Jerrold L. Vitek, M.D., Ph.D., professor and Head of the Department of Neurology at the University of Minnesota, is an internationally-renowned neurologist and movement disorder specialist. Although Dr. Vitek has received many professional accolades for his achievements throughout his illustrious career, he still retains the same high level of interest in what led him to medicine in the first place: his love for helping patients.
As a movement disorders specialist, Dr. Vitek regularly diagnoses and treats patients with Parkinson’s disease, a progressive neurological condition that causes tremors, rigidity, slowness of movement and postural changes which can lead to difficulties doing regular activities and even walking. Some of his patients are affected by a disorder called dystonia, a movement disorder characterized by abnormal muscle contractions which cause involuntary twisting and repetitive movements.
Currently, there are no cures for either condition. But, there are treatments that can make the conditions more manageable.
In search for the right treatment, Dr. Vitek evaluates the patient and identifies the severity of their symptoms to help determine the best treatment option. Early on, patients with Parkinson’s disease are prescribed a series of medications to replace dopamine (L-dopa and dopamine agonists). Most patients with Parkinson’s disease see improvements in their movement when taking these medications, but over a period of 5 to 7 years the medications typically have diminished effectiveness and increased side effects.
For dystonia, patients are typically treated with a combination of medications that block acetycholine or affect other neurotransmitters (chemical messengers) in the brain which help to minimize muscle spasms and relax the muscles. Unfortunately, these medications aren’t always effective and may have too many side effects for patients with dystonia.
It’s at these points that Dr. Vitek will have a patient evaluated to determine if he/she is a suitable candidate for deep brain stimulation (DBS) surgery. If the patient is a suitable candidate and decides to go ahead with surgery, a DBS lead (insulated wire) is surgically inserted into a site deep within the brain known to control movement. A few weeks later, the patient has an insulated wire extension and neurostimulator which is used to provide the power source and make DBS parameter adjustments, implanted in their body under the skin. Electrical impulses are sent from the neurostimulator at selected DBS settings through the extension wire to the lead implanted in the brain to stimulate this region of the brain and change the pattern of electrical activity into a more normal state, thereby improving their symptoms.
DBS treatments for patients with Parkinson’s disease and dystonia can be very effective, providing some patients with long-lasting results and a sense of normalcy, despite their condition. Dr. Vitek sees the impact that treatment he provides can personally have on a patient.
“One of the many amazing things about working with these patients is that we can see them improve with DBS right before our eyes.” Vitek said. “For example, in patients with Parkinson’s disease, their tremors cease, their posture improves and they are often able to walk normally. It’s remarkable.”
By understanding more about where and how the brain is operating abnormally in each of these conditions as well as how DBS affects activity at the cellular level to improve specific symptoms, Dr. Vitek and his colleagues are better equipped to develop and test new DBS treatment strategies. Ultimately, this research can translate into changes in clinical treatment options for affected patients, thereby improving patient symptoms, minimizing possible side effects, and improving quality of life.
“I’ve been working with patients for a long time, but I never lose the thrill that comes with helping people. For me, that feeling never gets old.”