Calming the Tremors
Deep brain stimulation improves quality of life by reducing tremors.
Alan Clark enjoyed riding his motorcycle on breezy, Sunday afternoons down the uncrowded roads near his home. In early 2015, Clark noticed that his left arm would jerk a little while he was riding. Assuming it might be associated with his back problems, Clark made a visit to his primary care provider, where they ordered a CT scan and eventually diagnosed him with Parkinson’s disease.
Clark was prescribed carbidopa and levodopa, a combination of medications used to treat Parkinson’s. The medications initially worked, dramatically reducing the tremors on his left side. For the next few years, Clark was getting along fine, until the tremors worsened. This resulted in Clark taking more medications and experiencing anxiety as he found it more difficult to be around people.
“I was becoming more isolated,” Clark said. “I didn’t want to go out to restaurants or even be around my friends in church.”
Clark tried other medications for Parkinson’s, but they either didn’t work or caused serious side effects. He remained on carbidopa and levodopa for several more years, dealing with his tremors and anxiety.
Clark eventually came to the tough decision to sell his motorcycle, since he was no longer confident that he could keep his balance while riding.
In 2021, Clark was researching online and discovered deep brain stimulation, or DBS, a treatment that can help reduce the symptoms of epilepsy, Parkinson’s and other movement disorders.
DBS is a surgery to implant a device that sends electrical signals to brain areas responsible for body movements. Electrodes are placed deep into the brain and are connected to a stimulator device. Similar to a heart pacemaker, a neurostimulator uses electric pulses to regulate brain activity.
Once surgery is complete, the DBS device is programmed in the outpatient clinic by a neurologist. Successful DBS allows people to potentially reduce their medications and improve their quality of life.
The DBS team at UF Health Jacksonville
With a recommendation from his doctor, Clark met with Daryoush Tavanaiepour, MD, chair of the Department of Neurosurgery and medical director of the Neuromodulation Program. After an extensive evaluation process with a multidisciplinary team of neurologists and neurosurgeons, Clark was considered a good candidate for DBS.
Tavanaiepour and his team performed two separate surgeries in late 2021. The first surgery was to place an electrode, which is a thin, insulated wire inserted through a small opening in the skull and implanted in a targeted area of the brain. Along with the electrode placement, another insulated wire extension was placed under the skin of the head, neck and shoulder, connecting the lead to the neurostimulator.
The second surgery was to implant an impulse generator battery in Clark’s abdomen. Both surgeries went well.
DBS programming sessions
Several months after surgery, Clark underwent programming sessions with the DBS neurostimulator. This device is battery-operated and programmed to control symptoms, similar to a cardiac pacemaker.
The DBS neurostimulator is able to identify the stimulator settings that improve symptoms and those that cause side effects. To reduce the likelihood of side effects, settings are manually adjusted while the patient is moving their arms, talking, standing and walking.
Clark continues to have routine follow-up visits with Joseph Legacy, MD, a UF Health Jacksonville neurologist who specializes in movement disorders.
Since having the DBS surgery, Clark has regained the ability to do many simple activities, such as twisting a nut onto a bolt, buttoning his shirt, eating cereal, combing his hair and brushing his teeth.
Clark’s social anxiety is now gone. He enjoys visiting his favorite restaurants and meeting up with friends at church.
“My golf putting has gotten a lot better,” Clark said. “My cat is happy that I’m back to normal. With the tremors, I couldn’t even coordinate my hands enough to pet the cat.”
Visit UFHealthJax.org/DBS or call 904.383.1022 to learn more about DBS, or ask your doctor for a referral to schedule an appointment.