Photo from Neurosurgery One

Originally Posted On: https://www.neurosurgeryone.com/blog/dbs-remote-programming-expands-access-for-rural-patients/

The Denver DBS Center is one of the first in the country to now offer remote programming for deep brain stimulation (DBS). This advancement gives more patients — particularly those living in rural or remote areas — access to DBS, a life-changing surgery that helps control the symptoms of Parkinson’s disease, essential tremor and other movement disorders.

DBS is a procedure that uses electrical impulses to lessen the symptoms of Parkinson’s disease, essential tremor, and other movement disorders. The procedure is so successful that it allows many patients the opportunity to continue working, enjoying hobbies and activities, and socializing for years longer than without surgery. However, many people with these conditions who live in rural or remote areas are unable to access this treatment as it is generally performed in urban cities and – until now – required multiple visits back each year for programming.

Remote DBS programming is conducted with the patient at home connecting via telehealth to their neurosurgeon or neurologist, eliminating the need for repeated visits for follow-up programming.

“Everything in medicine is moving in the direction of making things easier for our patients and quicker to access,” says Dr. David VanSickle, Denver DBS Center neurosurgeon and a national leader in robotic-guided asleep deep brain stimulation for patients with Parkinson’s, essential tremor, and other movement disorders.

Remote Programming Eliminates Multiple Trips to Far-Away Urban Centers

Until the development of remote DBS programming, patients had to physically go into the offices of their DBS neurosurgeons or neurologists to have their DBS system initially programmed and then re-adjusted. During the first six months after surgery, patients typically need their DBS device programmed every month. Once the ideal settings are determined, patients continue to see their neurologist regularly for re-programming, which can be as often as every three months. Because Parkinson’s disease and essential tremor are progressive diseases, the DBS system must be reprogrammed as symptoms change.

Using a new wireless iOS platform developed by  Abbott, the Denver DBS Center can adjust patients’ DBS systems remotely and patients can make modifications to their system within the parameters set by their neurosurgeon.

“I cannot overstate the importance of remote programming,” Dr. VanSickle says. “It allows us to reach our patients in remote areas, from farming areas of Kansas and Nebraska, to mountainous areas such as Durango, and from far south of Denver such as New Mexico, or far north of here such as Wyoming and Montana. We have treated patients from across the country and even some from outside the U.S. This advancement really opens up the world to DBS.”

Deep Brain Stimulation Underutilized by Patients

Currently, only about 10% of patients with Parkinson’s disease who qualify for DBS have the procedure done–many of them because they live too far away from a DBS center, Dr. VanSickle says. “Unfortunately, the other 90% of patients have a worse quality of life.”

DBS for essential tremor also is vastly underutilized, Dr. VanSickle says. Essential tremor causes uncontrollable shaking, typically in the hands and head. Patients with essential tremor often isolate due to embarrassment, which negatively affects their quality of life and health. In the past five years, DBS quality has improved so that there is now a less than 1% complication rate. “For less than a 1% risk with asleep robotic DBS, patients have a 99% chance of stopping at least 95% of their tremors.”

Art Nixon, of Brush, Colo., was one of the first patients to utilize the new remote programming technology. After his first adjustment made remotely, he was amazed at the improvement. “I’m going to be able to take my wife out to dinner. This is an amazing day,” Mr. Nixon said as he choked up with tears. “I can’t tell you how much this means to me.” [Watch the video of Mr. Nixon’s journey below.]

Denver DBS Center, an affiliate of Denver-based Neurosurgery One,  was the first in the country to perform robotic-guided Asleep Deep Brain Stimulation. Unlike traditional deep brain stimulation that is performed with the patient awake, patients remain asleep during the implantation surgery. Using robotic guidance and performing the procedure with the patient asleep, Dr. VanSickle achieves more accurate placement of the electrodes, shorter procedure times, and improved outcomes for patients.