The global pandemic of COVID-19 is no doubt the top of mind for people around the world. It has also forced us to look at our health and take into consideration any underlying medical conditions. Those living within these conditions are also among those at the highest risk. Let’s take a moment to take notice of the global community living with life changing neurological conditions. The World Health Organization estimates that there are over one billion people living with neurological conditions. These conditions are one of the leading causes of DALYs (disability-adjusted life years) as well as the cause of death globally. Some of the common neurological disorders include dementia, epilepsy, headache disorders, multiple sclerosis, neuroinfections, , plus stroke, traumatic brain injuries and Parkinson’s disease.
Let’s focus on the later in particular since it is Parkinson’s disease awareness month. According to the Parkinson’s Foundation, each year nearly 60,000 Americans are diagnosed with PD and over 10 million worldwide. Keep in mind, there are thousand that are undiagnosed since many don’t seek assistance until symptoms become apparent. Parkinson’s disease is characterized by selective degeneration and loss of neurons that use dopamine as a neurotransmitter from a brain area called the substantia nigra and results in disabling motor symptoms, such as tremors, rigidity or stiffness, slowness of movements, or impaired balance and coordination. There are slow secondary symptoms that may not be as apparent but impact the person’s daily function; loss of facial expressions, impaired fine motor dexterity, slurred speech or loss of movement to name a few.
There are many treatments being explored for PD such as medications, biological treatments and rehabilitation techniques. In our feature focus this month, we will hon in on the neurotechnology developments for PD and some related movement disorders such as essential tremor and dystonia.
Deep brain stimulation has rapidly emerged as an effective treatment for the motor symptoms of Parkinson’s disease after dopaminergic medications are no longer effective. DBS involves a surgical technique which requires implantation of a neurostimulator similar to a pacemaker and the insertion of an electrode tip into the brain. This illustration from the Cook Childrens’s Medical Center provides a good explanation of the implantation process. Post-surgery, the neurostimulator is programed by a trained clinician to individualize the stimulation settings. The distinct mechanisms by which DBS affects physiological processes are still largely unknown.
Advances in our understanding of the neural mechanisms involved with movement disorders — and in normal movement — promise to enhance DBS therapies for Parkinson’s disease. Investigators have speculated that the changes in neuronal activity that occur with DBS may also be neuroprotective and perhaps slow the progression of the disease. Over the last several years, there have been an increasing number of research studies that point to the long- term effects of DBS in the treatment of Parkinson’s disease. DBS was first approved for treatment of essential tremor. Essential tremor is the most common form of tremor and affects approximately 4 percent of individuals over age 40. Here is a link to find a clinician trained in deep brain stimulation technology. The search tool is provided by Neuromodec.
Exercise is also a vital part of staving off the symptoms of PD. In 2009, The Parkinson’s Foundation initiated the Parkinson’s Outcomes Project, a clinical study of over 13,000 participants to gain an understanding of the impact of exercise on the symptoms associated with PD. The study demonstrated that beginning an exercise regime early can slow the quality of life decline associated with PD and overall help with disease management. They recommend a minimum of 2.5 hours of exercise per week. There are neurotechnologies to help with rehabilitative exercise particularly for those who may have difficulty with balance or movement. Functional electrical stimulation cycling is one neurostimulation system. There are also other wearable and surface stimulation devices to aid in muscle movements. Assisted treadmills and balance suspensions are other forms of assistive equipment.
Parkinson’s disease is a movement disorder and some people may experience drop foot syndrome. This is a condition in which the flexing of the foot may be difficult while walking. The condition can leave to unexpected falls. Drop foot stimulation systems are available to help with this condition. There are many companies that offer they such as Bioness, Odstock Medical and Accelerated Care Plus.
In recent years, there has also been a development of non-invasive treatment s for common symptoms of movement disorders. Here are some of these developments:
- Cala Health has entered the market with a wrist wore device for the treatment of hand tremor.
- Brainways has been developing their transcranial magnetic stimulation system for the treatment of Parkinson’s disease.
- Researchers at Western University in Canada and the London Health Sciences Center in Ontario are investigating the use of spinal cord stimulation to improve movement among those living with PD, particularly tremors and spasticity.
- Under investigation by researchers at Queensland University in Australia as well as those at Castilla La Mancha University in Spain are looking at the effects of combined therapy of transcranial direct stimulation and gait training to improve walking abilities.
These are just a few examples of the recent efforts to development neurotechnologies to improve the quality of life for those living with Parkinson’s disease. Just as there are varied progressions of PD, there are varied technologies for treatment. Neurotech Network offers free resources and a directory of devices specifically for Parkinson’s disease. Check out our Parkinson’s disease resource page here.
The content for this article was provided by Neurotech Network. Research briefs were provided by Neurotech Reports.The source of references include the World Health Organization, Parkinson’s Foundation and Michael J. Fox Foundation.
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