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Dr. Helen Bronte-Stewart is the John E Cahill Family Professor in the department of Neurology and Neurological Sciences. She is a neurologist, neurophysiologist and movement disorders specialist, who has used her training in mathematics and physics, bioengineering, neurology, movement disorders, and single unit electrophysiology in primates to develop a rigorous translational program in motor control research in human subjects with movement disorders. Dr. Bronte-Stewart is the Director of the Human Motor Control and Neuromodulation Laboratory, where she has developed computerized, quantitative measurements of motor behavior, which are being implemented in a wide range of Movement Disorders. She is also the Co-Director of the Stanford Balance Center, Her research investigates the brain’s contribution to abnormal movement in human subjects, using synchronous brain recordings and quantitative kinematics, and how these are modulated with different frequencies and patterns of neurostimulation. Dr. Bronte-Stewart’s team was the first in the United States to implant a sensing neurostimulator, from which they can record brain signals directly, and use the patient’s own neural activity to drive the first closed loop neurostimulation studies in Parkinson’s disease. This work has led to her team receiving a BRAIN Initiative grant to perform the first closed loop deep brain stimulation studies for gait impairment and freezing of gait in Parkinson’s disease. She is the North America Lead Investigator for the first pivotal international trial of adaptive DBS in Parkinson’s disease – the ADAPT trial.
My research focus is human motor control and brain pathophysiology in movement disorders. Our overall goal is to understand the role of the basal ganglia electrical activity in the pathogenesis of movement disorders. We have developed novel computerized technology to measure fine, limb and postural movement. With these we are measuring local field potentials in basal ganglia nuclei in patients with Parkinson's disease and dystonian and correlating brain signalling with motor behavior.
Bilateral Closed Loop Deep Brain Stimulation for Freezing of Gait Using Neural and Kinematic Feedback
Deep Brain Stimulation of the subthalamic nucleus (STN) has become a standard of care,
FDA-approved treatment for Parkinson's disease, with stimulation delivered at a constant
amplitude and voltage, operating in an open-loop fashion that does not respond to a patient's
current state. Although gait deficits and freezing of gait may initially respond to
continuous open-loop deep brain stimulation (olDBS) and medication, the symptoms often recur
The episodic and predictable nature of FOG makes it well suited for adaptive DBS (aDBS) and a
device that overcomes the limitations of traditional high frequency olDBS and is capable of
adapting therapy either in the frequency or intensity domain transiently to treat FOG while
also treating other PD signs such as tremor and bradykinesia.
The purpose of this study is to determine the feasibility of an adaptive DBS system, that
responds to patient-specific neural and kinematic variables with customized DBS parameters.
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Adaptive Closed Loop Neuromodulation and Neural Signatures of Parkinson's Disease
Continuous deep brain stimulation (cDBS) is an established therapy for the major motor signs
in Parkinson's disease. Currently, cDBS is limited to "open-loop" stimulation, without
real-time adjustment to the patient's state of activity, fluctuations and types of motor
symptoms, medication dosages, or neural markers of the disease. The purpose of this study is
to determine if an adaptive DBS system, responding to patient specific, clinically relevant
neural or kinematic feedback, is efficacious on the motor Unified Parkinson's Disease Rating
Scale (UPDRS III) and specific phenotypic measures in Parkinson's Disease compared to OFF
therapy (i.e., OFF DBS and withdrawn from medication) and more efficient than cDBS. Not every
recruited participant completed every part of the protocol.
Stanford is currently not accepting patients for this trial.
For more information, please contact SPECTRUM, .
Effects of Deep Brain Stimulation (DBS) Frequency on Neural Synchrony
The purpose of this study is to evaluate the effects of low frequency deep brain stimulation
on subthalamic nucleus neural synchrony. Low frequency stimulation does not improve the
cardinal motor signs of Parkinson's disease, and may be beneficial only for gait and speech.
This study will provide insight into what the effects of low frequency stimulation are on
Neural Signatures of Parkinson's Disease
The purpose of this study is to provide objective measurements of abnormal movements of the
body in correlation with neural activity of the brain and track how these change over time.
This may allow for the development of objective evaluation of the neural activity causing
abnormal movements, which may lead to the ability of the DBS system to stimulate the brain by
sensing the abnormal neural activity that is causing abnormal movements.