Spring 2018

KO for PD

After deep brain stimulation surgery to treat her Parkinson’s disease symptoms, a true fighter is back in the gym


Three days a week, Kelly Cargill can be found throwing punches and lifting weights with her trainer. A different three days she’s going to group Zumba or strength-training classes. Whenever the weather allows it, the retired art teacher walks with her neighbor or dog or tends to the gardens around her Orono, Minnesota, home. 

Cargill, 56, tried her best to stay active after she was diagnosed with Parkinson’s disease at age 48. 

It started as a tremor in her left pinky finger that moved up her hand and arm and eventually down her left leg. She powered through many of the negative effects of the disease itself—such as wiggling in her leg and jerky arm movements—and the medications used to treat it for about four years.

But the medications became less effective for her over time. She lost energy. Multiple times a day, she experienced waves of extreme anxiety as her medications wore off. 

She was also very bothered by facial distortions that people who have Parkinson’s sometimes experience, which can severely diminish a person’s quality of life. 

“I was like, ‘Please, God, don’t let that happen to me,’ and when it happened, I was a puddle,” she says. “My whole face would scrunch up, and it was not pretty.” 

Parkinson’s was wearing her down. 

That’s when Cargill and her doctors decided it might be worth a visit to the University of Minnesota to learn more about deep brain stimulation (DBS) surgery, another treatment option—though not a cure—for people whose Parkinson’s isn’t well-controlled with medication. 

“I had heard about the surgery, but I wasn’t sure about it because it was very scary-sounding,” she says. 

It seemed scary, at least, until she met University of Minnesota Health neurosurgeon and DBS specialist Michael C. Park, M.D., Ph.D. 

“He spent 2½ hours with my sister and me. He was very calm. He explained everything,” Cargill recalls. “I could feel all the fear run out of my body.” 

‘Pacemaker for the brain’ 

She didn’t know it at the time, but Cargill had just made plans to undergo surgery with some of the field’s foremost experts. 

“In my opinion, we have the best DBS program in the country, if not the world,” says M Health neurologist Jerrold Vitek, M.D., Ph.D., who also leads the Medical School’s Department of Neurology and directs the Neuromodulation Research Center. “We have a diverse group of scientists and clinicians who all work together, from biomedical engineering, neuroimaging, neurosurgery, neurology, neuroscience, etc. We’re a broad, diverse group with common interests.” 

Even better

A University of Minnesota Health team in December became the first in the country to implant a newly approved medical device that could further help people living with Parkinson’s disease and other movement disorders. 

Boston Scientific’s new Vercise DBS system allows the care team more precision and flexibility over previous models, says neurologist Jerrold Vitek, M.D., Ph.D., who was the lead national researcher on the clinical trial to evaluate the device. 

Vitek is happy with what he’s seen so far from the Vercise. But his team at the U of M Medical School is also collaborating with the competition to develop devices that are even better yet. 

“We are very clear with the companies,” he says. “We work with whomever because we want to get the best product to the patient.”

In fact, in August 2016, the University became part of an elite group of eight academic medical centers across the country to be named a Udall Center of Excellence for Parkinson’s Disease Research by the National Institutes of Health. Philanthropy supported several studies that helped build this leading reputation. 

DBS is a procedure of precision. With guidance from scans and neurologists trained in identifying deep brain structures using a technique call microelectrode mapping, a neurosurgeon places a lead in a targeted area of a patient’s brain to alter his or her symptoms. The lead connects to an implantable pulse generator—“a pacemaker for the brain,” Vitek says—which is implanted under the patient’s skin and delivers electrical stimulation to the brain. 

“What we’re doing is affecting circuitry in the brain that controls movement and has gone awry, eliminating the symptom,” explains Park, an assistant professor of neurosurgery in the Medical School and a MnDRIVE Neuromodulation Scholar. 

Working with imaging expert Noam Harel, Ph.D., at the University’s world-renowned Center for Magnetic Resonance Research, the DBS surgical team gets the best possible picture of the target area in a patient’s brain via a high-field 7 Tesla MRI scan. Typically, hospitals are equipped with standard 1.5 or 3 Tesla scanners. 

Michael C. Park, M.D., Ph.D., and Jerrold Vitek, M.D., Ph.D., continue to improve DBS outcomes through their team’s use of up-and-coming technology.

But it’s not just about the right technology, Vitek emphasizes: “It’s who’s using it. Folks here are very good at handling the data and at giving us a very good idea of where the target structure is.” 

The imaging expertise is quite valuable after surgery, too, Vitek says. That’s when the care team evaluates the correlation between lead placement and results. 

“Understanding this is what’s going to move the field forward,” he says. 

While DBS surgery has approval from the U.S. Food and Drug Administration to treat Parkinson’s and essential tremor, it also carries humanitarian device exemptions that allow it to be used for dystonia and obsessive-compulsive disorder. And Vitek foresees many other applications. 

“I would say that any circuit disorder could be treatable with DBS,” he says. “Depression. Addiction. Epilepsy. Pain. Potentially even Alzheimer’s. I think the field of DBS is wide open.” 

Back in the gym 

In April 2016, working with Vitek and fellow M Health neurologist Scott Cooper, M.D., Ph.D., Park implanted a lead into Cargill’s brain. Three weeks later, she had another surgery in which she got her rechargeable battery pack. Then she worked with Tsega Orcutt, R.N., M.S.N., C.N.P., to fine-tune the stimulation the device provided to minimize her symptoms. 

Today, nearly two years after the surgeries, Cargill reports that her Parkinson’s symptoms are 85 percent gone, and her waves of anxiety have completely disappeared. 

“Everybody at the U was wonderful,” she says. “The nurses were wonderful, the doctors, the surgeons … I can’t say enough. They were really kind.” 

Kelly Cargill works out with her trainer, Herb Tanton Jr., three days a week. “It doesn’t matter how crappy I feel when I start,” she says. “When I’m done, I am so energized, and I feel so good. It’s amazing.”

Cargill, of course, was eager to get back to the gym. She vividly remembers the day one instructor told the group to stretch—and she did, this time with her previously cramped hand opened fully. She burst into tears. 

Cargill is simply thankful to be back in her boxing gloves—now with a new perspective. 

“I just live one day at a time, I really do,” she says. “I’m grateful for the days I feel good and grateful for the surgery.”

To learn how you can support DBS research, contact Eva Widder of the University of Minnesota Foundation at 612-624-8650 or ewidder@umn.edu.