Stanford PD Community Blog

How neurologist Helen Brontë-Stewart is personalizing Parkinson’s treatment.

DBS is a technique developed in the 1980s and 1990s in which a surgeon inserts electrodes deep into areas of the brain that are affected by Parkinson’s, then connects them to a small, battery-powered device implanted in the chest that sends electrical pulses back to the brain. The stimulation helps modulate the electrical activity in the targeted brain area, reducing abnormal brain signals and, thus, symptoms. Krehbiel reached out to a neurologist who was conducting research on DBS: Helen Brontë-Stewart, a professor of neurology and neurological sciences who has spent much of her career seeking to understand, measure, and improve the brain’s control of movement in the body.

This study looked at 216 people with Parkinson’s over a two-year period who were just beginning to take levodopa medication.  The goal was to investigate “the development of motor/nonmotor fluctuations and dyskinesia based on gender.”  During these fluctuations, levodopa is less effective or starts “wearing off.”  During these “off periods,” both motor and nonmotor symptoms may return or worsen until the next dose of levodopa.  Interestingly, the study found that being female was the strongest predictor of whether someone would develop off-period fluctuations and dyskinesia, over a two-year period.  In the study, nearly 65% of women had fluctuations while about 53% of the men did.  And 14% of the women experienced dyskinesia while only 5% of the men did. 

There’s an interesting essay in today’s New York Times about the environment and Parkinson’s. Excerpt: “Some 90,000 cases of Parkinson’s are now diagnosed each year in the United States, about one every six minutes on average. It is the world’s fastest-growing neurodegenerative disease, causing tremors, stiffness and balance problems. It is also the 13th-leading cause of death in the United States. One factor in its increase may be the way we have come to live, for there’s growing evidence linking it to a range of pesticides and industrial chemicals, including paraquat and substances used in dry cleaning.”