The Power of Deep Brain Stimulation

Spring 2011

For the past 15 years, Blair Ford, MDCM’85, has studied the application of deep brain stimulation (DBS) in patients with Parkinson’s disease. Due to tremor, stiffness or slowness, Blair Ford’s patients often have difficulty performing even the simplest tasks, such as picking up a cup of water or writing legibly on a piece of paper. But relief can come with the flip of a switch for some Parkinson’s sufferers. By electrically stimulating selected deep brain structures through implanted electrodes, symptoms of tremor, rigidity, stiffness, slowed movement and walking impairment can be dramatically relieved.

Deep brain stimulators are implanted on both sides of the brain with connecting wires and batteries. Medtronic. www.medtronic.com

“Brain science has grown exponentially over the past two decades,” says Ford, who is a professor of clinical neurology at Columbia University in New York City. “However, despite huge biomedical advances, the deepest workings of the brain remain beyond our understanding.”

McGill was fortunate to welcome Ford to Homecoming 2010, where he presented his fascinating work at the annual Class of 1985 Seminar. Through a brief lecture and videos, attendees witnessed the dramatic results he has achieved.

Despite its powerful effect, DBS operates using a simple concept. In the brains of patients with Parkinson’s disease, the circuitry controlling motor activity is disturbed by abnormal electrical activity. Using an electrode to stimulate these areas, it is possible to restore the electrical activity towards normal, and thereby reduce unwanted motor symptoms. Despite its proven effectiveness, however, DBS is not a cure for Parkinson’s and is not recommended for certain patients, such as those with balance impairment, depression or memory problems.

Developed in France in the early 1990s, DBS has replaced all other forms of surgical intervention for Parkinson’s disease. Supported by clinical experience and advances in neurosurgery, neuroimaging, biomedical engineering and neurophysiology, DBS has been used clinically in tens of thousands of patients worldwide. The procedure is currently being tested for other central nervous system disorders, including depression, Tourette syndrome, dystonia (a syndrome of twisting movements) and obsessive-compulsive disorder.

“From a scientific perspective, the idea of improving people’s lives using implanted brain electrodes seems like science fiction. The practical reality is that many patients with Parkinson’s experience dramatic relief from their symptoms and live better quality lives, thanks to DBS,” says Ford.

After graduating from McGill, Ford pursued training in internal medicine and neurology, becoming increasingly interested in movement disorders. In 1989, he established Columbia University’s Center for Movement Disorder Surgery, which has grown to become one of the busiest sites for this advanced treatment in North America. The Center’s neurosurgeons perform approximately 60 deep brain stimulation implantations annually. Ford’s research focuses on the long-term outcome of treatment and the effects on quality of life, with the goal of identifying those individuals most likely to benefit. In addition, he is currently conducting a clinical trial of gene therapy for Parkinson’s disease.

So, what’s on the horizon in neuroscience research? “A deeper understanding of how the brain works will eventually lead to effective treatment for damaged brain cells, for brain cancer and for brain degenerative diseases like Alzheimer’s and Parkinson’s,” says Ford. “That is what the scientific community strives for.”

[Annette Mahon]

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