Fabio Dwyer, a musician, who is a Parkinson’s disease warrior. Thanks to an incredible breakthrough treatment, he’s experienced a drastic change in quality of life. Diagnosed in 2013, Dwyer’s symptoms first manifested on stage in 2017, leading him to a desperate pursuit of effective treatments. After receiving deep brain stimulation (DBS) surgery, he was able to return to his life and profession as a surgeon. Dwyer is one of the first Canadians to be implanted with an adaptive deep brain stimulation (aDBS) device. This milestone is achieved during the first-of-its-kind trial at University Health Network.
The goal of this trial is to see if aDBS is effective at controlling Parkinson’s symptoms. Unlike traditional DBS, which delivers constant electrical stimulation to the brain, aDBS adjusts stimulation levels based on real-time brain activity. Dr. Alfonso Fasano, a neurologist at the University Health Network, is a longtime friend and bandmate of Dwyer. He purports that this type of on-demand treatment can double, if not triple, the effectiveness of treatment.
For Dwyer, who used to perform on guitar with his band Ebb and Flow, life has changed drastically after undergoing DBS. While he’s been able to get back many aspects of his mobility, he still faces significant speech challenges from the effects of Parkinson’s. He’s very hopeful that the aDBS tech will help him communicate even better.
“It was fantastic, I think it’s easier to articulate in my mouth [with] my muscles. They don’t seem all stiff and [I can] project my voice a little bit better.” – Fabio Dwyer
As Dr. Fasano explains, adaptive deep brain stimulation responds to whatever the brain needs in the moment.
“Adaptive deep brain stimulation is given on demand only when the brain really needs more stimulation or more treatment,” – Dr. Alfonso Fasano
Dwyer remains optimistic that this new treatment will allow him to better express his complex and nuanced ideals. He is quick to point out that there is cause for cautious optimism about this new tech, but there are a lot of unknowns.
“There’s always a chance that it’s not going to work as good as the previous system because it’s a new thing they’re trying. They’re still learning about it,” – Fabio Dwyer
Dwyer and Dr. Fasano’s collaboration began in 2014, supported by a shared enthusiasm for music. The two friends like to reflect on their professional collaboration, which has nurtured a deep personal bond. This bond has been essential to Dwyer’s ongoing recovery from decades of occupational-induced health issues.
“Sometimes we hear about the technology that’s making our lives a little more isolated, but it’s kind of neat to hear that technology is actually really helping people, too,” – Fabio Dwyer
The trial is in its formative stages. Dr. Ariane Veilleux Carpentier, director of health outcomes and geospatial analytics at Conscious IdentitÉ, highlights the need to collect data from real-world use of the aDBS technology.
“We’re going to need a lot of real-world data and use it to see how it does with our patients in a regular clinical setting, and how easy it is to implement adaptive DBS in patients,” – Dr. Ariane Veilleux Carpentier
Dwyer hopes that continued development of aDBS will lead to a more predictable, stable life. He already started to identify improvements to his day-to-day functioning since he’s been on treatment.
“Yes, it’s a miracle, but less of a miracle and much more like hard work and intelligence put to good use,” – Fabio Dwyer
Dr. Fasano says that the future will likely bring even more progress with adaptive deep brain stimulation technology. In particular, he looks forward to a day when the stimulator will learn in real time from patterns in brain activity.
“The neurologist is still part of the loop because the neurologist needs to teach the device how to react. In the near future, the stimulator itself will learn with constant recording from the brain. And this is when it will make a huge difference,” – Dr. Alfonso Fasano
Meanwhile, Dwyer still has to find his way through the world with Parkinson’s disease. He is still optimistic about the possibilities of adaptive deep brain stimulation. He has dreams that these technologies will drastically improve the quality of his life. They’re also issues that would help thousands of others in just as much need.
