As new technologies by Medtronic seek to improve deep brain stimulation for people living with Parkinson’s disease, we talk to functional neurosurgeon Dr Lennart Stieglitz to learn more about the treatment
In a recent interview, Dr Lennart Stieglitz – a neurosurgeon based in Zurich, Switzerland – shares insight into deep brain stimulation (DBS), a procedure in which electrodes are placed inside the brain to treat Parkinson’s disease and other movement disorders.
With over a decade’s experience in performing DBS surgery for people with Parkinson’s disease, Dr Stieglitz shares five things you might not know about the therapy.
1. A new generation of DBS aims to tailor the treatment
“Our results with a chronic stimulation are all already excellent,” says Dr Stieglitz. “But I hope we’ll find ways to stimulate with a new technology that might improve results.” He says one of the strongest benefits of Medtronic’s new DBS device is that patients have access to more “situation-adapted stimulation”.
2. DBS is a great option for young people with Parkinson’s disease
According to Dr Stieglitz, people with Parkinson’s who are starting “to feel the limits of their conservative treatment” are ideal candidates for the therapy.
“Those patients benefit most because they have the longest period ahead of them where they can take advantage of the rewards of the treatment,” says Dr Stieglitz. Older patients living with an advanced form of Parkinson’s disease might not have the same success with DBS. “Younger and earlier patients have the chance to get the most out of what deep brain stimulation can offer,” Dr Stieglitz adds.
A new generation of deep brain stimulation technology could benefit people with Parkinson’s.
3. New features allow patients to record their own data and keep track of their treatment
An added feature of the new Percept™ PC neurostimulator is an enhanced Patient Programmer, a handheld device that allows users to manage their therapy. With the ability to record their own data and control their stimulators, patients are able to maintain a more comprehensive dataset of their experiences.
Though Dr Stieglitz says non tech-savvy users may find this feature less accessible – he also notes some definite positives of the Patient Programmer. “What I like very much is the calculation of the battery life,” he says. “Now the Patient Programmer tells the patient how long the battery will be available.”
Another feature which Dr Stieglitz believes “is an absolute must” is that the device is MR conditional*. It is the only DBS system that is compatible with 3T full-body MRI scans, meaning that patients can leave the device on with certain stimulation settings while undergoing scans. Patients “can check themselves if their whole system is MR compatible”, he says, which is “the big advantage here”.
4. The enhanced programmer can help keep people with Parkinson’s safe during a pandemic
The coronavirus crisis presented a great challenge to people with Parkinson’s disease and their clinicians, as in-person healthcare appointments became a risk. “There were a lot of patients who were treated sub-optimally,” says Dr Stieglitz. “We nearly lost some of our patients during the pandemic.
“But enhanced documentation of these patients is a good first step for the future. It might be great to have some telemonitoring opportunities. That means to not only document and monitor symptoms on the patient’s handheld device, but also to stay in contact with us via the internet, so we can monitor patients under more difficult circumstances like a pandemic.”
5. The future could hold even bigger innovations in DBS
“I hope mostly that we are learning to treat patients better,” says Dr Stieglitz. “Maybe in the future we could even learn how to do multi-target stimulation. In the future we might have the technology and also the knowledge to influence complex networks in the brain in a more sophisticated way.”
But Dr Stieglitz feels the first priority should be making DBS therapy available to more people with Parkinson’s disease. “I hope that more patients will benefit from deep brain stimulation. This is the first thing – not to improve the treatments for a few patients, but to bring the treatments to more people in need,” he says. “I believe in the future of DBS.”
Medtronic’s Percept™ PC neurostimulator with BrainSense™ technology.
At a glance: benefits of the Percept™ PC neurostimulator
It can continuously sense and record brain signals, allowing clinicians to track patient-specific signals and correlate these with patient-recorded events
It’s the only DBS system that is compatible with 3T full-body MRI scans*, meaning it can be left on with certain stimulation configurations while the scans take place
It incorporates low pulse width, providing expanded stimulation options
It has improved battery longevity** and a comfortable new shape
It has an enhanced Patient Programmer*** through a custom-configured Samsung mobile device, allowing patients to manage their therapy more easily.
Need to know
Lennart Stieglitz is a functional neurosurgeon based in Zurich, Switzerland. His career began at the International Neuroscience Institute in Hanover, Germany and he learned to perform deep brain stimulation in 2008. His love of technology, as well as computer- and robot-assisted surgery, set him on the track toward functional neurosurgery. In 2013, he transferred to Zurich University Hospital, Switzerland, where he is now Chief of Service of Functional Neurosurgery.
Brief Statement: See the device manual for detailed information regarding the instructions for use, indications, contraindications, warnings, precautions, and potential adverse events. If using an MRI SureScan® device, see the MRI SureScan® technical manual before performing an MRI. For further information, contact your local Medtronic representative and/or consult the Medtronic website at medtronic.eu.
Disclaimer: Information contained herein does not replace the recommendations of your healthcare professional. See the device manual for detailed information regarding the instructions for use, indications, contraindications, warnings, precautions, and potential adverse events. For further information, contact your Health Care Professional.
* Medtronic DBS systems are MR Conditional, which means they are safe for MRI scans only under certain conditions. If the conditions are not met, the MRI could cause tissue heating, especially at the implanted lead(s) in the brain, which may result in serious and permanent injury or death. Refer to the MRI Guidelines for Medtronic Deep Brain Stimulation Systems for a complete list of conditions: http://professional.medtronic.com/mri
**Compared to Activa™ PC device. For median energy use in DBS for patients with Parkinson’s disease, with equivalent settings and no BrainSense™ technology usage
***Compared to the 37642 DBS Patient Programmer for use with Activa™ devices
This article is sponsored by Medtronic. The information in this article is given for information purposes only and does not represent an endorsement by the European Parkinson’s Disease Association of any particular treatments, products or companies. This article is not a substitute for advice from your doctor, pharmacist or other healthcare professional. Parkinson’s Life makes no representations or warranties of any kind, express or implied, about the completeness or accuracy of information provided.
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