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A New Grant Funds Parkinson’s Disease Research: A Q&A with Wael Asaad, MD

Wael Asaad, MD, PhD
Wael Asaad, MD, PhD

Rhode Island Hospital neurosurgeon Wael Asaad, MD was recently awarded a $486,000 grant from the Doris Duke Charitable Foundation. The Clinical Scientist Development Award will be used to research brain rhythms in Parkinson’s disease.

How common is Parkinson’s, and how does it typically impact a person’s daily life?  

Parkinson’s disease is a fairly common neurodegenerative disorder that afflicts more than 1 out of 5,000 people in the US. Those with this disease experience increasing motor system symptoms, such as difficulties initiating movements, abnormally slow movements, rigidity and tremors. Less apparent but equally disabling are cognitive and psychiatric difficulties that can be very prominent as the disease progresses.

How long have you been researching and treating Parkinson’s disease?  

The treatment of Parkinson’s disease is a large part of my clinical subspecialty. We perform deep brain stimulation (DBS) surgery for patients when medications begin to lose efficacy. This typically happens after about five to 10 years of treatment, at which point the side effects from medication can be just as disabling as the disease itself. DBS can have a profound effect on these symptoms and side effects, often restoring the ability to perform activities that were lost for several years. However, DBS is not a cure and does not slow down the underlying disease progression; it simply “turns the clock back” on many (primarily motor) symptoms.

I've been studying the neural circuits underlying Parkinson’s disease in humans with the disorder as well as in animal models that provide a “reference” for the normal roles of these circuits for the past eight years.

What are some of the changes in treatment over the past 10-20 years?  

DBS has increasingly gained acceptance by the medical community and by patients themselves. However, many patients who could benefit from this treatment are either unaware of it, are not referred to it by doctors who are still uncomfortable with the idea of brain surgery, or are reluctant themselves to undergo this procedure. Fortunately, as the benefits of this procedure become apparent, more people who might benefit are now considering it. Nevertheless, this treatment is not a cure, and so much better therapies are still very much needed.

What will this grant support?  

This grant will support our research directed at understanding how various neural oscillations contribute to or hinder movement in humans with Parkinson’s disease. We record neuronal activity from key circuits as patients perform visual-motor tasks, and correlate neural activity with behavioral markers of better or worse motor function. Our goal is to develop a more precise form of DBS that responds appropriately to undesirable brain states and “nudges” them toward better ones. This is in contrast to DBS today, which is simply a “dumb” steady stream of stimulation that is completely unresponsive to an individual’s brain state. We hope that a responsive system will be more efficient and also be more selective in how it treats the symptoms, and thereby have fewer side effects.

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