NNI establishes centre of excellence on World Parkinson’s Day to provide innovative care for patients

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Moving towards better outcomes, the National Neuroscience Institute (NNI) has signed a Memorandum of Understanding with global medical device company, Medtronic International Limited, to advance treatment for patients with Parkinson’s Disease (PD) with innovative deep brain stimulation (DBS) devices. By combining the strengths of NNI’s enhanced specialist care with Medtronic’s technological expertise, the two entities aim to unveil the feasibility of highly programmable and MRI-safe DBS devices – for patients who are not receptive to prescribed drugs to suppress the symptoms.

It is an opportune time for this partnership to be recognised on World Parkinson’s Day, to create a greater awareness of this devastating neurodegenerative disease and highlight the commitment and efforts of NNI to advance in treatments.

From this partnership, NNI aims to:

• Establish a Centre of Excellence for DBS focused on achieving the best outcomes for patients;

• Enhance patient access to DBS therapy through continuous patient education programmes;

• Develop fellowship training for clinicians from South East Asia and worldwide who wish to learn about DBS therapy;

• Play a leading role in the adoption of new technologies that enhance patient care; and

• Identify areas to cooperate in clinical research activities pertaining to the field of Brain Modulation.

Said Associate Professor Ng Wai Hoe, Medical Director, NNI, “Deep Brain Stimulation is a proven technique in alleviating disabling symptoms of PD. This partnership with Medtronic, a world leader in medical technology, will enable us to establish the NNI Centre of Excellence for DBS, in the forefront of brain modulation. The Centre will enhance patient care, safety and quality outcomes. It will also play an important educational role to help to establish similar centres in the region and enhance accessibility of high quality DBS therapy in the region.”

Ms Zenobia Walji, Vice President, Southeast Asia, Medtronic International Ltd, also commented, “Medtronic is a company that cares deeply about ‘Alleviating Pain, Restoring Health, and Extending Life’. So this partnership with NNI allows us to bring this mission to life, by bringing the most advanced technology, supported by education, to deliver better therapy access and improved patient outcomes.”

Controlling Symptoms with Effective Treatment

PD is the second most common neurodegenerative disorder, which affects about three in every 1,000 seniors aged 50 years and above. As Singapore’s population continues to age, the number of people with movement disorders will rise and there is currently no cure. At present, medication is prescribed to control symptoms and improve daily function. Minimally invasive surgery is available for patients who are in an advanced stage of the disease, and one such procedure is DBS.

Treatment for Future Positive Outcomes

DBS is a very well established treatment to relieve the motor symptoms of PD and its efficacy has been demonstrated in several large clinical trials. Says Dr Nicolas Kon, Co-Director, NNI Centre of Excellence for DBS; Consultant, Department of Neurosurgery, NNI, “We carefully select patients and counsel them as part of a multidisciplinary team before they undergo the procedure. After the device, which is like a pacemaker, is carefully implanted and turned on, our patients experience an immediate improvement in their movement.

This leads to a significant benefit in their overall function and quality of life. The improvement lasts for many years.” Dr Kon added, “Like any therapy; be it medical or surgical, DBS carries a small risk related to the procedure. NNI has a dedicated team (comprising neurologists, neurosurgeons, Advanced Nurse Practitioners (APNs), psychologists and therapists), which carefully screens patients prior to the procedure and supports at all stages of the treatment. This helps minimise risks and improve outcomes. We have also put in place processes to ensure that all our patients are cared for in a holistic manner tailored to their individual needs.”
Improving a Patient’s Quality of Life

A degenerative disorder of the central nervous system that impairs people’s motor skills and speech, PD leads to a progressive loss in quality of life. Mr Tan Tian Seng, 60, is someone whose life took a 180-degree turn when he started experiencing frequent headaches and head heaviness, which came in the way of his job as a taxi driver. He also suffered from memory lapses and was referred to NNI for further examination.

Following some physical assessments, Mr Tan was diagnosed at the age of 49. Ten years later in 2015, he learnt about DBS and went through a review on his health and medication status. As he was found to be a suitable candidate, he underwent the surgery last August. During his post-surgery care, Mr Tan was tended to regularly by a multi-disciplinary team. The device was turned on after a month and a half after full recovery, and his motor symptoms were effectively controlled. Today, he is able to lead a life; close to one that is led by many others.

As a chronic neurological disease, patients will still need to manage their health on a long term. Says A/Prof Louis Tan, Co-Director, NNI Centre of Excellence for DBS; Senior Consultant, Department of Neurology, NNI, “DBS is an established effective treatment for patients who experience wearing-off symptoms after many years of medication. This means that the symptoms of PD will return before the next dose of medication is due. As time goes on, these symptoms become more distinct leading to an on-off effect. Hence, DBS treatment should be considered for these patients.”