A former military and commercial pilot has become the first Parkinson’s disease patient in the D.C. area to utilize a newly approved adaptive brain stimulator.
Rick Schena, from Alexandria, Virginia, along with his doctor at MedStar Health in McLean, has started using advanced technology—adaptive deep brain stimulation—as part of his treatment for Parkinson’s disease, a neurodegenerative condition.
“Mr. Schena has been living with Parkinson’s for 17 years,” said Dr. Fernando Pagan, a neurologist specializing in movement disorders. “He experiences slowness in movement, significant tremors, and overall rigidity—these are typical motor symptoms of the disease.”
Until recently, Schena relied on a range of medications for management of his symptoms.
“I reached a point where the medications were losing effectiveness, and increasing them could lead to side effects like hallucinations,” explained Schena.
Last September, he underwent brain surgery at MedStar Georgetown University Hospital, utilizing a state-of-the-art intraoperative MRI system.
“He now has a pulse generator implanted here,” Pagan remarked, gesturing to Schena’s right clavicle. “It’s a small, rechargeable device linked to two electrodes in the brain, specifically targeting the subthalamic nucleus, which helps minimize unwanted movements.”
This neurostimulator continuously monitors brain activity throughout the day.
The results of deep brain stimulation (DBS) closely resemble those of medication, enabling a significant reduction in Schena’s oral medications—approximately a 60% decrease post-implantation.
Schena remarked that the combination of DBS and medications has drastically improved his symptom control. “I’d say the tremors are about 98% gone,” he said.
‘Welcome to the 21st century’
On Friday, Schena’s treatment reached a new level.
“Just last month, the FDA approved adaptive DBS,” Pagan shared. “It’s a program driven by AI that personalizes the settings for him.”
Since receiving the device, Schena has been able to adjust the settings via a smartphone app as needed. For instance, consuming protein can weaken his medication’s effectiveness, so he can slightly increase the amplitude as required.
The new adaptive DBS can monitor brain signals and automatically adjust in response, providing optimal symptom control tailored to the activity he is engaged in—whether he’s sleeping, reading, or exercising.
Schena, now the first in the D.C. area to use this recently approved aDBS, had a representative from Medtronic, the manufacturer, present during the process involving his treatment.
Pagan configured the device’s parameters based on Schena’s recent brain activity.
Gathered around an iPad displaying Schena’s brain activity, Pagan and other medical professionals collaborated with a field consultant to capture and apply the necessary settings.
After analyzing the data, they established the amplitude and frequency for the stimulation.
When set to lower settings, Schena felt no change; however, increasing the levels resulted in visible improvement, with him smiling at the noticeable boost in therapy.
Pagan asked Schena to open and close each fist quickly to assess his movement ease.
“Repeat after me: today’s a sunny day,” Pagan instructed. Schena complied. “Now say Massachusetts,” though his pronunciation was slightly slurred.
Pagan cautioned that excessive stimulation could impact speech and adjusted the therapy accordingly.
After making a few final modifications, Pagan turned to Schena.
“Congratulations, you are officially the first patient in the D.C. metro area using adaptive deep brain stimulation,” he said, shaking hands with Schena, who responded, “Thank you, Dr. Pagan — I appreciate you, brother.”
“Welcome to the 21st century,” joked Pagan as the room filled with supportive remarks from the gathered doctors and attendees.
