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A stimulating mind

October 25, 2010


Dr. Jerrold Vitek.

Jerrold Vitek is an expert at deep brain stimulation, a promising treatment for Parkinson's disease and other movement disorders.

Photo by Richard Anderson

Neurologist Jerrold Vitek is out to mobilize his department—and patients

By Deane Morrison

For people with Parkinson's disease and other movement disorders, the trouble starts deep in the brain, out of sight and out of reach for conventional therapies. But not for Jerrold Vitek.

The new professor and chair of the University of Minnesota Department of Neurology has extensive experience in a surgical technique that has already improved the lives of many patients.

Called deep brain stimulation, or DBS, it delivers electrical impulses directly to specific areas of the brain. There, the impulses counteract the pathological activity that causes symptoms. Besides Parkinson's disease, it has helped patients with such conditions as dystonia—characterized by sustained, uncontrollable muscle contractions—tremors, obsessive compulsive disorder, and depression.

Diagram of DBS.In deep brain stimulation, electrical pulses are generated by a pacemaker-like device implanted under the skin of the chest and delivered to the brain by electrodes implanted through the skull.

Illustration: Medtronic

"I think its applications will be expanded in neurology and maybe outside the neurological realm," says Vitek. "For example, one researcher has explored using DBS in the hypothalamus of the brain to treat obesity."

Room to grow

Vitek, a native of Meadowlands in northern Minnesota, received M.D. and Ph.D. degrees from the University of Minnesota. After faculty positions at Johns Hopkins University, Emory University, and, most recently, the Cleveland Clinic, he joined the University in July. From his new post, he wants to see his department grow, expand its clinical services, and develop translational research, which is geared to turning its findings into new medical practices as quickly as possible. 

"We wanted to add further strength and expertise in treating movement disorders and in the department," says Frank Cerra, the University's Medical School dean and senior vice president for health sciences. "And Jerrold Vitek was far and away the best person to do it."

Vitek also wants to grow the University's DBS program.

In DBS, an internal impulse generator—similar to a pacemaker—is implanted under the skin of the chest. It's connected by a wire to an electrode positioned in the brain, most commonly in an area called the sub-thalamic nucleus (STN).

But another brain site, called the GPI (internal segment of the globus pallidus) may be as good a target as the STN, and easier to find. Vitek and colleagues designed a clinical trial to test this, and preliminary results indicate that stimulating the GPI produces outcomes as good as those from stimulating the STN.

Vitek is now working with Aviva Abosch, a University of Minnesota neurosurgeon who has performed DBS implants, and her team. Having received a doctorate in neurophysiology as well as an M.D., Vitek, who now pursues research in the pathophysiology of Parkinson's disease and dystonia, bolsters the team's strength in the basic science and treatment of movement disorders.

Using animal models, "We're exploring the brain circuits involved in the disease," Vitek explains. "If we can understand what goes wrong in those circuits, we'll be in a better condition to fix the problem."

Although not considered a cure, DBS has been shown to reduce symptoms of Parkinson's disease and allows doctors to lower a patient's medications, drastically improving their quality of life, Vitek says.

"Long-term use of anti-Parkinsonian medication, plus progression of the illness, often leads to, for example, hallucinations or a sudden return of symptoms, including a temporary inability to move," he says. "DBS can vastly improve patient symptoms."

 

 

Tags: Academic Health Center