Doctoral student in neuroscience, McGill University
In memory of Delphine Martin Graduate Student Award: $30,000 over two years
Subthalamic deep brain stimulation in Parkinson’s disease: Effect on the mobility of patients and their caregiver
Although it might seem obvious that someone with Parkinson’s disease will move more if he or she undergoes surgery to relieve the symptoms of the disease that inhibits their motor movements, what happens after surgery is surprising. Many people with Parkinson’s are no more physically active after surgery than they were before – even though their symptoms significantly improve.
For Jean-Francois Daneault, a McGill University doctoral student, this observation raises questions about a better approach to improving the quality of life for these patients.
“They’ve been living for so long with this disease, they become sedentary and it takes more than just relieving their motor symptoms to change that kind of behaviour,” says the neuroscientist.
Daneault draws this conclusion from surveys of patients before and after they undergo deep brain stimulation surgery. This procedure installs a small device that emits electrical signals in the brain area most affected by Parkinson’s. A successful outcome of surgery restores control over the body’s muscles, and eliminates the tremors and stiffness that are hallmarks of this disease.
Daneault, who studied kinesiology as an undergraduate student, is using his two-year grant from Porridge for Parkinson’s to examine the survey data in detail. He’s recommending that patients start exercise or physiotherapy programs before surgery so it’s easier to keep moving afterward.
He also suggests patients and doctors reconsider when to resort to surgery. Currently, patients typically receive drugs to treat their symptoms, and surgery is only performed when those drugs stop working, or begin to cause serious side effects. Daneault believes if surgery were an option even before either of those two things happened, people would spend less time being physically inhibited, making the transition to greater activity easier.
Restricted movement “takes a toll, not just on patients, but everybody around them,” Daneault says, noting that caregivers should also enjoy a better quality of life when a patient becomes more mobile and independent. “If we do the surgery earlier on, perhaps we’d have better outcomes.”
Daneault plans to finish his doctoral work by next year and continue exploring Parkinson’s disease at Harvard University, where he has been invited to join the laboratory of his post-doctoral supervisor.