Gail Jardine says it’s a bit like changing the channels on a television. Never has wielding a remote control, however, been so life altering.Jardine is referring to the electrodes implanted in her spine in late December, and the device that turns them on and adjusts their frequency, an experimental treatment for Parkinson’s disease being spearheaded by a Canadian team.Until a few months ago, the former school board employee would frequently freeze as she was walking – and fall over – a common and debilitating symptom of the condition.Now the so-called spinal-cord stimulation she is helping test has eliminated the problem and transformed her daily routine like “night and day.”“I walk with my husband,” said the 66-year-old London, Ont., resident Thursday. “I can go around the house without a cane. I can play with my grandkids, do all the things I used to do.”
Parkinson’s patient Gail Jardine with husband Stan recently on a walk that she says would not have been possible before receiving experimental spinal-cord stimulation treatment.
Lawson Health Research Institute
Jardine is part of research by a team at London’s Western University, which is using electrical pulses into the spine to target walking impairments that can be all but impossible to treat otherwise.Dr. Mandar Jog, the neurologist leading the work, has published just one paper involving the initial five patients — last May — and cautions that it is early days, far from “fixed and finished.”Other experts have noted such symptoms have a subjective element and are susceptible to placebo effect.But he says the results to date have been surprisingly promising, making dramatic improvements in many of the patients enrolled in his trials.Two who had been housebound and reliant on wheelchairs went on vacations under their own steam — one leaving his wife in tears at the change — while others have eliminated repeated falls that can have disastrous effects.“We’re not making people run the Boston Marathon, that’s not the idea,” Jog said. “We’re not curing the disease, but … even getting people to not fall is a big deal for them.”Parkinson’s occurs in people whose brains fail to produce enough dopamine, a chemical that carries signals between brain cells and controls movement. The result can be tremors, slowness and stiffness, impaired balance and rigidity, among other symptoms.Even getting people to not fall is a big deal
Treatments include drugs that spur dopamine production and, for less than 10 per cent of patients, deep-brain stimulation, where electrodes are implanted in the brain.But the drugs do little for gait problems such as those Jardine had, and deep-brain stimulation can actually make them worse, Jog said.Scientists working with Parkinson’s-suffering rodents and primates had reported good results with spinal-cord stimulation as long as a decade ago.Yet researchers were slow to follow up with human trials, leaving one leader in that science, Duke University’s Miguel Nicolelis, “frustrated that people haven’t really trusted his work,” Jog said.The Canadian and his colleagues at Western’s Lawson Health Research Institute are among a few teams worldwide to experiment in people.With an out-patient procedure that takes about an hour, electrodes are implanted in the spine. Patients use the “remote control” to adjust the frequency, as well as turn on and off the generator when they wake in the morning and at night .
Parkinson’s patient Gail Jardine with Dr. Mandar Job in his lab at Western University.
Lawson Health Research Institute
Jog says his research suggests the jolts of electricity in effect “reawaken” or trigger established walking patterns. The study uses sensor-based technology to objectively measure changes.The paper published last year on the original five subjects reported improvements after six months in step length and speed, ability to stand up from sitting position and confidence in walking. And freezing of gait — known among neurologists by the evocative acronym FOG — was all but eliminated.Five years after those pioneers were first treated, one has died, one saw improvements taper off after three and a half years, but the other three continue to enjoy the changes, Jog said.Still, there are skeptics. In a letter to the journal that published the Western paper, Dr. Erich Talamoni Fonoff of Brazil’s University of Sao Paulo acknowledged the idea’s promise but noted “it is well known that some PD symptoms can improve remarkably with placebo.”Freezing of gait, in particular, is highly influenced by attention, stress and environmental distractions, he said. Fonoff called for double-blind trials, in which a control group of patients receives a dummy procedure to compare against the real treatment. Jog admits it’s theoretically possible his subjects have been experiencing a placebo effect, but said randomized controlled trials would be difficult to properly conduct with the spinal-stimulation technology.And, he suggested, the placebo issue is of questionable relevance if patients continue to do well years later.Meanwhile, his team is also trying spinal-cord stimulation on another 10 Parkinson’s patient and on people with other movement disorders, such as progressive supranuclear palsy – for which there is virtually no treatment. It could also help the many sufferers of “vascular gait disorder,” whose movements have been impaired by mini strokes.Jardine was diagnosed 12 years ago nd eventually had to quit her job as an education analyst, stop driving and be all but housebound.“I had freezing really bad. Your feet just lock up and you just topple over,” she said. “I was fortunate I hadn’t broken anything.”Jardine is convinced that what started four months ago is much more than a mere placebo effect and sees no signs of the stimulation’s benefits wearing off.In fact, she said, “I’m feeling it more and more.”• Email: email@example.com | Twitter: tomblackwellNP