Spotlight: Deep brain stimulation specialist Leo Almeida, MD, joins M Health Fairview
Neurologist Leo Almeida, MD, joined our team of movement disorder experts in December. Almeida specializes in deep brain stimulation (DBS), a treatment for several common movement disorders including Parkinson’s disease.
We sat down with Almeida to learn more about his new role, the future of movement disorder treatment, and how our team brings leading-edge DBS research to patients at our clinics and hospitals.
What is your role with M Health Fairview?
I serve as division chief for movement disorders with University of Minnesota Medical School. On the clinical side, I’m working together with my colleagues to bring leading-edge research direct to patient care. I see patients primarily at M Health Fairview Neurology Clinic – Edina and perform brain mapping during surgeries at M Health Fairview University of Minnesota Medical Center.
What was your path to Minnesota?
I’m originally from Brazil. After finishing medical school, I completed my neurology residency at the University of Alabama. I did my fellowship in movement disorders at the University of Florida and stayed on there as a faculty member before coming to Minnesota.
What are movement disorders?
There are several conditions that we classify as movement disorders. A few of the most common are Parkinson’s disease, essential tremor, and dystonia. They’re all neurological conditions, meaning they stem from a problem in the brain and nervous system, and they all affect a person’s ability to move.
Do you have areas of expertise within movement disorder treatment?
My main area of expertise is deep brain stimulation (DBS), which is a treatment option for Parkinson’s disease, essential tremor, and dystonia, as well as other non-movement disorders. When I was at the University of Florida, I ran our DBS troubleshooting clinic. We helped people who had devices implanted outside of our institution figure out why their device wasn’t working properly and adjust it to better address their symptoms.
The legacy of pioneering DBS research and treatment is part of what drew me to Minnesota. Our DBS treatment program has been around for over 25 years, and the University of Minnesota is one of the few Udall Centers of Excellence for Parkinson’s Disease Research in the United States. The center is led by Jerrold Vitek, MD, PhD, a neurologist with M Health Fairview and head of the Neurology Department at University of Minnesota Medical School.
The Udall Centers of Excellence are a government-sponsored initiative to help boost research into Parkinson’s disease. Each center has a specific theme, and ours is focused on DBS. This benefits M Health Fairview patients by bringing the latest in Parkinson’s treatment to our clinics and advancing treatment for all people with the disease.
How does deep brain stimulation work?
A neurologist first meets with each patient and assesses their condition and symptoms. For example, someone with Parkinson’s may experience a range of movement-related symptoms, from tremors to slowness of movement to abnormal postures from excessive muscle contractions. We can target these unique issues through DBS, and there’s an array of other therapies as well.
If DBS is the right option, the first step is to be evaluated by a team of specialists including a movement disorders neurologist, a trained neuropsychologist, the neurosurgeon, and others. The team structure varies a little from institution to institution. The surgical team then places an electrode in their brain. This electrode is connected by wire to a pacemaker-like device in the patient’s chest, which can deliver stimulation to correct the abnormal electrical signals originating in the brain that are causing the patient’s symptoms.
What’s next in deep brain stimulation treatment?
DBS is already approved for some non-movement disorders including obsessive compulsive disorder and epilepsy. There’s a lot of research happening to expand its use to treat other conditions such as Tourette syndrome, depression, and chronic pain, among others.
For patients with Parkinson’s disease, essential tremor, and dystonia, we’re refining how we implant the electrode and how we monitor it after surgery to better target each person’s unique array of symptoms and minimize side effects. DBS has been approved to treat these disorders for a couple of decades, so now it’s about making the clinical application better and more efficient for patients.
The implants also now allow us to view the brain’s activity in real time. We can monitor how active the disease is by looking at the electrical pulses in the brain and seeing how they respond to stimulation. Certain device settings may be more efficient than others, and we can compare them side-by-side. We can also now direct those pulses towards a certain region of the target, similar to a lighthouse, which makes it more precise. The future of stimulation also includes responsive therapy, where we’ll be able to have the device respond to those changing signals as needed, which can improve the implant’s battery life and reduce side effects.
