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Dr Reddy with DBS device

Upstate is first hospital in region to use recording device for deep brain stimulation to improve treatment for neurologic disorders

Upstate University Hospital is the first hospital in New York state outside of New York City to use a new recording technology to help patients suffering from neurologic disorders such as Parkinson’s disease, essential tremor and epilepsy.

The U.S. Food and Drug Administration approved the new deep brain stimulation device called Percept PC Neurostimulator in July. In addition to delivering deep brain stimulation therapy, or DBS, to patients, the device also records the event, which can help doctors identify when to optimally deliver electrical stimulation, thereby lessening a patient’s movement disorder symptoms.

Gaddum Reddy, MD, is director of Adult Functional Neurosurgery at Upstate and specializes in DBS therapy. The Percept’s ability to record symptoms in addition to its standard delivery of therapy will benefit the patient in many ways, Reddy said.

“Now, when a patient comes to see me I can see what their (brain waves) looked like,” he said. “If they were able to press record, that data is saved on their device and when they come back to see us we can look at it and analyze that information. That will allow us to take the next step to selectively program for only when they have symptoms.”

Deep brain stimulation is used to treat the side effects of movement disorders such as Parkinson’s disease, essential tremor or dystonia. The therapy is similar to a cardiac pacemaker but the electrical stimulation is in the brain rather than the heart; both have batteries implanted in the chest. DBS can lessen the side effects that medications for movement disorders cause, Reddy said, and while not considered a cure, can improve a person’s quality of life. A challenge of DBS is that stimulation is near constant, which means it’s happening even when the patient might not need it, which drains a lot of battery power.

“This will allow us to only stimulate when you need it – when you’re having a tremor or rigidity,” he said. The recording function of the Percept will allow Reddy to better tailor treatments to a patient’s needs and condition, he said. The battery can last five years or more.

The Percept recording device, which can fit in the palm of your hand, is surgically implanted in the chest with wires connected to the brain to deliver deep brain stimulation. About three weeks after the Percept is implanted, the patient may begin having the ability to record their brain waves using a handheld remote, similar to a smart phone. The patient can record instances as frequently as needed and are encouraged to record periods of extra rigidity or shaking, for example. At the next office visit, Reddy and Neurologist Dragos Mihaila, MD, can download that recorded data and analyze it to find patterns. Those brain wave and function patterns will help the doctors find period of times for when to best deliver DBS, Reddy said. That course of treatment can be adjusted over time as the patient continues to record events.

That data is only available to the doctor when the patient is in the office but can be streamed live for real-time monitoring, Reddy said. Medtronic, which developed Percept, has been creating DBS equipment for 25 years. The Percept is compatible with existing DBS equipment meaning the recording feature and its battery pack can be connected to existing DBS technology in a patient.

The recording can be constant but smaller periods of time will be most helpful to doctors, Reddy said.

“You can record all of the time,” he said, “but you really want to use it selectively to get a good snapshot for what’s happening.”

Caption: Gaddum Reddy, MD, director of Adult Functional Neurosurgery at Upstate, holds part of the new Percept PC Neurostimulator inside the Upstate Brain and Spine Center, which opened this spring at Upstate Community Hospital.