Involuntary tremors — shaking or trembling movements that come and go without a person meaning to do them — can be scary and debilitating. They’re also the most common symptom of Parkinson’s disease, a progressive nervous system disorder that affects more than 1 million people in the U.S. and has no cure.
Parkinson’s, the most common movement disorder, primarily affects men older than 60 and can impair walking, speech and coordination.
But through an advanced surgical procedure known as deep brain stimulation (DBS), neurological specialists are helping patients regain control over those symptoms. The treatment uses an implanted device to regulate brain activity linked to tremors and other movement disorders.
DBS is part of the new functional neurosurgery program at Novant Health New Hanover Regional Medical Center in Wilmington, a program specifically tailored to treat problems caused by abnormal brain activity or nerve signaling. Movement disorder specialist Dr. Rebecca Pratt, who is heading up the program, describes the effects of the DBS procedure as “night and day,” allowing patients to experience drastically reduced involuntary tremors and an improved quality of life.
Advanced treatment for tremors and movement disorders.
How the deep brain stimulation procedure works
Before surgery, neurosurgeon Dr. Greg Davis uses noninvasive imaging, like an MRI or CT scan, to identify the best location for an electrode implant in the brain. The treatment involves two procedures. First, the electrode — which is 1.3 millimeters wide, or roughly the thickness of a strand of spaghetti — is implanted in the brain through a tiny opening in the skull. Then a battery pack is placed near the collarbone and connected to the electrode with a thin wire, all completely implanted underneath the skin. The pack generates electric pulses that regulate movement disorder symptoms.
Surgery is performed while the patient is awake so specialists can monitor speech and movement in real time. This usually takes less than an hour.
Putting control in the patient’s hands
Within a few weeks, the DBS is activated and patients often notice immediate improvement. Pratt then fine-tunes the device’s signals, customizing the strength of the electrical stimulation, frequency or speed of the pulses, duration of each pulse and which contact points on the device are active. This helps match the treatment to the person’s individual symptoms and reduce side effects. Pratt can adjust the settings over time as the patient’s needs change, creating a completely individualized experience, and allowing her, she said, to find the right settings so the patient will be “as steady as a rock” when the device is turned on.
One of the smarter features of the DBS system is its ability to detect unusual brain activity and fine-tune stimulation on its own. This not only helps target symptoms more precisely but can also stretch battery life further.
Patients have real control over their device, too. They can turn up the stimulation before activities that require steadier movement, or dial it back if they notice any unwanted side effects. They can also switch it off temporarily — whether that's during sleep or when walking through airport security.
Improving daily life
The impact on daily life can be remarkable. One patient shared that after he struggled to simply hold a pen, the surgery made it possible for him to write again.
After the procedure, follow-up visits with Pratt are typically scheduled every three to six months to monitor progress and fine-tune settings as needed.
It's worth knowing that DBS is not the right fit for everyone with Parkinson's. It's generally considered when medication alone isn't doing enough to manage symptoms. The best place to start is a conversation with your primary care doctor, who can help you weigh your options and decide if it may be right for you.
For many people living with movement challenges, DBS has the potential to make a real and lasting difference in everyday life.
FAQs
DBS regulates abnormal brain activity associated with movement disorders. Once the device is activated to the patient’s specific needs, they experience fewer tremors, improved mobility and greater independence.
Potential complications include device-related issues or infection or bleeding at the implant site. Most patients recover without difficulty, and specialists work to minimize risks.
If you have Parkinson's disease or another movement disorder and medications no longer control symptoms, talk with your primary care physician. They can discuss treatment options and refer you to a movement disorder specialist for evaluation.
