About 100,000 people worldwide undergo deep brain stimulation to treat Parkinson’s disease, dystonia and tremor when traditional medications or treatments fail to provide symptom improvement or relief. It is also being explored as a treatment for other neurological and psychiatric disorders for which medical therapy has not been effective in alleviating symptoms.
Deep brain stimulation (DBS) involves stimulating portions of the brain through a small implanted device. After the device is implanted, a clinician programs the device to target each patient’s individual symptoms. They establish settings that determine how much stimulation is needed to improve symptoms, a process called programming.
Programming DBS devices can be challenging and requires specialized training and time. Normally, a clinician needs to meet with the patient several times to define a set of stimulation settings that provide optimal improvement in symptoms. Given clinical assessments can be subjective, programming sessions can oftentimes lead to a trial-and-error process.
University of Minnesota researchers may have found an alternative method, which would speed up the programming process for both clinicians and patients with Parkinson’s disease. It would identify settings more quickly and easily. The findings from this MnDRIVE project were recently published in Parkinsonism and Related Disorders.
“In the past, we’ve had to use qualitative methods, that can be quite subjective, but our new approach uses quantitative measurements to help us refine DBS settings objectively,” said Jerrold Vitek, M.D., Ph.D., a principal investigator on the project, and Chair of the Department of Neurology.
Vitek and Tseganesh Orcutt, N.P., with the University of Minnesota Neurology Clinic, tested a motion sensor device developed by Great Lakes Neurotechnologies, which aims to automate DBS programming. The sensor tracks the changes in tremors and bradykinesia, symptoms of Parkinson’s disease in which the limbs can shake and movements are slowed, as they relate to changes in DBS stimulation settings. A computer algorithm processes that information to establish the best DBS settings for each patient.
In standard procedures, DBS programming sessions can take more than twice as long as a typical evaluation by movement disorder neurologists.
“This is a more efficient and effective approach,” Vitek said. “Patients will make fewer trips for care and in the end we will see reductions in health care costs.”
There is also a shortage of clinicians specially trained in DBS. The new automated approach would give primary care physicians who do not have extensive training or experience with DBS devices a tool that will help them to optimize DBS settings for patients with Parkinson’s disease.
“A DBS specialist will conduct the initial procedure and programming, but afterwards, the fine-tuning could be done anywhere,” Vitek said.
Additional research and development will be conducted before the automated sensor is available for commercial use and distribution, but the outlook is exciting. With this programming approach, Parkinson’s patients could be able to receive treatment closer to home by their own primary care physicians.
“Ultimately, we want to do whatever we can to improve the quality of life for people with Parkinson’s,” Vitek said. “This is one way we hope to accomplish that.”
This research was made possible in part through MnDRIVE, a landmark partnership between the University of Minnesota and the state, which provided a $36 million investment to research advancements in brain conditions, global food ventures, robotics, and the environment.
This study was also funded by an NIH Small Business Innovations (SBIR) grant to Joseph P. Giuffrida, President of Great Lakes NeuroTechnologies in Cleveland, Ohio. Read more.
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