Stimulating-1.jpg

Stimulating Research on Parkinson’s Disease

Above

Dr. Michael Rezak, MA ’72 is the medical director for the Movement Disorders Center and heads the Movement Disorders Functional Neurosurgery Program at the Neurosciences Institute of Central DuPage Hospital. He also serves as medical director for the Parkinson’s Disease Research Society and the APDA Midwest Information and Referral Center and National Young Onset Center. 

Calling deep brain stimulators “virtually miraculous for the right patient,” Dr. Michael Rezak, MA ’72 is a member of a group of medical experts who implant the devices within the brains of patients suffering from Parkinson’s disease and other movement disorders. Rezak, a neurologist, teams up with a nurse specialist, neurophysiologist, and a neurosurgeon to provide this breakthrough procedure that can dramatically restore normal function.

Last March, Windy City Live presented by ABC’s Chicago affiliate featured Dr. Michael Rezak, MA ’72 discussing an inspiring success story due to life-altering advancements in Parkinson’s disease research. One of his patients astounded audience members as they watched a video of her movements with and without turning on her deep brain stimulator (DBS). The must-see video is quite dramatic in terms of what the stimulator has done for her. “She has gone from non-functional in her 50s to being productive and happy,” Rezak noted. “We actually turned off the stimulator, so the audience could see the involuntary and uncomfortable movements of Parkinson’s; they were amazed. Within about 30 to 60 seconds of turning the device on, she was moving normally again. It often takes a few days to experience the full effect of the stimulation, but this particular patient reacts like a light switch. She told the audience that the procedure gave her back her life. When we witness how we impact lives, it renews our energy to keep researching.”

With an impulse generator surgically positioned under the skin of the chest, the deep brain stimulator works through high-frequency electrical stimulation signals affecting a particular group of neurons within the brain’s movement circuit. For Parkinson’s, the device is implanted in the subthalamic nucleus or the globus pallidus. For other movement disorders, different areas of the brain are targeted.

Rezak explained that Parkinson’s disease begins with the loss of dopamine, a neurotransmitter in the brain. This loss upsets a certain circuit in the brain that is instrumental in smooth movement, and the signals are highly abnormal as a result; however, the DBS can re-regulate those signals and restore much more normal movement. “Similar to how a pacemaker affects the heart, the DBS regulates those signals. Of course, it is much more complicated than a pacemaker because the brain is such a vastly complex organ,” Rezak added.

After his patients’ initial recovery from the implant surgery, Rezak said they aren’t aware that the DBS is there. The implant is usually activated one month after surgery to allow swelling in the brain to subside. Prime candidates for this procedure include those whose illnesses have progressed to the point where medication no longer manages the symptoms. With his patients’ health at the heart of his research, Rezak said, “It pains me to know how many people could benefit from the implant procedure but aren’t aware of its availability.”

With nearly 10 million Parkinson’s sufferers worldwide, Rezak said the degenerative disease is especially challenging for young patients because of their families, social lives and careers. As a result, early detection, diagnosis, and management of the symptoms of movement disorders, primarily Parkinson’s, are key to his research at Central DuPage Hospital in Winfield, Ill. Unfortunately, people lose about 80 percent of their dopamine before they experience their first motor symptom.

In the midst of a building program, Rezak’s hospital is supporting a million dollar research lab and has hired a molecular neurobiologist. “We’re actually drilling down to the level of protein abnormalities in Parkinson’s and the idea that Parkinson’s disease is a prion — or infectious — disease; we have evidence that there is some transmission of the abnormalities that we see in cells from one group of cells to the next, and that’s how the disease actually involves more of the brain over time,” Rezak explained. “For example, our neurobiologist is looking at the abnormality in the protein and trying to figure out how we can rectify that. Researchers placed Parkinson’s dopamine cells in a Petri dish with normal cells, and one week later, the normal cells had the pathological, abnormal lewy bodies; the abnormality found in diseased cells had migrated inside the healthy cells. We are pushing hard to find the answers.” 

Online

Visit bradley.edu/go/ht-BrainStimulator to view the Windy City Live video.

As a movement disorders researcher since 1992, Rezak noted that only a small percentage of Parkinson’s disease is inherited. “My hunch is that Parkinson’s is caused by a combination of something in the environment — such as pesticides and herbicides — along with a person’s genetic predisposition to develop Parkinson’s,” he remarked. Research shows that huge numbers of Parkinson’s patients live in farming areas such as Nebraska, where people drink well water and are exposed to toxins that leak into the groundwater.

Parkinson’s researchers also have determined two major findings that Rezak is currently examining: the significance of rapid eye movement (REM) sleep disorders and the loss of smell as early symptoms of the disease. At an international meeting, he presented a paper on the importance of a DaTscan, an imaging technology that uses a small amount of a radioactive drug to enable physicians to measure dopamine levels in the brain. Rezak also incorporated a test based on 176 smells. “There is no question that people who have positive DaTscans showing loss of dopamine also have a loss of the sense of smell,” he noted. “REM sleep disorders also present a major risk factor. Research shows that 40 percent of people with REM sleep disorders will eventually develop the chronic disease or a variant of it. These may be two of the most significant findings right now.”   

— Karen Crowley Metzinger, MA ’97