American doctors have begun implanting a new deep-brain stimulation system by Medtronic Inc. that senses and records brain activity at the same time it delivers therapy to treat Parkinson's symptoms, essential tremors and epilepsy, the company announced Thursday.
The Activa PC+S deep-brain stimulation system may allow researchers to actually make the link to brain signals that cause the devastating and debilitating shaking related to Parkinson's — or to a host of other neurological and psychological disorders.
In much the same way that doctors 40 years ago used what they learned about heart rhythms to develop pacemakers that automatically adjust to patient activity, neurologists hope they can eventually develop technology that can automatically adjust therapy to what's happening inside a patient's brain.
"The hope is, in the future, we can understand what brain signals are related to the abnormal movements," said Dr. Helen Bronte-Stewart, a neurologist who is using the Activa PC+S DBS device for research at Stanford University. "Then we won't need to stimulate constantly with one set of parameters, but can automatically adjust therapy. Like a sophisticated thermostat."
The first European implants of the technology took place in Germany in August.
'More and more real'
"It's really now becoming more and more real," said Lothar Krinke, vice president and general manager of the deep-brain stimulation business in Medtronic's neuromodulation division. Medtronic hopes to conduct research at up to 20 centers worldwide.
Deep-brain stimulation (DBS) therapy uses a surgically implanted medical device, similar to a pacemaker, to deliver mild electrical pulses to targeted areas of the brain to control symptoms of movement disorders and other diseases. More than 100,000 patients worldwide have received Medtronic's DBS therapy.
The Activa PC+S system received CE Mark approval for use in the European Union in January. It has not yet been approved by the U.S. Food and Drug Administration for commercial use in the United States, but doctors can now begin implanting the device for research purposes.
The first two implants of the Activa PC+S DBS system in the United States took place at Stanford Hospital & Clinics and the University of California, San Francisco Medical Center in patients with advanced Parkinson's disease.
Research teams led by Bronte-Stewart, director of the Stanford Movement Disorders Center and professor of neurology and neurological sciences at the Stanford University School of Medicine and neurosurgeon Dr. Philip Starr, professor of neurological surgery and surgical director of UCSF's Bachmann-Strauss Dystonia and Parkinson Foundation Center of Excellence, are the first in the United States to use the system.
The system uses sensing technology and an adjustable algorithm to gather brain signals. That data will be made available to physicians worldwide for use in clinical studies. They will use the system to map the brain's responses to DBS therapy and explore new applications.
'It's absolutely fabulous'
Bronte-Stewart, who has been doing this research in the operating room for nearly a dozen years, said the implications of what doctors learn from this technology will be huge.
"For me, it's absolutely fabulous. This has been my research goal ever since I moved from doing neurophysiology in a primate to understanding movement disorders in a human," she said. "I have been building a laboratory for precisely this reason. … This project is allowing me to really expand the information that we are gathering. It's the absolute true definition of the window into the brain."