Fighting Parkinson’s: The brains behind medical miracles

A device developed in Clonmel is greatly improving the quality of life for patients who suffer from incurable diseases such as Parkinson’s, writes John Daly

In the world of modern medical science, technological miracles conceived and developed in laboratories continue to change lives around the world. Such is the story of the Vercise Deep Brain Stimulation system. For people suffering movement disorders such as Parkinson’s disease, Dystonia and essential tremor, daily life can be a constant struggle characterised by involuntary and rhythmic shaking, painful stiffness and an incapacity to hold or control everyday items.

While there is no outright cure for such disorders, the quality of life endured by sufferers has been greatly enhanced with the aid of a device manufactured by Boston Scientific at its Clonmel facility. An implantable pulse generator that helps stimulate specific areas in the brain using electrical signals, the company’s Vercise Deep Brain Stimulation (DBS) system for the treatment of tremor is the first designed to offer precise neural targeting, allowing physicians to customise therapy for patients with such conditions.

The system also incorporates a rechargeable battery that can last up to 25 years. Over 5,000 DBS devices have been produced in Clonmel, with more than 100 people employed in their manufacture there.

One of the first commercial implantations of the Vercise DBS system was performed in Germany, at the University Hospital Cologne, led by Professor Dr Veerle Visser Vandewalle, head of the department of stereotaxy and functional neurosurgery. “Essential tremor can be very debilitating for patients in their day-to-day activities such as writing and eating,” he said.

The Vercise DBS system is designed to manage ET symptoms effectively and improve patient quality of life. It features independent current control, which gives clinicians the ability to control stimulation precisely for a neural target to help minimise unwanted side effects.

The pulse generator is surgically inserted under the skin, usually just below the collarbone, and produces small electrical signals which pass along fine wires positioned in the sub-thalamic nucleus in the brain. The system includes unique Clinical Effects Map software which captures data over time, visually summarises the progress of individualised patient therapy, and enables physicians to monitor and modify treatment as needed. These features allow for programming flexibility, designed to enable better outcomes with fewer side effects.

“This system exemplifies the Boston Scientific commitment to advancing DBS therapy and providing impactful and transformative technology to reach a broader range of patients suffering from these debilitating diseases,” according to Maulik Nanavaty, president, Neuromodulation, Boston Scientific. “Our clinical evidence, unique software solution and expanded portfolio, now with both rechargeable and non-rechargeable devices, enable physicians to provide their patients with a tailored solution.”

Boston Scientific’s Vercise Deep Brain Stimulation (DBS) system allows physicians to customise therapy for patients with conditions such as Parkinson’s.

Essential tremor can be a progressive disorder, typically starting on one side of the body, and then gradually affecting both sides. It is most commonly seen in older adults, however the onset of symptoms may occur at any age. The exact cause for ET is unknown, but it is found to be mostly hereditary, where children of a parent with the condition have a 50% chance of inheriting the condition. “With the launch of this system, Boston Scientific continues to demonstrate its commitment to provide more access to DBS therapy to more patients,” Nanavaty added.

We believe this advanced technology can play a critical role in improving the lives of patients who suffer from these devastating conditions.” Stephen Carcieri, a Research Science Fellow who has worked Boston Scientific for the past 10 years, was involved in the development of the DBS system from an early stage.

“It was incredibly gratifying for me to be part of the team that worked on a product that has brought such comfort to so many people. When I first started in neuromodulation, I was interested in it from a scientific perspective, but when I realised what a meaningful difference it can make in a patient’s life, it transformed the way I think about our work. Developing new technology is great, but improving outcomes and dramatically changing patient’s lives is the most rewarding part of my job,” he added.

He recalled one particular incident that brought home the true impact of how such an innovation can impact on the world: “A few years ago I was in Madrid for a conference and we were meeting with a group of neurologists. My colleague had a Boston Scientific sign to identify our team for the neurologists in the crowd. At one point, a very elegant older woman approached us and asked if we worked for Boston Scientific, and we immediately assumed she was one of the neurologists.”

In fact, the woman was not part of the conference — but was actually a Parkinson’s patient who had a Boston Scientific DBS device implanted a few years earlier.

“She had no signs of having Parkinson’s disease, because her DBS therapy had been so successful. Just by coincidence, she was staying at the same hotel and had seen the Boston Scientific sign, and she wanted to come by and thank us for changing her life. I will never forget her.”

A new life with DBS

Tony Ryan, 62, from Newport, County Tipperary, was diagnosed with Parkinson’s Disease, aged 32. His wife Mary explains Tony’s journey with DBS, and how it impacted on their lives.

“Tony was diagnosed with Parkinson’s Disease aged 32, almost 30 years ago now. He wasn’t so much affected by the tremors, for Tony the biggest problem was muscle stiffness, which seriously affected his speech and walking. Before he had the DBS operation, his Parkinson’s was progressing and he was having to take more and more tablets. At one point, he was taking 40 tablets a day. The amount of medication was starting to make him more unwell and causing him to feel very sick. It was at this point our specialist started talking to us about DBS – which we had been told about previously, but at this stage, it was felt that Tony was a good candidate for the surgery.” The next step involved a three day assessment and as Tony’s specialist had thought, he was an ideal candidate for DBS. Given his optimistic frame of mind, his stamina and his ability to just get on with things, the doctors thought the DBS would work very well for him. So in January 2011, he had the DBS operation.

Our abiding memory of this time is that Tony had the operation on the Wednesday and by the following Friday the stimulation was turned on. It was remarkable.

"Tony was able to walk up and down the corridor with no stiffness, it was incredible. We were home 10 days later and although the stimulation settings have needed some adjustments from time to time, we’ve really never looked back. Tony is on half the medication he was and we really are so grateful that he was able to have the deep brain stimulation surgery.”

Tony and Mary’s daughter, Marie, works at the Boston Scientific facility in Cork.

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