Can we predict who is at risk of facing cognitive issues in PD and address them earlier? These are the questions being pursued by Dr. Goldman of the PDF Research Center at Rush University Medical Center.
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Christopher W. Hess, M.D.
How does the brain cope with the changes of Parkinson’s disease (PD)? According to Christopher W. Hess, M.D., a Research Fellow at PDF's Research Center at Columbia University Medical Center, the answer may help us to understand the movement symptoms of PD and perhaps diagnose PD earlier.
Dr. Hess, who is the first recipient of PDF’s Ronald and Isobel Konecky Third-Year Research Fellowship in Movement Disorders, previously completed his residency in neurology at Columbia. During the first two years of his fellowship in movement disorders (funded by PDF), Dr. Hess honed his skills in the care of people with PD under the supervision of Stanley Fahn, M.D., PDF’s Scientific Director, and Seth Pullman, M.D. As the Clinical Motor Physiology fellow, he also learned about deep brain stimulation and became interested in researching how the nervous system affects movement in Parkinson’s.
His fellowship provides him with the additional training that PDF believes is necessary to practice at the highest level in the field. In his third year, Dr. Hess says, “I now have the opportunity to apply what I’ve learned to the research questions in which I am interested.”
Dr. Hess is investigating the brain’s ability to adapt to the changes brought on by Parkinson’s, which he thinks may delay its early symptoms.
It turns out that the brain — both its cells and the connections between them — can change and adapt when faced with new experiences, including illness. For example, in PD, the area of the brain known as the basal ganglia — which helps to produce the body’s voluntary movements — stops working when it loses dopamineproducing cells. When this happens, Dr. Hess speculates that other parts of the brain may lend a helping hand for a short time. This means that although the basal ganglia are not working properly, other parts of the brain kick in to ensure that a person with PD does not initially experience any symptoms. In fact, those symptoms might not be noticeable to a person with PD until the time when the brain can no longer help out, or compensate.
In the coming year, Dr. Hess will test his theories in 30 volunteers. He will use non-invasive techniques — a magnetic device or direct electrical current over the head — to stimulate the areas of the brain that are suspected of compensating for PD. In theory, this could temporarily stimulate or shut down brain activity in those areas, potentially uncovering or worsening a person’s hidden movement symptoms. He will measure his volunteers’ movement symptoms with the help of some new tools. These include spiral analysis, which studies the way a person draws a spiral shape, and computerized analysis, which records and analyzes tremors and other movement symptoms.
Dr. Hess will be looking for changes in symptoms that may help him understand which parts of the brain are responsible for compensating in PD. His long-term research aim is “to better understand how the changes that occur in the Parkinsonian brain give rise to the symptoms that people with Parkinson’s experience.”
He also hopes his studies may pave the way for better objective tests that could help diagnose PD earlier in its course, perhaps before a person notices any symptoms.
“There are very few programs where you can both do research and get in-depth clinical experience,” adds Dr. Hess. “With the support of PDF, I’m able to spend a third year putting together everything I’ve learned.”
Dr. Hess’ research is funded through PDF’s Fellowship and Career Development Awards. In FY2013, the budget for this program is $1.38 million.