A team of neurosurgeons and neurologists at UHealth – the University of Miami Health System has successfully treated a Central Florida man with Parkinson’s disease using a new implantable deep brain stimulation device.
The team was the first in South Florida and among the first in the country to implant the Vercise DBS technology — developed by Boston Scientific and recently approved by the Food and Drug Administration (FDA) — adding to UHealth’s options for deep brain stimulation treatment.
DBS treats severe hand and body tremors and other symptoms associated with Parkinson’s disease by stimulating a targeted region of the brain through implanted leads or thin wires that are connected and powered by a pulse generator implanted in the chest.
The patient, Kenneth Girlardo, is a 71-year-old U.S. Army veteran from the Orlando area who was diagnosed with Parkinson’s disease in July 2010. He began experiencing severe, debilitating tremors, and Girlardo and his family saw a downward spiral in his overall mobility and quality of life. He says he stopped driving, and “everything was a major task.”
The Vercise device has eight contacts on each lead that deliver electric impulses to the brain, enabling physicians to deliver a prescribed amount of stimulation. In addition, the Vercise pulse generator is the smallest, rechargeable DBS device available in the U.S. It has a battery life of up to 15 years, minimizing the need for replacement surgery.
Like many people living with Parkinson’s disease, Girlardo stopped responding to the half-dozen daily medications he took to control his tremors, making him a candidate for DBS treatment. The two-part procedure was performed at UHealth Tower in March by neurosurgeon Jonathan R. Jagid, M.D., associate professor of neurological surgery, and guided by neurologist Corneliu Luca, M.D., Ph.D., assistant professor of neurology and director of UHealth’s Deep Brain Stimulation Program.
Jagid, who has performed approximately 1,000 DBS surgeries, said that Girlardo’s procedure was “perfectly smooth.”
“The first surgery took about four hours to place leads on each side of the brain, in the deep areas called the subthalamic nucleus,” said Jagid. “Mr. Girlardo stayed a night in the hospital and then came back a week later to have the remainder of the system — the extension cables and generator — implanted under general anesthesia.”
Luca and Jagid played a pivotal role in clinical trials of the Vercise DBS system for FDA ap-proval as part of UHealth’s Center for Parkinson’s Disease and Movement Disorders, South Florida’s only National Parkinson’s Foundation-designated Center of Excellence.
Parkinson’s disease is a slowly progressive, chronic neurodegenerative condition that affects up to 1.5 million Americans, with 40,000 to 60,000 new cases diagnosed each year. While its cause remains a mystery, about 15 percent of patients are diagnosed before age 50, and the disease affects one of every 100 persons over the age of 60.
“DBS is a well-established procedure for Parkinson’s disease, similar to a pacemaker for the heart,” said Luca. “By inserting wires deep in the brain, we are able to change the pathological oscillations, or arrhythmias, in the brain to a state that is physiologic, thereby reducing motor symptoms of the disease.”
When doctors recently activated and custom programmed Girlardo’s device, his tremors stopped. The husband and father became optimistic about living a normal life and, most of all, dancing with his wife again.
“I think it’s fantastic,” he said. “I never thought they [the doctors] could do what they did.”
“We’re very happy to see today that he had very good results,” said Luca. “His tremors improved 100 percent. After we turned on the device, he started walking. The stiffness he was experiencing also improved tremendously.”
The system is operated by a remote control device, which Luca programs and shows patients how to use to apply stimulation on their own.
“It’s user-friendly. It’s not just the doctor who can do it,” said Girlardo. “I feel very lucky that things went well.”
With family by his side, Girlardo beamed with optimistic pride, because he is now able to keep his tremors at bay and move with ease. He is even returning to playing golf, since he has also regained the ability to swing his arms.
“I hope this technology helps improve the time he can spend with the family — especially my kids, his grandkids,” said his son, Kenneth Girlardo Jr. “I hope that he’s able to do more of the things that he used to be able to do.”