Groundbreaking technology for those with movement disorders
In groundbreaking news for patients with movement disorders, neurologists with The University of Texas Health Science Center at San Antonio are among the nation’s first to use technology that enables deep brain stimulation that adapts as symptoms change.
Deep brain stimulation, known as DBS, is the placement of electrodes in the brain connected to a battery-operated generator in the chest similar to a cardiac pacemaker, first approved in 1998. A small impulse of electricity moves from the generator to the electrodes to stimulate a specific area of the brain, relieving some symptoms and side effects for those with Parkinson’s disease, dystonia, epilepsy and essential tremor conditions.
Until now, those electrical impulses needed to be manually adjusted with doctor visits, for persons with implanted sensing DBS generators. The new adaptive DBS technology essentially is a software update that sets the generator battery to continually adjust stimulation based on the patient’s symptoms, using a tablet like an iPad that connects through Bluetooth.
“What the new technology now does is you turn it on and adjust the stimulation based on the patient’s symptoms, so it senses the symptoms and delivers the appropriate stimulation. So, treatment is not one size fits all; it’s very individualized,” said Okeanis Vaou, MD, associate professor and chief of the movement disorders division in the Department of Neurology, Joe R. and Teresa Lozano Long School of Medicine, at UT Health San Antonio.
Vaou also is affiliated with the school’s Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases and University Health, and sees patients with neurodegenerative and sleep disorders. She and her team were chosen by the technology’s manufacturer as one of the first locations nationally, and the only one in Texas, to launch the product for patient care. The product received federal Food and Drug Administration approval on Feb. 24.
Vaou and her team – Pablo Coss, MD, Leila Saadatpour, MD, and Sarah Horn, MD, all clinical assistant professors of neurology at UT Health San Antonio – switched on the adaptive DBS technology with the first patient on March 25, and followed with another six patients that same week. It all happens during a regular patient visit, taking anywhere from 20 minutes to an hour. Vaou has high hopes for the first patient outcomes.
“The studies have shown that it does offer therapy and symptom optimization and improves patient quality of life,” she said. “Imagine people with Parkinson’s when they have a tremor. The stimulation therapy automatically adjusts, and it increases. When they don’t (have a tremor), it goes down, and so forth. So, it follows the symptoms and delivers the appropriate treatment at each step of the way.”
Alexander Papanastassiou, MD, associate professor of neurosurgery in the Long School of Medicine, typically implants the sensing DBS devices at University Hospital for patients. Following the implantation, the patients come in periodically for Vaou and her team to download information from the generator, and then adjust the stimulation level manually. Now, that adjustment becomes automatic.
“The device had sensing (capability), so it basically just sensed the brain signals and we then took the information and made the best informed decision in programming, but it never adjusted itself,” Vaou said. “The change now is that it automatically adapts to the patients’ symptoms.
“This is a unique technology to this device,” she said.
Vaou and her team were chosen for their vast experience with DBS, and because they stay at the forefront of new technology. Last year, they also were one of the first to take part in implanting a newly approved sensing rechargeable DBS device with a 15-year battery life allowing more continual treatment of patients with movement disorders.
That technology was a significant improvement over previous non-rechargeable devices that required replacement every three to four years.
The movement disorders division at UT Health San Antonio is designated a Parkinson’s Foundation Comprehensive Care Center, the first of its kind in Texas, recognizing operations providing excellent care to people with Parkinson’s disease within a broad geographic region.
To learn more about the movement disorders program available at UT Health San Antonio or to schedule an appointment, please call 210-450-0500.