and there is currently no cure. However, treating the symptoms can significantly improve a patient’s quality of life.
Since the 1990s, DBS has been approved to treat Parkinson’s disease patients when medication is no longer effective. Since its debut, updates to the system have greatly improved its safety and effectiveness, making it a more practical, and sustainable long-term treatment option.
"It’s like getting fitted with a pair of glasses," said Prof. Alesch. Just as the optometrist adjusts your glasses so you can see clearly, they can adjust the electrical field to a patient’s movements using DBS. But as with glasses, it’s no cure; when the machine is turned off, tremor symptoms return.
This new device tested in the "Vantage" clinical trial, called Vercise™ and made by Boston Scientific, is small, flexible and rechargeable. It also has multiple independent current controls to shape the electrical field within the brain, making the system more flexible to patients needs.
"The rechargeable battery is a major advantage to the system. It allows doctors to adjust the strength of the treatment without the fear of running out of power too quickly. This means that patients can extract a greater benefit from the system on the whole," Prof. Alesch explained. In previous models, patients had to undergo additional surgery every 3-4 years to replace the unit, increasing the risks of infection, re-implantation, and of course, the cost. The rechargeable system is simple and convenient, and no more complicated than charging a cell phone.
The World Health Organization estimates between 7 to 10 million people worldwide are affected by Parkinson’s. Within Austria alone, the Parkinson Selbsthilfe Österreich estimates that around 20,000 patients currently have the disease. By 2040, the European Parkinson Disease Association expects it to surpass cancer as the most common group of medical conditions.
"I see DBS as becoming a more common treatment option in the future for patients as prices come down," explained Prof. Alesch.
The Vercise™ device has already been approved for use in Europe and Israel.