For more than two decades, doctors have been able to reduce many symptoms of Parkinson’s disease through deep brain stimulation (DBS). DBS uses implanted electrodes to deliver electrical stimulation deep within the brain. But one symptom continues to elude treatment: “freezing of gait” (FoG), which makes it hard to walk and can lead to dangerous falls.

In order to clear the FoG, Luka Milosevic, a researcher with University Health Network in Toronto, is deploying a new kind of electric stimulation, better attuned to FoG’s distinctive signature. This could result in major advancements in taming a disease that robs more than 100,000 Canadians of many aspects of their life and dignity.

“The study could lead to a more sophisticated application of DBS for all Parkinson’s symptoms in addition to FoG (Freezing of Gait)”
– Luka Milosevic

In the past two years, advancements in the medical device industry are allowing DBS implants to not only deliver stimulation, but to perform wireless readings of brain activity in real time. Previously, wires or bulky machines would impede a patient’s ability to freely walk around while recording brain activity, making the causes of FoG notoriously difficult to pinpoint – and treat.

The new technology will help illuminate the unique “signature” of FoG in the brain, and highlight potential areas and strategies for targeted stimulation.

“FoG is a very stubborn feature of the disease, which made me interested in trying to understand the neural underpinnings of these gait difficulties,” explained Dr. Milosevic. “Perhaps once we understand more about the physiological features, then we can develop targeted therapies to ameliorate the symptom.”

Beyond the implications for FoG, Dr. Milosevic said the study could lead to a more sophisticated application of DBS for all Parkinson’s symptoms.

Currently, DBS indiscriminately delivers stimulation 24 hours a day. However, if researchers can learn more about which brain activity is tied to particular symptoms, they can deliver targeted stimulation only when necessary.

This shift could help preserve a device’s battery life – a critical need, as changing a device’s batteries requires surgery – and help reduce the side effects of DBS.

“The number one priority is to improve a patient’s gait, to give them their mobile independence back and enhance their quality of life,” said Dr. Milosevic. “But this study also signals a strategic shift in DBS delivery methods. We want to advance the technology as a whole. This will have implications on any symptom and any brain disorder in which DBS is a potential therapeutic option.”

Dr. Milosevic is a recipient of a 2020 Future Leaders in Canadian Brain Research Grant from Brain Canada, which is funding this project. The Foundation’s signature grant program – which will support up to 100 early career researchers in five years – is designed to invest in the boldest and brightest ideas at the most critical juncture of a researcher’s career: the beginning.

“We are giving promising researchers the jump-start they need to explore
daring, innovative and high-potential lines of research that could help us
find solutions to diseases such as Parkinson’s”
– Viviane Poupon

“By providing this early-career support, we are giving promising researchers the jump-start they need to explore daring, innovative and high-potential lines of research that could help us find solutions to diseases such as Parkinson’s,” says Brain Canada President and CEO, Dr. Viviane Poupon. “It is an investment today that is sure to yield breakthrough discoveries for the challenges of tomorrow.”

“This grant gave me the opportunity to do something that is truly exciting for me, and that I know is a health care priority,” said Dr. Milosevic.

To learn more about Brain Canada-funded projects, please visit braincanada.ca

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