News
Advances in deep brain stimulation
Jan 27, 2023
Advances in deep brain stimulation (DBS) are offering a potential step forward for patients with Parkinson’s Disease, Essential Tremor and Dystonia throughout WA.
Hollywood Private Hospital Neurologist Dr Julian Rodrigues and Neurosurgeon A/Prof Steve Lewis are at the forefront of adopting the latest technological innovations such as intraoperative CT (computed tomography), remote brain stimulator programming and directional DBS, now with sensing capability.
DBS requires surgery to implant a device (a neurostimulator) that sends electrical signals to areas of the brain responsible for movement.
Hollywood is the only site in WA using remote programming of DBS, which allows Dr Rodrigues to assess patients over live video and adjust their implanted DBS device for better symptom control.
“I can offer treatment to patients living 20 km away, or over 2000 km away, from the comfort of their own home. It’s a Godsend for movement-impaired patients who sometimes struggle to attend regular appointments.”
Research has found that the remote programming of DBS can be beneficial, useful and help reduce the issue of distance for access to healthcare.1
In 2017, Hollywood was the first hospital in WA to implant a directional DBS lead system which enables stimulation of minute areas of the brain more precisely.
The benefits of directional DBS can include reduction in side effects from overstimulation and better symptom control.2
Directional DBS electrodes capable of recording brain activity were surgically implanted into a patient at Hollywood on June 27 in another first for WA. This technology has sensing capabilities to provide insight into circuit functions.
“It essentially downloads brain signals.” Dr Rodrigues said.
“By interpreting these signals, I am hopeful we can predict more specifically where to stimulate, reducing the trial and error aspect.
“The data collecting capabilities of DBS recordings have exciting prospects in terms of analysing abnormal brain rhythms and developing automated treatment algorithms using AI [artificial intelligence].”
Scientists predict DBS recordings could shape future therapeutics, including the ongoing development of adaptive and intuitive DBS.3
Hollywood Director of Medical Services, John Maxwell, said it is a priority for the hospital to offer novel technologies to help improve patient outcomes.
“We are thrilled to support our neurologists as they embrace new techniques and medical innovations,” Dr Maxwell said.
1 Christine D. Esper, Aristide Merola, Lyndahl Himes, Neepa Patel, Yarema B. Bezchlibnyk, Drew Falconer, Daniel Weiss, Corneliu Luca, Binith Cheeran and Zoltan Mari. Necessity and feasibility of remote tele-programming of deep brain stimulation systems in Parkinson's disease, Parkinsonism & Related Disorders. Volume 96, 2022, Pages 38-42. ISSN 1353-8020, https://doi.org/10.1016/j.parkreldis.2022.01.017.
2 Kramme J, Dembek T, A, Treuer H, Dafsari H, S, Barbe M, T, Wirths J, Visser-Vandewalle V: Potentials and Limitations of Directional Deep Brain Stimulation: A Simulation Approach. Stereotact Funct Neurosurg 2021;99:65-74. doi: 10.1159/000509781. https://www.karger.com/Article/FullText/509781#
3 Neil M. Drummond, Robert Chen. Deep brain stimulation and recordings: Insights into the contributions of subthalamic nucleus in cognition. NeuroImage, Volume 222, 2020, 117300, ISSN 1053-8119, https://doi.org/10.1016/j.neuroimage.2020.117300.
Anaesthetist Simon Zidar, Neurologist Julian Rodrigues and Neurosurgeon Stephen Lewis before the first procedure in WA where directional DBS electrodes capable of recording brain activity were surgically implanted into a patient.