Bringing networks back online
Transcranial Magnetic Stimulation for cognitive enhancement in Parkinson's Disease: Evaluation of clinical effect and functional brain changes
The brain’s ability to rewire itself by forming new connections among neurons—a concept called neuroplasticity—is one of the most exciting, hopeful developments to emerge from brain research in the past three decades.
At the University of Calgary, Dr. Stefan Lang is building on this new knowledge of plasticity to try to improve the concentration, planning and decision-making abilities of people with Parkinson’s disease who are suffering from cognitive decline.
Lang is using a non-invasive technique called transcranial magnetic stimulation (TMS) to deliver rapid electrical pulses to the areas of the brain important for cognition. The pulses, generated by a strong magnet, are delivered at a specific frequency in a specific pattern, to encourage the brain to create new connections across damaged pathways.
Previously, TMS was used primarily to target the brain’s motor cortex, to improve motor function. Lang’s approach follows up on a pilot study that his supervisor, Dr. Oury Monchi conducted, which targeted the prefrontal cortex. That study showed some improvements in the attention span of people with Parkinson’s disease.
“We know that these brain networks are not working properly,” says Lang. “We’re hoping we can bring them back online (using TMS) and that could improve these cognitive abilities in people with Parkinson’s.”
Lang also wants to learn how many treatments people need to show improvements, and how long those improvements last.
Although he’s a neurosurgical resident, Lang has taken several years off those studies to devote to this research because he believes he can help more people with Parkinson’s by finding a technique to repair their brain networks than by treating individual patients.
He’s also convinced, though, that his clinical experience is critically important to his research—because he can focus on the real-world problems he sees in the clinic.
If Lang’s research does demonstrate that TMS can help rewire the brain to improve cognitive symptoms, it may benefit not only people with Parkinson’s disease but also those with ADHD, depression, schizophrenia and other neuro-cognitive disorders.
“I hope this will be translated into a clinical treatment that will be offered to people,” he says.