Brain stimulation could treat anxiety in people with Parkinson’s, scientists say | Parkinson’s disease

Scientists say brain stimulation could be used to treat anxiety in people with Parkinson’s disease, after they made an “exciting” discovery about brain waves.

More than 10 million people worldwide are living with Parkinson’s, and about one in three have troublesome anxiety that affects their daily life.

Deep brain stimulation (DBS) is already offered as a treatment to help with the physical symptoms of the disease, such as stiffness, slowness and tremor.

But now experts are hailing a “fantastic” breakthrough in their understanding of a specific brain wave, which they say “opens the door” to DBS being harnessed to relieve symptoms of anxiety.

Dr Lucia Ricciardi, a senior lecturer in neurology at City St George’s, University of London, and a co-lead author of the research, said: “Anxiety has been recognised as a major unmet therapeutic need in Parkinson’s disease, and our results now offer hope.

“We show that deep brain stimulation has the potential to have wider-reaching benefits for people living with Parkinson’s than we previously thought.

“It opens the door for us to explore new and advanced neuromodulation treatments tailored to individual patients’ needs to relieve anxiety and a range of other symptoms.”

Research teams at City St George’s and the University of California, San Francisco (UCSF) recruited 33 people with severe Parkinson’s who were having DBS surgery to tackle their physical symptoms.

Neurosurgeons implanted tiny electrodes into their brains and then tracked different types of brain waves in three different settings in the UK and US with different devices.

Ricciardi said: “We discovered for the first time that there’s a strong connection between brain activity in a part of the brain called the basal ganglia, and anxiety levels in people with Parkinson’s disease.

“When we measured the brain waves, we found that higher levels of a type of brain wave called theta power were linked to more severe anxiety.”

The team suspected that there might be some connection between this type of brain activity and anxiety, Ricciardi said. “But we were surprised to see just how strong this link was. This strong link was found across three groups of patients in different locations with different devices – which shows just how robust these results are, which is an exciting step forward for us.

“This finding is fantastic as it opens new avenues for us to explore, which will help us understand what’s happening in the brain to cause anxiety in Parkinson’s disease.”

Despite the huge number of people with Parkinson’s who are affected by anxiety, for decades there has been a big gap in understanding the underlying biological causes, and treatment options have been limited.

Ricciardi said: “Although it’s still early days, our goal is to take this research and develop a DBS system that can automatically adjust to help manage anxiety. The idea is that by sending targeted signals to the brain, we can help balance the activity that’s related to anxiety. This could help people feel less anxious and improve their mood.

“Essentially, we want to make a treatment that responds to how the patient is feeling in real time, which could lead to better results for those dealing with anxiety.”

One of the patients who took part in the study, Jonathan Lovett, said: “It would be a huge step forward if DBS could help deal with non-motor symptoms such as anxiety.”

In his case, anxiety was one of the “early markers” of the disease, the 73-year-old from Surbiton, south-west London, said, “so much so that I spent almost two years in analysis trying to figure out why I was continually sad and on edge”.

He added: “Parkinson’s is a complex disease, almost impossibly so, and advances in technology that allow sophisticated and intelligent control of the devices set to work on brain behaviour, gathering data, remote monitoring, fine-tuning medication, trends and pinch points could be life-changing.”

Dr Simon Little, an associate professor of neurology at UCSF, co-led the study, which was supported by the UK’s Medical Research Council and the National Institutes of Health in the US.

He said he hoped the discovery would not only help people with Parkinson’s but might also provide insight into how to treat anxiety in people who did not have the condition.