Movement Disorders Research
Basic Science Research
There are a number of laboratory studies being conducted within the Department that are aimed at better understanding the fundamental mechanisms of movement disorders and finding new therapies that can be moved to clinical trials. The laboratory of Philip Starr MD, PhD is researching the electrical activity in the basal ganglia to understand this brain structure’s role in both normal and abnormal movement. The laboratory of Paul Larson MD is developing new methods for using interventional MRI to perform deep brain stimulation surgery and infusions into the brain for therapies such as gene transfer. The laboratory of Krystof Bankiewicz MD, PhD is involved in several lines of investigation, including gene therapy strategies for Parkinson’s disease; infusion of growth factors into the Parkinsonian brain; the role of neuroinflammation in Parkinson’s disease; and gene therapy for Huntington’s Disease.
Deep Brain Stimulation for Movement Disorders
Through clinical trials, investigators in the Department of Neurological Surgery are defining the optimal brain target for deep brain stimulation (DBS) in Parkinson’s disease, exploring new surgical therapies for movement disorders, and studying the use of new brain stimulation devices and new techniques for DBS insertion. The movement disorders group has defined the technical approach to microelectode-guided DBS implantation for dystonia, resulting in the first American publication on this technique. Another current investigational protocol is examining the use of interventional MRI during DBS, and surgery is performed within an MRI scanner to provide high-quality images of the brain during surgery and allow neurosurgeons to confirm accurate placement of the electrode while minimizing the risk of bleeding complications.
New Indications for Deep Brain Stimulation
The Department's movement disorders group has also launched a pilot trial of DBS for severe cluster headache. When unresponsive to medication, cluster headache may cause enormous suffering and disability. DBS of the hypothalamus, which is abnormal in patients with cluster headache, shows promise for treating this disorder. Our faculty members are also partnering in a new surgical program with the UCSF Psychiatry faculty, and trials of DBS in major depression and Tourette’s syndrome are in the planning stages.
Gene Therapy for Parkinson’s Disease
The movement disorders group at UCSF has participated in two of only three gene therapy trials for Parkinson’s disease worldwide. In phase I and phase II trials, genetic material was infused into parts of the brain involved in Parkinson’s disease to alter their function in a positive way. Phase II and phase III trials to continue evaluating this therapy are anticipated.