Focused ultrasound thalamotomy in Parkinson’s Disease

UVA’s Scott Sperling and Jeff Elias, who already used focused ultrasound to treat essential tremor, have just published the results of  a small study showing the efficacy of the technology in Parkinson’s Disease.

The sound waves were shown to interrupt brain circuits responsible for the uncontrollable shaking associated with the disease. The researchers claim that their study also offers “comprehensive evidence of safety” in its effect on mood, behavior and cognitive ability, which has not previously been studied.

According to Sperling, “In this study, we extended these initial results and showed that focused ultrasound thalamotomy is not only safe from a cognitive and mood perspective, but that patients who underwent surgery realized significant and sustained benefits in terms of functional disability and overall quality of life.”

27 adults with severe Parkinson’s tremor that had not responded to previous treatment were divided  into two groups. Twenty received the procedure, and a control group of seven (who were later offered the procedure) did not. Participants reported improved quality of life, including their ability to perform simple daily tasks, emotional wellbeing, and a lessened sense of stigma due to their tremor, at both three and twelve months.

The team found that mood and cognition, and the ability to go about daily life, ultimately had more effect on participants’ assessment of their overall quality of life than did remor severity or the amount of tremor improvement.

Cognitive decline was seen in some participants after the study, in that they were less able to name colors and think of and speak words. The cause of this was unclear, and must be investigated. The researchers suggested this could be a result of the natural progression of Parkinson’s.


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Implanted sensors track dopamine for a year

Helen Schwerdt, Ann Graybiel, Michael Cima, Bob Langer, and MIT colleagues have developed and implantable sensor that can measure dopamine in the brain of rodents for more than one year.  They believe that this can inform the treatment and understanding of Parkinson’s and other brain diseases.

According to Graybiel, “Despite all that is known about dopamine as a crucial signaling molecule in the brain, implicated in neurologic and neuropsychiatric conditions as well as our abilty to learn, it has been impossible to monitor changes in the online release of dopamine over time periods long enough to relate these to clinical conditions.”

The sensors arenearly invisible to the immune system, avoiding scar tissue that would impede accuracy. After  implantation, populations of microglia  and astrocytes were the same as those in brain tissue that did not have the probes.

In a recent animal  study, three to five sensors per were implanted 5 millimeters deep in the striatum. Readings were taken every few weeks, after dopamine release was stimulated in the brainstem, traveling to the striatum. Measurements remained consistent for up to 393 days.

If developed for use in humans, these sensors could be useful for monitoring Parkinson’s patients who receive deep brain stimulation.


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AI driven, music-triggered brain state therapy for pain, sleep, stress, gait

The Sync Project has developed a novel, music-based, non-pharmaceutical approach to treating pain, sleep, stress, and Parkinson’s gait issues.

Recent studies showed Parkinson’s patients improved their gait when listening to a song with the right beat pattern, and post surgery patients used 1/3 the amount of self-administered morphine after listening to an hour of music.

Lifestyle applications include Unwind, an app detects ones heartbeat, and responds with relaxing music (customized by machine learning tools) to aid sleep, and the Sync Music Bot, which uses Spotify to deliver daily music to enhance work, relaxation, and exercise.

With further clinical validation, this non-invasive therapy could replace drugs for better, targeted, personalized interventions.


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Verily’s health sensing research watch

The  Verily Study Watch passively captures health data for continuous care platforms and clinical research. Key features described by the company include:

  • Multiple physiological and environmental sensors are designed to measure relevant signals for studies spanning cardiovascular, movement disorders, and other areas. Examples include electrocardiogram (ECG), heart rate, electrodermal activity, and inertial movements.
  • A long battery life of up to one week in order to drive better user compliance during longitudinal studies.
  • Large internal storage and data compression allow the device to store weeks’ worth of raw data, thus relaxing the need to frequently sync the device.
  • A powerful processor supports real time algorithms on the device.
  • The firmware is designed to be robust for future extensions, such as over-the-air updates, new algorithms, and user interface upgrades.
  • The display is always on so that time is always shown. The display is low power and high resolution for an appealing look and a robust user interface. Note: currently, only time and certain instructions are displayed. No other information is provided back to the user.

The watch will be used in Verily’s current and forthcoming studies, such as the  Personalized Parkinson’s Project, meant to track progression, and the Baseline study, meant to understand transitions between health and disease.


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VR training to reduce falls in Parkinson’s, dementia

Tel Aviv University’s Jeff Hausdorff has created a virtual reality treadmill system in an attempt to prevent falls in Parkinson’s  and  dementia patients.

Current interventions focus on improving muscle strength, balance and gait.  By integrating motor planning, attention, executive control and judgement training, using VR, therapies can also address the cognitive issues associated with falls.

In a recent study of 282 participants,  146 did treadmill + VR training, and 136 did treadmill training alone. VR patient foot movements were filmed and shown on a screen, in order for them to “see” their feet walking  in real-time. The game-like simulation included avoiding and stepping over puddles or hurdles, and navigating pathways. It also provided motivational feedback.

Fall rates were similar in both groups before the training. Six months after, those who participated in the VR intervention fell 50% less. Those who did not train with VR had consistent fall rates. The biggest improvement was seen in Parkinson’s patients.

Patients can receive the combined therapy at the Hausdorff-led Center for the Study of Movement Cognition and Mobility at Tel Aviv’s Ichilov Hospital.

Click to view the Tel Aviv Sourasky Medical Center video.


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Carbon electrode technique tracks dopamine in the brain

Michael Cima and MIT colleagues have developed a more precise tool to measure dopamine in the brain, to be able to study its role in in learning, memory, and emotion.

The new carbon electrode based technique can cover more of the brain, and provide longer, more accurate neurotransmitter readings, than previously possible.

The goal is a better understanding of neurtransmitter related diseases, and potential therapies to boost dopamine levels, in conditions that dysregulate it, such as Parkison’s disease.

According to lead author Helen Schwerdt: “Right now deep brain stimulation is being used to treat Parkinson’s disease, and we assume that that stimulation is somehow resupplying the brain with dopamine, but no one’s really measured that.”


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VR for early neurodegenerative disease detection, personalized rehabilitation

Tomsk Polytechnic and Siberian State University scientists David Khachaturyan  and  Ivan Tolmachov have developed a VR based neurodegenerative disorder diagnosis system.  The goal is the early detection and tretment of diseases, including MS and Parkinson’s.  The next step is the use of VR systems, like Glass and Kinect, for personalized rehabilitation.

50 subjects, both healthy and already diagnosed, used VR headsets,  a non-contact sensor controller and a mobile platform during a variety of activities.  Changes in posture and balance were detected, and compared to a human  skeleton model of 20 points on the body.  Deviations from the model indicated disease.  Differences in reactions of those with difference diseases was also noted —  Parkinson’s patients experienced hand tremors, and others experienced compromised coordination.

A clinical trial  will be completed in 2017.


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Implant + wearable to track neuromodulation effectiveness

Medtronic is linking its implanted devices with Samsung’s phones and tablets to better monitor the effectiveness of neuromodulation technologies.  (Click to view Samsung release.)

Those with implanted neurostimulators, which  send electronic signals to targeted areas of the brain to block symptoms, can have a more active role in the management of their diseases.  Parkinson’s, essential tremor and dystonia patients will hopefully benefit from the initiative.

Data from the devices will be sent to a patient’s mobile devices, including phones, wearables and tablets, in real time.  It can also be sent directly to a doctor to help them better understand patient symptoms and progress, and appropriately adjust therapies.

The two companies announces a similar partnership for the management of diabetes earlier this year.


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NeuroTech NYC – June 8, 2016 @ the New York Academy of Sciences

 

Wearable + exercise app to improve Parkinson’s symptoms

MIO and Beneufit have partnered to develop wearables to target the symptoms of Parkinson’s disease.

The pdFIT exercise app was developed to improve manual dexterity and fitness levels in Parkinson’s patients.  The wearable continuously monitors progress via sensors on the wrist.

The company claims that its Optimal Heart Rate  technology cancels noise caused by movement, due to an added accelerometer.  This improves the accuracy of the heart rate monitoring algorithm.

WEARABLE TECH + DIGITAL HEALTH SAN FRANCISCO – APRIL 5, 2016 @ THE MISSION BAY CONFERENCE CENTER

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Study: Cancer drug improves Parkinson’s cognitive, motor functions

A small, early stage trial (with no control group) at Georgetown has  found that a small dose of the leukemia drug nilotinib (brand name “Tasigna” by Novartis) produced “meaningful clinical improvements” in 10 out of 11 patients.

The potential impact is significant, and the researchers believe that expanded studies will validate the  promising results. During the trial, participant dopamine levels increased so much that they were advised to reduce or stop taking other drugs.

The investigators reported that one participant, who was confined to a wheelchair,  was able to walk again, and three participants who could not speak were able to hold conversations.

The study marks the first time a therapy appears to reverse the “cognitive and motor decline in patients with these neuro-degenerative disorders,” according to Professor Fernando Pagan, who led the study with Charbel Moussa.

There has been some success with stimulation treatments for Parkison’s symptoms, and advances in early diagnosis and monitoring, but there is no known cure for this debilitating disease.  (See ApplySci Parkinson’s coverage, 2013-2015.)

Click to view Georgetown University Medical Center video.

WEARBLE TECH + DIGITAL HEALTH SAN FRANCISCO – APRIL 5, 2016 @ THE MISSION BAY CONFERENCE CENTER

NEUROTECH SAN FRANCISCO – APRIL 6, 2016 @ THE MISSION BAY CONFERENCE CENTER