Parkinson’s disease is a movement disorder that can cause tremors, muscle stiffness, poor balance and speech difficulties. Symptoms can be helped by medication, but patients often find that medications become less effective over time. For further symptom control, some patients turn to deep brain stimulation (DBS) and neurosurgeons like Dr. Guy McKhann, a specialist in movement disorders at Columbia University Irving Medical Center/NewYork-Presbyterian Hospital.
Now Dr. McKhann shares some big news for people considering DBS for Parkinson’s disease: A DBS system from a new maker has been approved by the FDA. It’s the latest step in the ongoing process of improving DBS technology. Says Dr. McKhann, “Basically, there are now three companies all pushing the race forward to make the technology better and better, which is really good for patients.”
Deep brain stimulation uses small electrical currents to disrupt the abnormal electrical patterns in the brain that cause Parkinson’s symptoms. To treat a patient using DBS, neurosurgeons like Dr. McKhann implant thin electrodes in precise areas deep within the brain. Leads, or wires threaded under the skin, connect the electrodes to a battery pack, usually implanted near the collarbone. Doctors program a tiny computer in the battery pack to deliver small electrical currents from the tip of each electrode. Doctors adjust the stimulation settings until they find those that best control each patient’s symptoms while producing the fewest side effects.
For a long time, the only maker of DBS devices was a company called Medtronic. Then, in 2016, a second company entered the market. That company, St. Jude Medical (since acquired by Abbott), had something new to offer: a way to control the stimulation at each electrode more precisely. Instead of sending the pulse out in 360 degrees around the electrode tip, the newer “directional lead” system lets doctors “steer” the pulse, sending it out from only one-third or two-thirds of the electrode tip. This improved precision may help doctors target symptoms while minimizing side effects.
Now a third company, Boston Scientific, offers a DBS system with its own improvements. The rechargeable battery system is smaller and, depending on charging patterns, can potentially last significantly longer than previous batteries. The company is also developing their own directional lead electrodes.
Having three companies in the arena should “stimulate” even more improvements in the technology for deep brain stimulation.
Learn more about Dr. Guy McKhann at his bio page here.
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