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Enhancing deep brain stimulation to treat Parkinson’s disease

Enhancing deep brain stimulation to treat Parkinson’s disease

Our researchers have developed groundbreaking technology to improve the accuracy of deep brain stimulation surgery. 

  • Bionics Institute researchers have discovered a way to improve deep brain stimulation electrode placement during surgery. 
  • The research team are also developing an implantable device that can automatically control the level of therapy in response to progression and varying symptoms over time. 
  • This technology is set to transform deep brain stimulation surgery and treatment outcomes for people with Parkinson’s disease. 
  • The Bionics Institute has set up a company, Deep Brain Stimulation Technologies, to market this device for use in clinical settings. 

What is deep brain stimulation?

Deep brain stimulation (DBS) involves the implantation of electrodes into the brain to deliver electrical impulses that block the abnormal brain signals causing symptoms in conditions such as Parkinson’s disease.

Guided by a combination of medical scans and reports from the patient on their symptoms, deep brain stimulation electrodes are implanted into the brain while the patient is awake.

The electrodes are connected via a wire to a battery-operated stimulator device implanted under the skin in the upper chest, which is programmed to deliver the appropriate stimulation for each patient to reduce symptoms such as tremor and muscle rigidity.

Following surgery patients regularly attend programming sessions to adjust the device so that symptoms are alleviated without side effects.

What are the limitations of deep brain stimulation?

Current DBS therapy is hindered by two factors.

Firstly, inserting the electrode into the correct part of the brain is challenging even for experienced neurosurgeons and patients usually need to be awake to report on symptoms during placement of the electrode.

Secondly, stimulation is applied at a constant level determined at each programming session following surgery.

However, symptoms and the need for specific levels of stimulation continually fluctuate and the lack of flexibility can result in too much or too little stimulation, leading to unwanted side effects or poor symptom control.

How are Bionics Institute researchers enhancing deep brain stimulation?

The Bionics Institute DBS team developed groundbreaking technology to overcome these constraints.

Our researchers discovered that certain neural clusters in the brain associated with Parkinson’s disease respond to electrical stimulation with a large signal or Evoked Resonant Neural Activity (ERNA).

They have developed a system that captures the ERNA signal, meaning surgeons can implant DBS devices in anaesthetised patients with greater accuracy using the signal as a guide.

The technique will also be incorporated into the DBS device, enabling it to deliver levels of stimulation that adapt to each individual patient’s needs as they vary over time.

ERNA signal recordings have been made in a large cohort of patients undergoing DBS surgery to guide placement of the electrode and approval has been granted for a multi-centre trial to increase our understanding of the treatment benefits.

The Bionics Institute has set up a company, Deep Brain Stimulation Technologies to market this device. While donations are not needed to for this DBS research, we need funding for our new research.

Next steps

In 2019, the Bionics Institute set up a company, Deep Brain Stimulation Technologies (DBST), to further develop and commercialise this technology and ensure it benefits patients around the world.

The Bionics Institute research team has been contracted to DBST to complete development of both a system to assist neurosurgeons and an implantable DBS research device that will be capable of recording the ERNA signal over time. The team is also investigating the use of ERNA-like signals for other neurological disorders.

The DBS team has been expanded to include additional research clinicians and specialised engineers, and preparations are underway for a clinical study in two neurosurgical research centres overseas.

The research team

Bionics Institute lead researchers:

Professor Hugh McDermott and Dr Matt Petoe.

External researcher:

Dr Paul Minty

Clinical collaborators:

Dr San San Xu, Mr Kristian Bulluss and A/Prof Wesley Thevathasan.

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