Q&A with Parkinson's disease researcher

Two major research milestones changed the course of Parkinson's disease, and Erica Mandelbaum of Tampa benefited from both. The mother of two was diagnosed when she was just 36. "I was furious," recalls Mandelbaum, who is now 58. "That lasted a couple years. Then I decided it was time to live."

The most commonly prescribed medication, which replaces a chemical in the brain in short supply in Parkinson's patients, helped for many years. Then she developed uncontrollable physical symptoms: shaking, foot dragging and stooped posture. Enter deep brain stimulation, an implanted battery-operated device that stimulates areas of the brain that control movement and blocks abnormal signals to those areas.

"It was a lifesaver for me," said Mandelbaum, in a soft, at times out-of-breath, voice, her speech (and vision) affected by Parkinson's. But DBS "has been a medical miracle for me. With it, I am able to go bike riding, swimming, grocery shopping," she said.

To learn more about how research has improved life for Parkinson's patients and what's in store for the future, the Tampa Bay Times spoke with Dr. Robert Hauser, one of Mandelbaum's physicians, a researcher and director of the USF Health Byrd Parkinson's Disease and Movement Disorders Center of Excellence.

When was the first major turning point for Parkinson's treatment?

In the late '60s a big breakthrough came when researchers introduced levodopa, a replacement for naturally occurring dopamine, which is in short supply in PD. Before that we had no real treatment. Patients got progressively worse, their movements became slower, their bodies stiff. With this drug, their lives improved tremendously and they lived longer. It took Parkinson's disease from devastating to manageable for many years.

What if the medication doesn't help much or the effect of the medication seems to stall?

We can help a large number of people with deep brain stimulation, introduced around 1990 and the second renaissance in treatment. It helps smooth and maintain the symptom response to medication through the day. But we want to do better than that.

You mean it has its limits, too?

Yes. DBS addresses motor symptoms such as slowness, stiffness and tremor. Unfortunately in Parkinson's disease, other parts of the brain are affected, and patients eventually have problems with thinking, memory and balance. We want to stop that from occurring or to at least delay or slow progression to those problems. That means we need to identify it earlier before any of that happens.

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Q&A with Parkinson's disease researcher