January 6, 2026

@michaelokun

Could we use peripheral nerves to repair Parkinson's brain networks and do it during DBS surgery? MAYBE. van Horne and colleagues describe in a new paper in Neurosurgery Practice two cases where a person’s own peripheral nerve tissue was implanted into both the nucleus basalis of Meynert and the substantia nigra at the time of bilateral deep brain stimulation surgery. Autologous peripheral nerve tissue grafts means using a small piece of a person’s own nerve to deliver natural growth signals to injured brain cells. Nucleus Basalis of Meynert is a deep brain hub that supports attention and memory through the chemical acetylcholine. Substantia nigra is a dopamine producing region critical for movement in Parkinson disease. Key Points: - The surgical approach was feasible and it safely combined nerve graft delivery into two deep brain targets during DBS. - No serious adverse events were linked to the grafts and brain imaging showed no procedure related injury. - Motor outcomes were stable or improved and cognitive testing in one participant showed mixed changes, including improvements in some memory related tasks. My take: The idea of using the body’s own 'repair biology' to support vulnerable brain networks during DBS is quite interesting. It is not a cure and it is not ready for routine care, however could it provide an avenue to address non-motor Parkinson's features. Here are 5 points that resonated w/ me: 1- Using a person’s own nerve could avoid the need for immune suppression and tap growth factors. 2- Targeting both movement and cognitive circuits acknowledges the full lived experience of Parkinson's. 3- Safety must come first, and this report showed that adding grafts in two individuals did not meaningfully increase risk. 4- Signals of possible network support were intriguing, however the number of subjects was very small. 5- The future will require more rigorous trials to learn who may benefit and when to intervene, and of course if the juice is worth the squeeze. https://journals.lww.com/neurosurgpraconline/fulltext/2026/03000/autologous_peripheral_nerve_tissue_grafts.4.aspx #parkinson #deepbrainstimulation #fixelinstitute #michaelokun