The U.S. Food and Drug Administration (FDA) has approved four deep brain stimulation (DBS) devices for Parkinson’s. While each device is unique, all DBS systems have the same basic components and work in a similar fashion. Each includes thin wires, or leads, implanted in the brain, and a neurostimulator and battery, implanted in the chest or abdomen. Doctors program the neurostimulator to deliver small electrical pulses through the leads into areas of the brain that control movement in order to lessen Parkinson’s disease (PD) symptoms. The differences in devices represent innovation and widen treatment options.
Medtronic’s DBS was the first to be FDA-approved for PD, in 1997. Over the past two decades, Medtronic has added newer systems with rechargeable and non-rechargeable batteries. Rechargeable batteries may last up to 15 years but require regular recharges. Non-rechargeable devices last, on average, about three to five years, depending on an individual’s settings. A person with this Medtronic DBS device can undergo most MRI scans safely when certain conditions are met.
The Abbott Infinity DBS was FDA-approved for Parkinson’s in 2016. The Infinity brain leads allow “directional stimulation,” which is a potentially increased ability to steer electrical stimulation toward symptoms and away from side effects. Abbott DBS operates with Apple iOS software and controllers for a possibly more familiar interface and easier programming experience. Abbott’s new technology, the first of its kind in the United States, also allows people with these devices to communicate with their clinician and receive DBS adjustments remotely, from their home or other location with WiFi or cellular access. People with this Abbott DBS system may have most MRI scans safely when specific procedures are followed.
Boston Scientific Vercise
Boston Scientific’s Vercise became available for PD in Europe in 2012, and it first gained FDA approval in 2017. Vercise’s brain leads contain more points (eight vs. four in other systems) through which doctors can precisely deliver and control electrical stimulation. Vercise can use either a non-rechargeable or rechargeable battery, and rechargeable devices may last 15 years or more. People with the Vercise DBS may safely undergo most MRI scans as long as several conditions are met.
Medtronic Percept was approved in Europe in early 2020 and gained FDA approval in June 2020. This first-of-its-kind device can sense and record an individual’s unique brain signals. With this data, doctors may be able to correlate patient symptoms with actual brain signals, which might eventually allow more precise DBS adjustments for possibly better symptom control and fewer side effects. Patients also can track their medications and symptoms in an electronic diary, which uses Samsung technology, so that they and their doctor can look for patterns between symptoms and brain signal changes. The battery lasts, on average, about five years, and is compatible with other Medtronic DBS leads. (This means if you have a Medtronic battery that is due for an exchange or have difficult-to-control symptoms, you could consider switching to Percept.) Percept is compatible with most MRI scans as long as safety conditions are met.
When deciding on a DBS device with your doctor, consider:
- Whether you want a rechargeable battery
Rechargeable batteries may need fewer replacements over your lifetime, but they require regular recharging.
- How you’ll interact with the device
Everyone should be able to check their battery and turn their device on and off, but some people also want to adjust settings at home within parameters set by their doctor. Evaluate the user-friendliness of each device’s personal programmer.
- Your doctors’ experience and recommendation
Your neurosurgeon and movement disorder specialist may be more familiar with placing or programming one device or may have more positive results with another.
Note that a clinical trial has not directly compared these DBS devices, so it’s not clear if one works “better” than another.