WHEN YOUR MEDICATION IS NO LONGER WORKING WELL, THERE MAY BE ANOTHER OPTION

Posted: April 1, 2021
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WHEN YOUR MEDICATION IS NO LONGER WORKING WELL, THERE MAY BE ANOTHER OPTION

Published with permission from Boston Scientific

When 54-year-old Suzanne Friedman got diagnosed with Parkinson’s disease, she tried everything, including an hour of exercise each day, to try to stop the disease in its tracks. But despite her best efforts, it continued to progress, and eventually, her medicine began to make her tired and stopped working well. It was then that Suzanne started the search for other options.

DBS, or Deep Brain Stimulation, is similar to a pacemaker—but for the brain. Thousands of patients have benefited from DBS over the last twenty years.1 A well-established, safe, surgical procedure places a small, thin device called a stimulator just under the skin in the chest, sending electrical signals via one or two thin, insulated wires to the brain. It’s designed to help control motor symptoms and can reduce the need for medications that can have unwanted side effects.2

Just like a pacemaker, the DBS battery will need to be changed every three to five years* in a short surgical procedure. However, some devices are rechargeable and can be implanted for at least fifteen years* without a battery replacement, requiring only about an hour of easy recharging a week using a wireless recharging system.

One thing to consider when selecting a DBS system is that Parkinson’s disease is a progressive disease, and even with DBS, it will continue to advance and change. New technology developed by manufacturer Boston Scientific allows very precise amounts of current to be delivered to very precise areas of the brain. These new DBS systems with current steering technology, gives doctors an incredibly sensitive and precise “steering wheel” to manage the challenging terrain as their patients’ needs change.

There is a window of opportunity for getting DBS. Research has shown that the best time to get DBS is when Parkinson’s disease medications are just starting to become less effective, but before symptoms become severe and the response to medication is unpredictable.

On the day that Suzanne’s device was “turned on,” she brought her husband Steve and her daughter with her. Steve recalls how nervous Suzanne was, worrying that it wasn’t going to work. “We were sitting there and her leg is shaking, her foot is shaking. They turned on the device and all of a sudden, the foot stopped. They turned it off and the foot started again. Turned it back on, the foot stopped. My daughter started crying.” After the programming, the three of them went out to eat, and Suzanne was walking like her old self again.

For Suzanne, one of the greatest gifts DBS has given her is consistency. “Life before DBS was a struggle. I was suffering every day. Now, [my experience has been that] I don’t have to worry about whether my medicine works, whether it’s not going to work, when I have to eat, when the next medicine’s due. I’m sleeping better, not napping every day, being able to stay up late. Everybody keeps telling me that I seem happy and that they see me smiling more.”

Gardner J. A history of deep brain stimulation: Technological innovation and the role of clinical assessment tools. Soc Stud Sci. 2013;43(5):707-728. doi:10.1177/0306312713483678

Jerrold L Vitek, et. al., Subthalamic nucleus deep brain stimulation with a multiple independent constant current-controlled device in Parkinson’s disease (INTREPID): a multicenter, double-blind, randomized, sham-controlled study, The Lancet Neurology, Volume 19, Issue 6, 2020, Pages 491-501.

**Battery life is dependent on the stimulation settings and conditions

Indications for Use – The Boston Scientific Deep Brain Stimulation Systems are indicated for use in: Bilateral stimulation of the subthalamic nucleus (STN) as adjunctive therapy in reducing some of the symptoms of moderate to advanced levodopa responsive Parkinson’s disease (PD) that are not adequately controlled with medication.

Bilateral stimulation of the internal globus pallidus (GPi) as an adjunctive therapy in reducing some of the symptoms of advanced levodopa responsive Parkinson’s disease (PD) that are not adequately controlled with medication.

Contraindications: The Boston Scientific Deep Brain Stimulation Systems are not recommended for patients who will be exposed to the following procedures: Diathermy as either a treatment for a medical condition or as part of a surgical procedure, Electroconvulsive Therapy (ECT), and Transcranial Magnetic Stimulation (TMS). The safety of these therapies in patients implanted with the Vercise DBS System has not been established. Patients implanted with Boston Scientific Deep Brain Stimulation Systems without ImageReady™ MRI Technology should not be exposed to Magnetic Resonance Imaging (MRI). Patients implanted with the Vercise Gevia™ or Vercise Genus™ or Vercise DBS Lead-only system (before Stimulator is implanted) with ImageReady MRI Technology are Full Body MR Conditional only when exposed to the MRI environment under the specific conditions defined in ImageReady MRI Guidelines for Boston Scientific Deep Brain Stimulation Systems. Boston Scientific Deep Brain Stimulation Systems are not recommended for patients who are unable to operate the system or are poor surgical candidates or who experience unsuccessful test stimulation.

Warnings: Unauthorized modification to medical devices is prohibited. You should not be exposed to high stimulation levels. High level of stimulation may damage brain tissue. Patients implanted with the Vercise DBS System may be at risk for intracranial hemorrhages (bleeding in the brain) during DBS lead placement. Strong electromagnetic fields, such as power generators, security screeners or theft detection systems, can potentially turn the stimulator off, or cause unpredictable changes in stimulation. The system should not be charged while sleeping. If you notice new onset or worsening depression, changes in mood or behavior or impulse control, or have thoughts of suicide contact your physician or emergency services immediately. Chemical burns may result if the Vercise Stimulator housing is ruptured or pierced. The Deep Brain Stimulation System may interfere with the operation of implanted stimulation devices, such as cardiac pacemakers, implanted cardioverter defibrillators, or medication delivery pumps. Patients should operate motorized vehicles or potentially dangerous machinery with caution. It is unknown if the device may hurt an unborn baby. Your doctor may be able to provide additional information on the Boston Scientific Vercise DBS System. For complete indications for use, contraindications, warnings, precautions, and side effects see DBSandME.com.

Caution: U.S. Federal law restricts this device to sale by or on the order of a physician.

Boston Scientific is in the PRO Wellness Village at ParkinsonsResource.org/the-wellness-village/directory/boston-scientific/ where they have been members since November 2018.