When Brian Parsons was watching Netflix, suddenly everything fell into place.
A documentary “About Freddie Roach” about a boxing trainer with Parkinson’s disease was being screened. Brain damage can cause uncontrolled movements, stiffness, and balance difficulties.
“I noticed his tremors were exactly like mine,” Parsons said. “The light bulb is out.”
Up until that point, he thought the tremor in his left hand was essential tremor, and so did his wife. “We wiped it out,” Parsons said. Even after realizing he might have Parkinson’s disease, he didn’t rush to see a doctor. “There is no difference.”
When she saw a neurologist about a year later, Parsons was frustrated with her drug options and worried about side effects.
Meanwhile, the tremor progressed from hand to arm. “As the years went on, it got worse and worse,” Parsons said.
His intolerance to drugs actually made him a candidate for another type of treatment: deep brain stimulation. Neurosurgery involves strategically placing electrodes in the brain to stimulate target areas.
Parsons, now 68, attended a seminar on DBS eight years ago, shortly after being diagnosed with it.
“From the beginning, I was in the game,” he said. “I was very impressed with the concept.”
According to Dr. Amir Faraj, a neurosurgeon who treated Parsons disease at Houston Methodist University, about 7 million people in the United States have essential tremor and about 1 million people have Parkinson’s disease.
Many patients who didn’t respond to medication had no choice without DBS, Faraji said.
Parsons’ first surgery to implant the electrodes was scheduled for April 2022. His second surgery to insert an impulse generator battery into his collarbone came two weeks later.
Parsons learned how to use the remote control to turn on the device and adjust the intensity.
When he turned it on, Parsons’ tremors were completely gone, he said. “I mean, it was 100%,” he said. “DBS is perfect.”
Since then, he has been able to stop taking his Parkinson’s medication.
“You can go to a restaurant and sit down and nobody will know you have Parkinson’s disease. ‘I can’t move. I can sit still.'”
There is only one thing he can change. “I wish I had done it sooner,” Parsons said. “I think the sooner the better.”
Dramatic change with DBS
Bonnie Hodgins, 74, also underwent DBS surgery to control essential tremor in her hands.
The Dickinson woman had heard of the possibility of DBS, but the thought of brain surgery was too terrifying. Eventually, her quality of life began to decline so much that she wanted to reconsider.
She couldn’t eat out in restaurants, play cards, or play dominoes. “Her hands shook so much that she knocked everything over,” she said. “I was very self-conscious.”
Hodgins had even given up cooking. “If you try to fill a measuring cup with liquid, it will be everywhere,” she said. “If you stir the pot of sauce, it will spread throughout.”
She met Falaj and underwent surgery in January 2022.
Since then, she has noticed significant improvement. For the first time in years, she can apply her own eyeliner, put on her earrings, fasten her buttons, and turn the pages of her book. “Needless to say, my life changed dramatically,” Hodgins said.
DBS development
Faraj explained that DBS is not a cure. When Parsons or Hodgins turn off the device, the tremors return.
“But with DBS, you can control those symptoms,” he said.
He specializes in movement disorder patients. His passion developed as a child, witnessing his grandmother’s shivering.
“I grew up watching it,” he recalled. “I really didn’t have a choice at the time.”
The concept of using a prosthetic device to deliver electrical current to the body is rooted in pacemaker technology first used in the 1960s, he said.
Shortly thereafter, researchers explored how pacemakers could be used to stimulate areas of the brain.
In fact, clinicians have been using electrodes to localize areas of the brain since the 1930s, and studies have noted that higher frequency stimulation may reduce symptoms in patients with movement disorders. Did.
In 1975, Medtronic began marketing a neurological device for treating pain and trademarked the term “DBS.”
By 1997, the Food and Drug Administration had approved DBS for essential tremor and in 2002 for Parkinson’s disease. In the decade that followed, DBS went from a marginal treatment to a more widely accepted treatment. It is now standard treatment.
Advances in technology have continued to propel DBS forward. Faraji has focused on improvements made possible by robotic surgery for implanting electrodes.
“DSB is to hit a target the size of a Tic Tac,” he said. “Millimeter errors are a big deal. Robots eliminate all those variables,” says Faraj.
Robot-assisted DBS
Faraji focused on DBS as a neurosurgery resident at the University of Pittsburgh.
“I was fascinated by how to make this process more accessible and streamlined for patients,” he said.
With robotic surgery, he said, the process is minimally invasive and is completed through “a hole smaller than a fingernail.”
This means that the risk of complications during surgery, including cerebral hemorrhage, is almost eliminated.
Faraj brought DBS robotics to Houston when he moved there two years ago. Baylor College of Medicine was also building a program at the time.
Houston Methodist developed the DBS program under neurosurgeon Dr. Richard Simpson. “He was at the forefront of his DBS,” Faraj said.
Since then, Houston Methodist has built a robust program using robotic-assisted surgery, making it one of the nation’s top centers.
“Thanks to this robot, this is one of the safest surgeries,” he said. “And with this operation, we remove the barrier. We restore the patient’s life.”
DBS is also being studied for other uses such as depression, obsessive-compulsive disorder, and Tourette’s syndrome.
“The indications for DBS are expanding and expanding,” said Faraji. “The door is wide open.”