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Institute of Neuroscience and Medicine
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What is Parkinson's disease?

Bild zur Forschung im Bereich Parkinson

In Parkinson patients, not responding to pharmacotherapy adequately any longer, or those with late sequels of pharmacotherapy, deep brain stimulation is the therapy of choice. Therefore electrodes are stereotactically implanted in the depth of the brain. Via the implanted stimulation device, high frequency stimulation is administered. This stimulation alters the behaviour of neuronal circuits, for instance by suppressing their activities (the neuronal firing is stopped). High frequency stimulation is an acute therapy, meaning: Therapeutic effects diminish after stopping stimulation within seconds (tremor) or minutes (akinesia).

Permanent high frequency stimulation is nowadays the gold standard in the treatment of movement disorders not responding adequately (anymore) to pharmacotherapy. 

This therapy has disadvantages: Not every patient has therapeutic benefits, there are side effects and the effects of the therapy can fade.
This was the initial point for the development of stimulation, directly countering the pathologic synchronization of neuronal activity. The neurons should not be suppressed, but outlive their pathologic behaviour, but in an unsynchronized manner. Our Coordinated Reset (CR®)-Stimulation leads via desynchronization to a decrease of the coincidence rate of still active neurons and so to a decreasing power of synaptic wiring in between neurons. Only active neurons can learn and unlearn pathological activity. While simple periodic stimulation powers synchronisation and hence strengthens pathological networks, desynchronizing CR® targets the opposite: pathologic networks and the subsequent dynamics are unlearned; the system changes from pathology into stable physiology.
In MPTP apes (animal model for Parkinson's disease) CR®-Stimulation showed significant effects up to 35 days after stimulation. In comparison standard high frequency stimulation needs a permanent input, which is much higher and has only acute effects, diminishing instantly after stimulation. First-in-man studies have proven those sustainable effects.


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