Mind control: Toronto doctors regulate patients' brains from afar using electrode stimulation

Imagine watching your brain activity on a computer screen in real time.

For Gord Luke, aWawa, Ont., resident with Parkinson's disease,that's now a reality. Sitting in a room at the Krembil Brain Institute in Toronto's west end, the 66-year-old can see his brain signals being tracked digitally, thanks tosurgically implanted electrodes in his brain and a newly approved device in his chest.

Building on decades-old technology known as deep brain stimulation (DBS), which can help control the shakes and muscle tightness tied to brain disorders such as Parkinson's, the device puts a new high-tech tool in physicians' tool kits: the ability to capture brain activity of DBS patients such as Luke around the clock.

"We can actually stream live from his brain," saidKrembil neurologist Dr. Alfonso Fasano.

As Fasano fiddles with the laptop, his patient'ssturdy frame is still, with the electrode stimulation keeping his symptoms at bay.

WATCH | What it's like to live stream your brain:

Brain stimulation in action

4 years ago

Duration 2:20

Dr. Alfonso Fasano tests the Percept PC deep brain stimulation system on Gord Luke, who has Parkinson's disease, at the Krembil Brain Institute in Toronto.

Controlling symptoms in real time

With a couple of clicks, Fasano tweaks the level of stimulation from the electrode in the right hemisphere of Luke's brain, and he quickly starts shaking his left foot is tapping up and down involuntarily. With another tweak, his foot is back firmly on the ground.

The short-term hope, according to Fasano and his colleague, neurosurgeon Dr. Suneil Kalia, is that patients will be able keep a digital diary of their symptoms, which physicians canmatch up to the ongoing log of their brain activity.

"Physicians can later look at that brain diary to see when symptoms were severe or betterand fine-tune their therapy," Kaliasaid.

In Luke's case, Fasano hopes he'll eventually be able to adjust the settings on the device from the comfort of his own home, in consultation with his medical team by phone, from thousands of kilometres away.

"We can record for days, months, the different signals in the brain," Fasanosaid. "This will be, like never before, a window into their activities."

The personalized treatments that followcould help alleviate symptomsfor years on end, according to Fasano and Kalia.

Approved by Health Canada in October, thePercept PC deep brain stimulation system was developed byMedtronic, a Dublin-based medical technology company.

Working alongside surgically implanted brain electrodes, the small, pacemaker-like device is placed under the skin of a patient's chest, which sends electrical signals through thin wires to a targeted area of the brain and offers real-time recording.

Patients with brain disorders such as epilepsy and Parkinson's tend to see symptom improvements once their DBS electrode implants are turned on. With the chest and brain implants working in tandem,physicians can now see exactly what's happening inside their patients'brains when that switch is flipped.

WATCH | Using an MRI to monitor a patient's brain activity and responses:

The brain at a distance

4 years ago

Duration 2:02

Dr. Suneil Kalia demonstrates how an MRI of a patient's brain enables doctors to monitor brain activity from afar when the patient is not in hospital.

Automatic adjustments may one day be possible

Previously, medical teams could only track those signals duringbrain surgery, according to Kalia.

"What this new device allows is whether it's the first day after surgery or even five years after the surgery, we can interrogate the device," he said.

Through ongoing research, Fasano says, the technology may lead to "adaptive stimulation" in the longer term, where the device adjusts the level of stimulation automatically.

It's a bit like a smart home thermostat. At first, those high-techtemperature controlsrequire a homeowner to adjust the settings manually. Too cold in the morning? Crank up the heat. Too hot by the afternoon? Turn it back down.

Over time, as the technology learns someone's patterns and preferences, the thermostat can start making those adjustments on its own regulating the temperatureand keeping people inside the house comfortable automatically.

Kalia said that's a lotlike how the implants could one day regulate or even predict and ward off symptoms, including seizures and tremors. The first three Canadians underwent surgery to install their new smart technology this fall, and there are more to come.

WATCH | What thePercept PC deep brain stimulation system allows doctors to do:

A new kind of deep brain stimulation

4 years ago

Duration 2:14

Dr. Alfonso Fasano of the Krembil Brain Institute at the Toronto Western Hospital explains how the Percept PC deep brain stimulation system works to help doctors keep an eye on patients' brains as they go about their lives.

'Like being with them all the time'

Though wary at first of having the procedure, Luke said he jumped at the chance to try the new device in November. HisParkinson's symptoms have worsened over the last six years.

"Your muscles tighten up, everything shakes, you shuffle more than walk, you're prone to falls," he said. "Itreally changes your life, big time."

Speaking to CBC News outside his downtown Toronto hotel, he said the day before his medical team at Krembil turned on the electrode, he was barely able to walk. Now,much of his shaking and unsteadiness has subsided.

Driving a car, spending more time outdoors, and carving wooden animal figurines areall pastimes Luke plans to pursue back home in Wawa.

It's not a cure, to be clear. But it offers Luke, who's a 10-hour drive from the Krembil specialists, a way to manage his disease's progression with fewer trips to Toronto and loga treasure trove of data for his medical team at the same time.

Fasano says that's a welcome change from the small glimpses of someone's life physicians typically get when patients like Luke visit, which can't possibly capture their day-to-day symptoms andflare-ups.

"It will be like being with them all the time," he said.