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Essentially erasing an essential tremor

Brad Ackerman,When I think of tremors, I picture an older man struggling to write, his fingers quivering. But for Brad Ackerman, an industrial designer shown at right, the trembling started early. For decades, a movement disorder known as essential tremor stymied his social life, career and daily activities. A recent article from Stanford Medicine News explains:

The tremor began to affect the direction of his life. In high school, he loved drawing and painting, but his tremor meant he could not easily hold or control a pencil, pen or paintbrush. He was in denial, telling himself that he just didn’t have the talent for art.

Although he learned to compensate, as he aged, the condition worsened. And the drugs he was prescribed had some unpleasant side effects:

The underpinning for essential tremor is irregular electrical activity in deep circuits of the brain. But for many years, medication was the only option available to quiet that activity... Ackerman did not like how he felt while medicated. “It just made me want to sit and do nothing,” he said. “It got harder and harder to do a drawing at work. After a while, I couldn’t do it.”

Fortunately, there was a newer, surgical remedy to alter the electrical activity. It involves implanting a device in his brain:

The treatment, called deep brain stimulation, is currently being used at Stanford to treat Parkinson’s disease and other movement disorders.

Ackerman had a procedure in February 2014 that involves MRI-guided placement of a small, insulated wire into one of the targeted brain structures. At the tip of that wire are four small electrodes that can release electrical impulses to block tremor. The wires are connected to a 2-by-3-inch battery pack that sits under the skin in the chest, just as cardiac pacemakers do. Like most people undergoing the procedure, Ackerman was awake during the process, providing feedback to his neurosurgeon, Casey Halpern, MD, so the surgeon could adjust the pacemaker to meet Ackerman’s particular needs.

Ackerman is pleased with the results. "It was much better and I can do my job better," he said in the piece. "I had such anxiety as a result of the tremor, from all the things I had to think about to do what most people consider simple tasks. My whole life has changed."

Previously: A spotlight on Stanford scientists' use of deep-brain stimulation to eavesdrop on problem neural circuitsStereotactic radiation offers relief from tremors and Stanford conducts first U.S. implantation of deep-brain-stimulation device that monitors, records brain activity
Photo by Norbert von der Groeben

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