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Deep brain stimulation helps control Parkinson's tremors

William Bridges descends staircase in his home.
William Bridges has newfound confidence after deep brain stimulation.

Tremors from Parkinson's disease abruptly slowed William Bridges' dancing feet. DBS helped regain his stride.

William Bridges, 58, never had a problem with movement. The active East Meadow resident and his wife enjoyed shuffle dancing together. But in 2011, tremors in his left hand led Mr. Bridges to his primary care doctor. The physician determined that the problem was likely a tic and prescribed medication to calm the episodes.

Yet the tremors only got worse. Concerned, Mr. Bridges finally saw a neurologist who diagnosed him with Parkinson’s disease.

A neurodegenerative disorder that affects brain cells that produce dopamine, a neurotransmitter, Parkinson’s disease causes tremors and can affect balance and walking and cause rigidity and stiff and slow movement (bradykinesia). Each year, about 60,000 Americans are diagnosed with Parkinson’s disease. There is no cure yet.

Restoring motor control

There is no ideal treatment for Parkinson’s disease. Many people, including Mr. Bridges, take levodopa, a drug that increases dopamine levels. One issue with drug treatment is that its effectiveness can wane, so symptoms return between doses.

Mr. Bridges made an appointment with Martin Neithammer, MD, a neurologist and movement disorders specialist with Northwell Health Physician Partners. He saw Mr. Bridges as a potential candidate for deep brain stimulation (DBS). During DBS surgery, a neurosurgeon implants electrodes into the brain that help control symptoms such as tremors. Dr. Neithammer referred Mr. Bridges to David Weintraub, MD, director of functional neurosurgery at North Shore University Hospital.

Mr. Bridges wanted to try DBS, but Dr. Weintraub suggested that he wait because medication controlled his symptoms most of the time. The best candidates for DBS surgery are those who experience increased motor-symptom fluctuations, according to Dr. Weintraub.

A year later, that happened for Mr. Bridges, and DBS surgery was a go.

“Deep brain stimulation surgery can provide significant improvement in symptom control and quality of life,” said Dr. Weintraub. He added that it can also reduce how much medication someone with Parkinson’s must take.

quotation mark Dr. Weintraub promised me he could make a difference in my life, my wife’s life, my family’s life. I can drive, I can walk, my tremors are almost nonexistent. What Dr. Weintraub did was brilliant.
William Bridges

What happens in DBS surgery

Neurosurgeons maximize safety for DBS surgery by completing it in three stages. They implant an electrode in one side of the brain during a 90-minute outpatient procedure. Then they perform the same procedure on the other side a week later. Finally, they implant a battery, similar to a pacemaker, in the chest that is connected to the electrodes.

During a follow-up office visit, the neurosurgeon activates the device and programs the electrodes to stimulate the brain as needed. The neurosurgeon then walks the patient through how to make adjustments to fine-tune the stimulation. You can often go home the same day that your electrodes are implanted.

“This is essentially outpatient brain surgery,” Dr. Weintraub said.

Deep brain stimulation has given Mr. Bridges a better quality of life than with medication alone, and he couldn’t be happier.

“Dr. Weintraub promised me he could make a difference in my life, my wife’s life, my family’s life,” he said. “I can drive, I can walk, my tremors are almost nonexistent. What Dr. Weintraub did was brilliant.”

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