Does DBS Cause Changes in Personality?

Since 2002, deep brain stimulation (DBS), the surgical implantation of a pacemaker-like device that sends electrical impulses to targeted parts of the brain, has been used as a treatment for motor symptoms of Parkinson’s disease (PD). But are patients trading part of their sense of self in exchange for improved mobility?

Packed house for INS annual meeting talk on DBS.

In the last decade, a growing number of published articles have raised the concern of personality changes in PD patients as a result of DBS, and tried to discern if the concern is real or overblown. At Thursday’s International Neuroethics Society (INS) meeting discussion “DBS: Continuity of Self,” panelists aimed to add clarity to the debate. “Speculation shouldn’t be divorced from clinical reality,” said panel moderator and ethicist Hannah Maslen, who introduced the session.

The speakers, philosopher and neuroethicist Frederic Gilbert, neuropsychologist Cynthia Kubu, behavioral neurologist Winston Chiong, and ethics researcher Jonathan Pugh, offered a range of perspectives. They largely focused on the state of the evidence and why it’s so difficult to assess personality changes in patients.

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Living with Parkinson’s

Alan Alda at Columbia cropped

Best known for M*A*S*H*, Alan Alda has also appeared in 48 films, on Broadway, and written two books. Photo credit: Eileen Barroso, Columbia University

It was hard to miss Alan Alda’s announcement this week on CBS This Morning that the legendary actor had been diagnosed with Parkinson’s disease more than three years ago. Alda, 82, said one of the reasons he was speaking out was to offer a message of hope to people who are living with the disease: “In the very beginning, to be immobilized by fear and think the worst thing has happened to you – it hasn’t happened to you. You still have things you can do. I’m taking boxing lessons three times a week. I do singles tennis a couple of times a week. I march to Sousa music because marching to music is good for Parkinson’s.”

Through the years, our Dana Foundation publications have often focused on both Parkinson’s disease and Alda’s passion to better communicate science to the public, which is part of our mission as well.

In 2015, about the same time that Alda learned he had Parkinson’s, I wrote “Alda Crushes It,” a blog on Alda’s lecture at Columbia University, entitled “Getting Behind a Blind Date with Science.” In this captivating lecture, co-sponsored by Dana and the Kavli Foundation, he talked about why he had co-founded his own center for science communication at Stony Brook University and how he had been inspired by his time as host of Scientific American Frontiers, a PBS program that explored any number of topics. He was engaging, insightful, and his enthusiasm was contagious.

A year later the publication I edit, Cerebrum, reviewed Alda’s new book If I Understood You, Would I Have This Look on My Face. We asked Eric Chudler, a neuroscientist at the University of Washington and the executive director of the Center for Sensorimotor Neural Engineering in Seattle, to tell us what he thought. Chudler wrote: “With humor and a clear, concise, and never stilted writing style, Alda takes readers on his journey to help experts convey neuroscience and other complex scientific topics to a variety of audiences.”

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In Memoriam: Nobel Laureate Arvid Carlsson, a Pioneer in Parkinson’s Treatment

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Photo: Johan Wingborg/University of Gothenburg

We regret to announce the loss of Dana Alliance member Arvid Carlsson, M.D., Ph.D., who passed away last Friday at 95 years old. Carlsson laid the groundwork for the treatment of Parkinson’s disease by discovering dopamine is a neurotransmitter that plays an important role in motor function. In 2000, this research won him the Nobel Prize in Physiology or Medicine with fellow Dana Alliance members Eric R. Kandel, M.D., and Paul Greengard, Ph.D., “for their discoveries concerning signal transduction in the nervous system.”

In 2001, Dana Alliance member John H. Byrne, Ph.D., wrote a Dana Foundation Cerebrum article to commemorate the 2000 Nobel Prize in Physiology or Medicine. He detailed Carlsson’s journey to his Nobel Prize winning research on dopamine:

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National Parkinson’s Awareness Month Interview with Robert Edwards, M.D.

Parkinson’s disease (PD) is a chronic, degenerative neurological disorder that affects roughly one in 100 people over the age of 60. With no biomarker or objective test to make a definitive diagnosis, PD has kept researchers searching for clues on how to treat, and hopefully prevent, the disease.

April is National Parkinson’s Disease Awareness Month, and so we sat down with Dana Alliance for Brain Initiatives member Robert Edwards, M.D., who specializes in the treatment of PD at the Parkinson’s Disease and Movement Disorders Clinic. Edwards is a professor of neurology and physiology at the University of California, San Francisco. His lab has received international recognition for demonstrating that vesicular monoamine transport protects against MPTP toxicity, suggesting an important mechanism that may also protect against Parkinson’s.

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Robert Edwards, M.D.

Regular exercise is proven to have positive effects on gait speed, strength, balance, and overall quality of life for people with PD. Though studies are still limited, dance therapy is said to greatly improve quality of life for this group, even more so than typical exercise. Can you talk a little bit about this?

RE: I am not an expert in this area, but exercise has clear short-term effects on function and for those more severely affected, on quality of life—those earlier in the disease are doing pretty well in any case. Presumably, exercise helps by improving the function of the basal ganglia circuitry that controls movement, much as it would in normal individuals. Dance therapy focuses on balance and other aspects of motor function different from standard exercises, so might be expected to add something new. Continue reading

Unlocking the Diseases of the Brain

Guest blog by Carl Sherman

One evening last week, I met the mini-brain.

I was introduced to this intriguing concept by three scientists who know it intimately, at a presentation on “Unlocking Diseases of the Brain with Stem Cells,” at the headquarters of the New York Stem Cell Foundation (NYSCF).

Melissa J. Nirenberg, M.D., Ph.D., NYSCF’s chief medical officer, introduced the subject from the perspective of a neurologist with 20 years’ experience, primarily with patients with Parkinson’s disease and other movement disorders.

“It was frustrating,” she said. While treatment can attenuate some symptoms for some patients, “we don’t have anything to offer them to halt or even slow disease progression.” The same goes for Alzheimer’s. “That’s why I’m here. At NYSCF, we’re focusing on treating the underlying disorders.”

Science Laboratory

Image: Shutterstock

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