Parkinson's disease typically starts with a tremor in the hands, but the progressive degenerative disorder of the nervous system leads to slowed movement, rigidness and slurred speech that worsen over time.
While there's no cure, symptoms can be eased either through invasive brain surgery or medication that can leave sufferers with involuntary jerks or tics.
Now a group of students led by researchers at the Johns Hopkins University have developed what they hope will become a third option: a non-invasive device Parkinson's patients could use at home to treat their symptoms.
"I think this kind of research is very valuable in terms of providing more flexibility for the patient," said Yousef Salimpour, a research associate neuroscientist at Hopkins who helped the students come up with the device. "I know many don't like surgery and don't like the side effects of the medication. This may be very valuable in terms of reducing the amount of medication or prolonging the time before surgery."
The 3D printed device, called STIMband, fits over a patient's head and positions electrodes over the part of their brain that controls movement, allowing patients to apply painless electrical stimulation to those areas for up to 20 minutes a day, easing their symptoms.
The spongy electrodes send a small amount of current into the brain, which is thought to change the level of dopamine.
"When you use it on the patient, you see results," Salimpour said. "But how it works, we don't know."
Roughly 1 million people suffer from Parkinson's disease in the United States. While it's not fatal, it can cause deadly complications, sometimes from falls caused by problems with movement. In its later stages, it also can cause depression, dementia, and other problems like sleep disruption. Well-known people with Parkinson's include actor Michael J. Fox and boxer Muhammad Ali.
The five-student team at Hopkins worked with about 40 people with Parkinson's disease who wore the device and gave advice on how to improve its fit and comfort. The team ran some preliminary tests with the device and saw some symptom improvements in patients, but has not yet performed formal clinical trials.
The STIMband won a second prize in VentureWell's BMEidea national design contest for biomedical and bioengineering students in June, and a first-place prize at another Hopkins competition. It was also a finalist in the Rice University Business Plan Competition.
David Blumenstyk, a student on the team whose grandfather died of Parkinson's disease in 1995, said the patients offered encouragement.
"We come from engineering backgrounds and we're removed from the problems we solve," said Blumenstyk, who graduated this spring with a degree from Hopkins' Center for Bioengineering Innovation and Design. "That was really different from what we expected, seeing patients' reactions and hearing their thoughts, how much support and interest they had. A lot of them wanted to be involved in the process, they wanted to sign up for clinical trials, they wanted to know if they could get it, they wanted to know whatever they could do to help us."
Ian Graham, another student on the development team, said working with the patients was key to troubleshooting issues like how to properly position the electrodes over the right part of a patient's head.
"I was expecting them to be a little more apprehensive, but all of them were willing to try on the headset even in the early stages," Graham said. "One of the patients said that before the early trials, he slept maybe one hour a night. After he said he slept five nights in a row through the night."
Before working with the students to develop the device, Salimpour had been developing non-invasive brain stimulation using electrodes placed on a patient's head.
Deep-brain stimulation has long been used to reduce some of the motor-related symptoms of Parkinson's, like stiffness and tremors, said Howard Eisenberg, a professor and the chair of neurosurgery at the University of Maryland School of Medicine. It doesn't help with symptoms like dementia, he added.
The procedure, which involves surgically inserting electrodes deep into the brain, comes with a small risk of rupturing a blood vessel and causing a stroke, he said.
The invasiveness and risk of traditional deep-brain stimulation spurred researchers like Salimpour to study ways to get stimulation into the brain without invading the skull, Eisenberg said.
While it remains to be seen how effective the device will prove in clinical trials, "they should be congratulated" for developing it, Eisenberg said.
The team obtained provisional patents covering the design of the device and would like to move ahead to obtain approval from the U.S. Food and Drug Administration, a process that can take years. This fall, another group of students will take over the task of further refining and improving the STIMband.