Docs dig deep with brain-based neurostimulator

Very Percept-ive: A new "deep-brain" neurostimulator is the first to also record brain activity.
By GREGORY ZELLER //

An innovative “deep brain” device that captures and records cerebral signals is changing the way Northwell Health physicians treat a drug-resistant form of epilepsy.

Introducing the Percept PC neurostimulator with BrainSense technology, which earned FDA approval in June, boasts two distinct trademarks (“Percept” and “BrainSense”) and packs a plethora of cutting-edge tech designed specifically to battle refractory epilepsy – a particularly nefarious form of the neurological disorder known also as intractable or uncontrolled epilepsy, highlighted by medicine-proof seizures.

Designed by Irish med-tech maker Medtronic, the deep-brain stimulation device is the first DBS unit to not only deliver tiny, stimulating electric shocks but also to detect and document brain signals – enabling dynamic therapies based on the individual patient’s specific neuronal activity, what Northwell Health calls “more data-driven and personalized treatment.”

That was the idea July 8, when North Shore University Hospital neurosurgeon Ashesh Mehta implanted tiny stimulation electrodes deep inside the brain of 21-year-old Broad Channel resident Brianna Sartor, who’s suffered debilitating seizures since childhood.

Ashesh Mehta: Mehta data-driven.

The two-part, minimally invasive Percept procedure marked the first DBS-based epilepsy treatment on Long Island – deep-brain devices are already used to treat Parkinson’s disease and other mobility disorders – and concluded July 22 when Mehta implanted the neurostimulator near Sartor’s collarbone, and connected the implants with tiny wires.

The neurosurgeon, director of the Laboratory of Human Brain Mapping at Northwell Health’s Feinstein Institutes for Medical Research, said electroencephalography brain scans had determined that Sartor’s seizures were originating from “critical areas of the brain which control movement and speech,” meaning resection surgery – essentially, removing the affected tissue, or in this case brain matter – wasn’t on the table.

That left the Percept, which was pressed into service as soon as it earned its epilepsy stripes from the FDA.

“[Sartor] was not a good candidate to receive resection surgery,” noted Mehta, also Northwell Health’s director of epilepsy surgery. “We are delighted that the Percept neurostimulator has been approved for the treatment of refractory epilepsy, so we can help patients like Ms. Sartor live a better quality of life.”

This is not the first time Mehta has surfed the cutting edge of neuronal activity; in fact, the real-time brain-activity mapping that separates the Percept from other DBS devices is kind of his thing.

And it’s not the first time Medtronic, which maintains its U.S. headquarters in Minnesota, has graced Northwell Health’s laboratories or surgical theaters. The med-tech maker created an implantable pacemaker and other wireless pacemakers now benefitting Northwell cardiac patients, as well as a cutting-edge 3D-imaging system in play at Huntington Hospital.

The latest collaboration between Northwell Health and the international innovator will take time to bear fruit: Sartor has already followed up with neurologist Fred Lado, epilepsy director for Northwell’s central and eastern regions, and been taught to adjust her implant as necessary, but with targeted electrical impulses stimulating brain activity, the reduction of seizure activity will be a gradual process over a course of months.

If it works as expected, though, it will be worth the wait, according to Lado.

“Our ability to offer DBS for medically refractory epilepsy further expands the options we can offer patients,” the epilepsy director said in a statement. “I am looking forward to working with Ms. Sartor to maximize the benefit of this new technology.”