A Parkinson’s patient plays clarinet during brain surgery

LONDON – The doctors prepared to carry out the brain surgery, their medical tools laid out. Their patient, wide awake on the operating table, was given an instrument of her own: her clarinet, which she began to play.

Denise Bacon, 65, blew into the mouthpiece as doctors stood behind her, piercing holes into her skull to implant electrodes that would deliver electrical pulses to the brain in a bid to improve her motor skills. The electrodes were connected to a pulse generator – a device likened to a pacemaker – which sent continuous pulses to modify the brain, helping her manage her symptoms of Parkinson’s disease, for which there is no cure.

Bacon underwent the procedure, known as deep brain stimulation (DBS), in London’s King’s College Hospital in July. The semiprofessional musician was diagnosed with Parkinson’s in 2014 and its symptoms greatly affected her ability to feed herself, walk and play her “beloved” clarinet, eventually forcing her to leave the concert band she played for, the hospital said in a statement.

One of the goals for the procedure was to help her play again, Keyoumars Ashkan, the neurosurgeon who carried out the operation, said Wednesday.

“If I can go back to playing clarinet, that will make a huge difference to my quality of life,” Bacon told Ashkan before the surgery, he said. As the results of DBS are instant, the best way to assess the procedure’s success was to have Bacon play as doctors stimulated her brain, one electrode at a time, doctors decided. Bacon was fitted with a type of stimulation device in her chest, which can monitor her brain activity and adjust stimulation when needed.

Parkinson’s, which affects an estimated 1.1 million people in the United States and 10 million worldwide, causes brain circuits that coordinate movement to misfire, causing symptoms including tremors, stiffness and slow movements. Other common symptoms include difficulty speaking and issues with sleep, coordination and balance.

Bacon was awake for the surgery: DBS patients are typically kept awake so doctors can assess their movements as they place electrodes into the brain and analyze their immediate impact, Ashkan said. Bacon was given a local anesthetic to numb her scalp and skull; the brain itself does not have any pain receptors.

“You can, on the table, immediately see the effect of the surgery,” Ashkan said. In Bacon’s case, as soon as the electrode was placed, doctors witnessed her finger movement becoming “immediately better,” he said.

The right side of the brain controls the left side of the body and vice versa, Ashkan explained, adding that when doctors placed the electrode on the right side of Bacon’s brain, her left fingers were “flying.”

The right fingers, which were not being treated, were not doing anything. “They were stiff and slow and couldn’t move,” he said.

Katherine Fletcher, research communications lead at Parkinson’s UK, said in an emailed statement that DBS offers those living with the disease “better control of symptoms when medications are no longer as effective.” Speaking of Bacon’s procedure, Fletcher said it was “incredible to hear how this life-changing treatment is not only helping individuals with symptoms, but regain the ability to do the things they love.”

In 2020, a violinist who learned she had a brain tumor after a seizure at a symphony played her instrument as doctors worked to remove it. That surgery also took place at King’s College Hospital, with Ashkan in the room.

“Images and videos of musicians playing instruments like a clarinet during deep brain stimulation remind us of the extraordinary power of modern therapies for Parkinson’s disease,” Michael S. Okun, co-author of “The Parkinson’s Plan” and medical adviser for the Parkinson’s Foundation, said in an interview with The Washington Post on Tuesday.

Ashkan said he hopes that Bacon’s story will offer hope to those living with Parkinson’s and also educate them about DBS as a treatment for their symptoms, which is offered free through Britain’s National Health Service. DBS surgery is also available in the U.S., according to the Parkinson’s Foundation.

After a DBS operation, patients are discharged for three or four weeks before returning to the hospital to have their stimulation device switched on. “It’s a permanent system that lasts forever,” Ashkan said, adding that Bacon is getting more mobile each day and slowly returning to hobbies such as swimming and hiking. “She’s finding quite a lot of improvement,” he said. “Hopefully she will sometime soon go back and play in the band again.”

Ray White, another member of the East Grinstead Concert Band in southern England – where Bacon played – said in an email Tuesday that the group was “delighted” to see Bacon making headlines for bringing a little music to the operating theater.