The articles listed on this page are from a variety of sources. 
1. The staff of DBS-STN often attends conferences or educational opportunities both nationally and internationally, and a brief understandable write-up of the information presented at the event will be provided for our readers to review. 
2. DBS-STN staff also identifies or writes various articles related to topics that are thought to be of interest for the reader of www.DBS-STN.org. 

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Neural Interfaces Workshop

The Parkinson Alliance/DBS-STN Research Team

November 15-17, 2004 Bethesda, Maryland From November 15 through 17, 2004, The Parkinson Alliance attended the "Neural Interfaces Workshop," which was a convention wherein the Annual Neural Prosthesis conference and the National Institute of Neurological Disorders and Stroke's DBS (Deep Brain Stimulation) Consortium came together to present advancements in our understanding and treatment of the brain.

We presented our research on "Quality of Life and the Role of Depression for DBS-STN Parkinson's Patients," which you can find on this website. The research we presented was well-received by the clinicians and researchers alike, and they are eager for us to continue providing feedback to them from the "patient's perspective."

To set the tone for this gathering, Dr. Joseph Pancrazio of the National Institute of Neurological Disorders and Stroke (NINDS) kicked-off the conference with an interesting point that highlighted the evolutionary aspect of our understanding of the brain. What was previously thought to be a "problem of the mind" has continued to evolve into a greater understanding that problems exist in the brain, specifically as it relates to changes in chemicals and brain structures. Centuries ago, Hippocrates stated, we "ought to know that from the brain and from the brain only arise our pleasures, joys, laughter, and jests as well as our sorrows, pains, griefs and lamentations. ... It is the same organ which makes us mad or delirious, inspires us with dread and fear, whether by night or by day, brings us sleeplessness, inopportune mistakes, aimless anxieties, absent-mindedness and acts that are contrary to habit... all these things we endure when the brain is not healthy."

As scientists from years ago began to realize that the "make-up" of the brain itself could impact its very function, individuals have come to find that some human behavior may not be attributed to an intangible mental construct, but rather an organic problem within the structures of the brain. Monumental advancements in this "understanding" have been made over the past two centuries, and particularly during relatively recent years. This conference demonstrated that we are gaining information in great magnitude about problems related to chemical changes/imbalances and neuroanatomical anomalies.

To date, we continue to find new paradigms wherein individuals are finding focal problems in the brain (within specific brain structures). As such, research scientists and clinicians are making extraordinary advances with both pharmacological therapies to help with neurochemical changes and focal stimulation to activate or inhibit specific anatomical structures, which will ultimately optimize brain function. Moreover, advancements in technology are helping us to reach optimal function of the brain, particularly after one develops a neurological injury or disease.

This technology will not only provide a better understanding about the mechanisms behind specific illnesses, but it will also pave avenues for remarkable treatment that can improve one's health, both physically and mentally, which will likely impact one's quality of life.

The presentations related to Deep Brain Stimulation covered a variety of areas (e.g., treatment with a variety of disorders, Parkinson's Disease, Huntington's disease to name a couple; as well as the neuroanatomical structures that are contributing to these respective illnesses). Some of the presentations provided a delightful, descriptive overview of DBS for Parkinson's disease patients, and other presentations were more in-depth and complex. If you are curious about an overview of DBS for PD patients, please review the "articles" on this website. With regard to the latter, the researchers attempted to provide a greater understanding about the pathophysiology (alteration in function as distinguished from structural defects) of Parkinson's disease. Moreover, they addressed the neuronal and cellular levels and how specific activity within the brain becomes "bursty" - increasing its firing rate between neurons within the brain (sending messages between structures in the brain). These bursts can either activate or inhibit actions within the brain. Within the context of PD, it is the lack of activity and/or inhibition of some neurons and overactivity in others that cause the motor symptoms of this disorder. Although the neurochemicals in the brain can accomplish this "firing" accurately when the chemical balance is within normal limits, it is this action and/or inhibition that deep brain stimulation induces to alleviate some of the motor symptoms of PD, since the neurochemicals are disturbed. Although the presenters identified significant progress in our understanding of the clinical deficits of PD as it relates to neuroanatomical damage or deficiencies, the true understanding about pathophysiology in this disease is still under debate. Brain structures are composed of many neurons and are characterized by complex interactions, and researchers continue to diligently investigate this scientific enigma. The take-home message is that research continues to explore these brain structures and how the chemicals within the brain, and now the deep brain stimulation, interact with them, which will eventually lead to improved treatment for PD. We would like to mention that although there were no presentations that discussed the importance of "programming" and "adjusting" the deep brain stimulator to better manage PD symptoms, it is quite evident that we have more homework to do to increase our understanding about this treatment. Moreover, through informal conversation and with the noticeable lack of formal discussion on this important facet of deep brain stimulation, it is vividly apparent that further research needs to be conducted. Specifically, it is clear that we need to continue investigating the benefits of DBS-STN (as well as its limitations), with a greater emphasis on the programming that succeeds the implantation. Furthermore, research scientists and clinicians are becoming more and more aware that programming and periodic adjustments following DBS-STN are critical in the effectiveness of the operation of the stimulator, but standardized approaches involving programming and adjustments have yet to be established. We want to inform you that The Parkinson Alliance is actively involved in sharing the creation and funding of a DBS educational program reform with "WE MOVE." Therefore, we can hopefully educate programmers to understand how to do adjustments to alleviate specific symptoms for each patient, and better understand the synergy between medication and stimulation. In closing, science continues to make impressive advancements in our understanding and treatment of the brain. We would encourage you to review the research summaries that we have provided on our website, DBS-STN.org, to gain a greater understanding about research that has enhanced our knowledge about DBS-STN for PD patients.



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