How Medtronic & UCSF gives Parkinson’s more control over symptoms
Deep brain stimulation is the process by which electrodes stimulate specific brain circuits to alleviate motor symptoms, which has long helped people with Parkinson's disease control tremors — but a new approach is helping further advance treatment.
Maria Shcherbakova, a neurology researcher at UCSF, noted that this approach, known as adaptive deep brain stimulation (ADB), is already improving the quality of life for patients who are less responsive to traditional deep brain stimulation. Unlike the conventional method of continuous stimulation through implantable brain devices, ADBS adjusts its electrical signals in real time based on the patient's brain activity.
Shcherbakova notes that this personalization gives patients better control over their unique symptoms with fewer side effects. When the drug is active to avoid excessive tremor, the therapy works with Parkinson's medication by reducing stimulation and increases as the drug wears out to reduce stiffness.
In February, Medtronic received the first ever FDA-approved its implantable ADBS system to treat people with Parkinson's disease. UCSF is one of the academic medical centers involved in the research to help advance the use of the technology and track how the method improves patient outcomes.
Shcherbakova noted that UCSF's research published last year showed that ADB can provide more precise control over Parkinson's symptoms by automatically adjusting stimuli based on brain activity compared to conventional DBS.
“This is not to say that this therapy is suitable for everyone and should be prescribed to everyone on conventional therapy. But for some people with Parkinson's disease, basic tremors and epilepsy, conventional therapy just won't help. So the implant that occurs will get this expensive process, then put it into practice, then install it into part and then install it into their brains.
For example, UCSF is treating young Parkinson's patients and competitive skateboarders who regained their ability to skate and work after receiving ADBS implantation, Shcherbakova said. Before he tried ADB, other treatments didn't help him with his symptoms.
She also noted that the therapy could help reduce the burden on caregivers by managing side effects more smoothly.
Shcherbakova added that although ADB has great potential to improve the quality of life in Parkinson’s patients, there are still some clinical and implementation challenges.
First, as brain activity and disease progression change over time, the therapy requires continuous adjustment.
Medtronic and its network of researchers are also working to ensure that the system is easy to use for neurologists everywhere, not just neurologists at the center of academic research. Shcherbakova explains that neurologists need training and organizational buy-in to integrate ADB into their workflow.
Although there are still some challenges in training clinicians and further personalized therapy, ADB can glimpse into the future where Parkinson’s patients can live a richer, more manageable life.
Photo: UCSF
