Feb 28 (Reuters) –
Welcome to Health Rounds! People with Parkinson’s disease often find that over time, their medication becomes less effective and their symptoms become harder to control. The gold-standard procedure for these patients involves implantation of electrodes in the brain. But today we report on a promising new non-invasive brain treatment. We also highlight a study showing that smart watches and other wearable gadgets can interfere with implantable electronic cardiac devices, and another study that suggests 3D-printed hearts may someday help surgeons pick the right valves for each patient.
In breaking news, see these stories from our Reuters journalists: Two experimental RSV vaccines will face scrutiny from a U.S. Food and Drug Administration panel this week; Keytruda disappoints in prostate cancer trial; and the FDA gives breakthrough designation to a melanoma treatment and approval to a hemophilia therapy.
Wearable smart gadgets can interfere with cardiac devices
Certain newer smartwatches, smart rings and other “smart” products can interfere with implanted electronic medical devices that control heart rhythms such as pacemakers, cardioverter defibrillators and cardiac resynchronization therapy devices, laboratory experiments suggest.
“This study raises a red flag,” said Benjamin Sanchez Terrones of the University of Utah in a statement. “We have done this work in simulations and benchtop testing following Food and Drug Administration accepted guidelines, and these gadgets interfere with the correct functioning of the cardiac implantable electronic devices we tested.”
Some smartwatches, at-home smart scales, and smart rings employ bioimpedance, a type of sensing technology that emits a very small, unnoticeable current of electricity into the body. The tissues’ response to the current is measured by the sensor, and the results can shed light on factors like skeletal muscle mass or fat mass.
As reported in Heart Rhythm, experiments funded by the U.S. National Institutes of Health showed the slight electrical currents can sometimes confuse the medical devices into operating incorrectly.
For example, the current could be interpreted by a pacemaker to mean the heart is beating fast enough, preventing it from working properly when necessary.
In a patient with an implantable cardioverter defibrillator (ICD), which is designed to shock the heart to restore a regular heart rhythm when needed, a wearable device with bioimpedance could trick the ICD into delivering an unneeded painful electric shock, the researchers said.
More research is needed to test the effects of the wearables on implantable cardiac devices in patients, Sanchez Terrones said. Meanwhile, the researchers said they do not recommend the use of wearables with bioimpedance technology in patients with implanted electronic heart devices.
Ultrasound procedure eases Parkinson’s symptoms
Patients with Parkinson’s disease that was not responding well to medication had significant improvements in tremors, mobility, and other physical symptoms after doctors used ultrasound to destroy a small structure in the brain, researchers reported in The New England Journal of Medicine.
Nearly 70% of patients treated in the trial were considered successful responders after three months of follow-up, compared to 32% of patients who received a sham procedure.
Two-thirds of those helped by the treatment had maintained that response a year later.
Longer follow-up is needed to determine whether focused ultrasound is more effective than deep brain stimulation (DBS), an invasive procedure considered the gold-standard treatment for Parkinson’s disease when medications become less effective, said study co-leader Dr. Howard Eisenberg of the University of Maryland.
“DBS is very safe, but it’s more of an ordeal,” and some patients are simply reluctant to have electrodes implanted into their brain, he said.
During the ultrasound procedure, patients lie in a magnetic resonance imaging (MRI) scanner wearing a helmet that delivers ultrasonic energy through the skull to the globus pallidus, a structure deep in the brain that helps control voluntary movement.
MRI scanning allows doctors to pinpoint the target and increase ultrasonic heat until the tissue is destroyed. Patients remain awake and provide feedback on whether their symptoms are improving.
For safety purposes, patients were only treated on one side of the brain. Eisenberg said a trial is now underway testing the treatment on both sides.
The U.S. FDA has approved the Exablate Neuro focused ultrasound system made by Insightec Ltd, which funded the study, but the treatment is not yet covered by insurance.
A 3D printout of your heart may one day help your surgeon
In the future, when someone needs a new heart valve or another cardiac implant, doctors may be able to print a soft, flexible 3D replica of the person’s heart to help determine which device would be most appropriate, researchers say.
“All hearts are different,” said Luca Rosalia of the MIT-Harvard Program in Health Sciences and Technology in a statement. “There are massive variations, especially when patients are sick. The advantage of our system is that we can recreate not just the form of a patient’s heart, but also its function.”
For example, when the heart valve leading to the aorta, which carries blood from the heart to the rest of the body, becomes narrowed – a condition called aortic stenosis – a synthetic valve is often implanted to widen the aorta’s natural valve. With the new procedure, doctors could first print a replica of the patient’s heart and aorta, then try various valves on the printed model to find which one works best, the researchers said.
As reported in Science Robotics, they first used heart scans from 15 patients with aortic stenosis to generate three-dimensional computer models of each patient’s cardiac anatomy. The models were 3D-printed using a polymer-based ink.
The team then fabricated sleeves similar to blood pressure cuffs that wrap around the printed heart and aorta to contract the heart, mimicking its pumping action, and the aorta, constricting it to mimic aortic stenosis.
The models accurately simulated the pumping pressures and blood flows that had been previously measured in the patients, the researchers said.
“We are hopeful that this model can pave the way toward…(improving) clinical care of the millions of people worldwide affected by aortic stenosis and other cardiovascular conditions,” the researchers said.
The National Science Foundation and the National Institutes of Health helped fund the research. (Reporting by Nancy Lapid; Editing by Bill Berkrot)