This article originally appeared in Pathways, a magazine published for physicians and the community by UMass Memorial Medical Center.

"Twenty years ago, the saying was that all neurologists could do was ‘diagnose and adios,'" said neurologist Paula Ravin, MD, director of the UMass Memorial Movement Disorders Center. "There weren't a lot of interventions for neurological disease at that time."

What a difference two decades of medical research makes. Advances in diagnostic and functional MRI, interventional radiology, neurosurgery and neuropharmacology have given neurologists and neurosurgeons - and their patients - a growing arsenal of effective treatment options.

UMass Memorial Medical Center, the clinical partner of the University of Massachusetts Medical School, remains on the cutting edge therapy wise by participating in research and clinical trials for a range of neurological conditions. Several such initiatives relating to deep brain stimulation (DBS) and Parkinson's disease are underway.

"In one, we're looking at the zona incerta and mood changes in DBS patients," Dr. Ravin explained. She is recruiting from among patients she is programming (see main article) to conduct assessments of mood on paper, then changing the electrode settings to the highest stimulation point and retesting mood. "We've completed about 10 patients so far," she noted.

Another study looks at improving the surgical procedure itself. Functional neurosurgeon Julie Pilitsis, MD, PhD, explained: "The surgery itself takes a long time. We target the area using MRI, then use microelectrode recording to decide if we're in the right spot. We listen to each neuron, watch the firing rates of different parts of the brain, and watch the patient's response. There's a lot of subjectivity,"
she added.

"So we're working on a computer-generated algorithm that will objectively assess all the firing rates to find the exact right spot," she continued. "Dr. Peter Novak (a neurologist and member of the UMass Memorial movement disorders team) has published his results based on a retrospective study, and we're now doing this prospectively."

Another study underway seeks to improve Parkinson's disease diagnosis by further understanding when and how the loss of smell is involved. "There's no way to clinically diagnose Parkinson's right now; it's a diagnosis of exclusion, and as many as 30 percent of patients are initially misdiagnosed," said Dr. Pilitsis. According to published studies, loss of smell is recognized to be an early symptom of the disease, so the aim of this study is to expand on earlier results and refine the specificity of that link with functional imaging.