New deep brain stimulation device gives doctors precise controls for treating movement disorders

Movement disorders such as Parkinson's disease and essential tremor affect more than 11 million people in the United States. Caused by communications breakdowns throughout the central nervous system, these conditions can lead to debilitating loss of muscle control, involuntary movements and loss of coordination.

While there are no cures for these movement disorders, there are several treatment options to help control symptoms and improve quality of life. One, deep brain stimulation (DBS), is a surgical procedure often used when medications fail to control symptoms or produce unpleasant side effects. DBS is like a "pacemaker for the brain." Surgeons, supported by a neurology and neurophysiology team, implant electrical leads into specific areas of the brain that control movements. A neurostimulator device connected to these leads can then send precise signals to regulate or block abnormal motor impulses to limit the shaking and loss of coordination.

The FDA first approved DBS for patients with essential tremor in 1997. The technology has improved continuously since then, with better brain imaging techniques to target precise areas of the brain. Now, device manufacturers are taking advantage of mobile computing technology to program and control DBS systems as well.

The University of Chicago Medicine is one of the first health care systems to successfully use the St. Jude Medical Infinity Deep Brain Stimulation System, recently approved by the FDA for patients with either Parkinson's disease or essential tremor. This is the first FDA-approved system which allows physicians to direct the stimulation and steer the electrical current towards the most critical brain structures neurosurgeons want to treat to improve the movement disorder, specifically the tremor. By the same token, the current can be steered away from areas that, if stimulated, would cause side effects. The system uses a wireless iOS software platform that allows physicians, and eventually patients, to program and adjust the system using an Apple iPad or iPod touch.

"This new technology adds significantly to the precision and safety of deep brain stimulation, as we can individualize deep brain stimulation even more to the individual needs of each patient," said Peter Warnke, MD, professor and Director of Stereotactic and Functional Neurosurgery.

Jerry Cougill, 64, from Braidwood, Ill., recently became the sixth person in the United States to have the new Infinity system implanted at UChicago Medicine. Cougill, a retired teacher and baseball coach, suffered from essential tremor, and felt that the medications he was taking were dulling his senses and affecting his speech. He said he noticed a difference in symptoms right away after the procedure, with a big reduction in shaking and much better motor control filmed a few weeks after the initial programming.

"I'm just glad to get back to my old self," Cougill said.

Mahesh Padmanaban, MD, assistant professor of neurology in movement disorders, added, "We are very happy to see that Mr. Cougill has been doing so well after the programming."

Tao Xie, MD, PhD, associate professor and director of the DBS program and movement disorder clinic in Department of Neurology, said he is excited to have this new device as one of the options for his patients.

"This is expected to deliver a better control of motor symptoms, with fine tuning of the symptoms by having more options to choose from precisely aligned electric contacts. It could also potentially reduce the side effects related to non-specific stimulation, save energy and possibly prolong the life expectancy of the battery," he said. "Even though programming could take us a bit longer than before to have more contacts checked, it is worthwhile given the benefits it brings about."