Deep brain stimulation

And, you know, I, I saw patients that were twice as sick, you know, every time I saw them and, and meds weren't helping.

And I said, "No, you know, I've just-- I've, I got to be a researcher." And so actually what I did then was I had to do not just one, but really two fellowships, one to catch up for some of the things I should have learned in a PhD, and the next into the neuromodulat- neuromodulation domain, which at that point was, uh, largely deep brain stimulation, vagus nerve stimulation, things in that space, much more invasive.

TMS didn't really exist yet.

But it's not a, it's not a direct path.

What I am using is a fraction, a tenth, a hundredth of that energy to modulate the brain instead.

Its advantage, the thing that makes it so exciting for me, is that unlike our other forms of brain stimulation, it is able to reach deep into the brain, be highly focal, so at millimeter scale and reversible.

And so what is this? This is, this is non-invasive, reversible, deep brain stimulation.

Um, and this is an opportunity to get at, I'll call them maybe the signal generators, the core subcortical structures that we know are involved in every one of our illnesses, but they're just out of reach until now.

And still practiced for a couple of years and then ended up deciding to retire in large part because of the Parkinson's.

And Stan, you also recently had DBS, right? So that's another part of your story.

DBS about last November, which was about eight, nine months ago.

Yep.

And Doug?

Stan, I think you had the next question, and this is maybe getting to the core of the issue.

Emerging therapies are exciting, but they aren't necessarily going to make our lives less complex in all ways.

We already have a lot of hard decisions with already approved therapies, and especially with the development of vial of an APCO, the infusion therapies, and DBS, all the advances that are being made there.

And we will disclose here that David Burdett also has a relationship with NeuroPace.

Now, shifting gears slightly from RNS to DBS or deep brain stimulation.

Yes, a slightly different approach.

Right.

So the Thuberg study looked at 14 patients who underwent DBS insertion.

Okay.

And they observed a mean of 57.1% reduction in seizure frequency just one month after the insertion.

Yeah, this raises an important question about how we forecast patient outcomes.

Happily.

So the DBS service, I'll start maybe by saying what DBS service or what DBS really is, because not everybody knows what it is.

I think speech and language therapists do have a very good handle, but just for people that maybe, you know, it hasn't come on their radar, it's a surgical procedure aimed at helping people that have movement disorders and maybe where pharmacological treatments are no longer working for them.

So conditions that spring to mind are Parkinson's disease, maybe an essential tremor and dystonia.

I interviewed for that job when I was on maternity leave in 2018 with my first son and The job came about through the work of Professor Tim Lynch, a neurologist that I've worked with here in the matter and the Dublin Neurological Institute for many years.

He's worked tirelessly behind the scenes to obtain funding to create that service.

Similar to what, you know, years ago we'd have had patients going to the UK through the treatment abroad scheme for DBS, but he really wanted to set up a service in Ireland.

So I think he and I have always worked well together.

Such seizures demonstrate that consciousness can be switched off and on in a matter of moments without stopping other brain functions like breathing, posture, or even basic movement.

deep brain stimulation can switch awareness on and off.

Deep brain stimulation, DBs, involves implanting electrodes into specific brain regions to deliver precise electrical pulses.

Originally developed to treat movement disorders like Parkinson's disease, DBs has also shown striking effects on consciousness in certain patients.

In rare cases, stimulation of the thalamus, a major relay hub for sensory signals, has restored awareness in people previously in minimally conscious states.

Conversely, stimulating some areas can momentarily disrupt awareness, almost like flipping a switch These findings suggest that consciousness depends on a delicate balance of activity across interconnected brain networks, and that manipulating these networks electrically can profoundly alter mental states.

While DBs is not a cure for disorders of consciousness, it offers valuable insight into the circuitry that supports our sense of being awake and aware.

Narcolepsy can cause people to collapse directly into REM sleep.

And that kind of puts a hole in the wrench, you know, for the next day.

So you haven't had the DBS surgery yet.

No, I haven't.

I've been able to monitor my path with exercise for the most part.

...

the pattern of activity that accompanies a patient when they're at their most lucid, and then try and stimulate that same pattern when they're at their least lucid? Um, and that's an idea that we've been throwing around for a year or so now with people that use so-called deep brain stimulation, which is a treatment that's used very effectively for Parkinson's disease now, where you, you put a, a microelectrode into the brain, you stimulate a part of the brain, and in the case of Parkinson's disease, it can control some of the symptoms.

Well, you know, there's, there's reasons to believe you could extend that to trying to, uh, if you, if you like, sort of, um, kickstart consciousness in some of these patients by stimulating the parts of the brain that are required for them to have some kind of subjective experience.

You can see why I called it science fiction.

Hey everyone, it's Jessica from The Secret Life of Parkinson's.

Um, there's a couple things that I wanna talk-- Well, actually, there's just one thing I wanna talk about, and it's, um, this, the symptoms that I didn't, I knew that DBS wouldn't cover, but it's something that I didn't really think about as much as I've been thinking about this past two weeks.

So I'm gonna show you two videos real quick.

One is gonna be when, uh, it's last year before my DBS of how dyskinetic I would be towards the end of the day.

Um, and then the other one is going to be, um, when I was working, so it's the same timeframe.

It's around last April of twenty-twenty five, and it shows the non-motor symptoms.

It was really the stiffness.

It was really difficult to, to deal with that.