The Activa® Tremor Control and the Activa® Parkinson Control therapies (Medtronic, Minneapolis, Minnesota, U.S.A.) are approved for the treatment of PD. The Activa therapies consist of a DBS lead, an implantable pulse generator (IPG) that is the power source for the system, and an extension wire that connects the DBS lead to the IPG. There are two DBS leads available. The intracranial end of both leads has four platinum-iridium contacts. One lead has contacts that are separated by 1.5 mm (Model 3387, Medtronic, Minneapolis, Minnesota, U.S.A.) and the second lead has contacts that are separated by 0.5 mm (Model 3389, Medtronic, Minneapolis, Minnesota, U.S.A.). The DBS leads are connected to the IPG by an extension wire that is tunneled under the skin down the neck to the IPG, which is generally placed in the infraclavicular area. The DBS leads are implanted stereotactically while the patient is awake and the extension wire and IPG are implanted under general anesthesia. There are two IPGs currently available; the Soletra® (Medtronic, Inc., Minneapolis, Minnesota, U.S.A.) and the Kinetra® (Medtronic, Inc., Minneapolis, Minnesota, U.S.A.). The Kinetra® has the advantage of using one stimulator to control the leads for both sides of the body, instead of two separate Soletra® neurostimulators, one for each side. The neurostimulators can be programmed for monopolar stimulation or bipolar stimulation. Adjustable parameters include pulse width, amplitude, stimulation frequency, and the choice of active contacts. The patient can turn the stimulator on or off using a hand held magnet or using an Access Review Therapy Controller®, which also has a feature to tell the patient if the neurostimulator is on or off. The typical stimulation parameters are frequency of 135 to 185 Hz, pulse width of 60 to 120 |js, and amplitude of 1 to 3 V.
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