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Key Concepts

• Brain cells, called neurons, communicate with one another through electrical impulses.
• In deep-brain stimulation, a battery implanted in a person’s chest delivers steady pulses of electricity to a targeted area of the brain. The artificial current interrupts or corrects dysfunctional electrical activity that is causing medical problems. Doctors can tailor the speed, strength and length of the pulses to get the desired result.
• Well established as a way of quelling the tremors that can afflict people with Parkinson’s disease, deep-brain stimulation is showing promise for a host of other ailments, including chronic pain and depression.

The video is brief, just a couple of minutes, but it’s reality TV as riveting as anything you’ll ever see. A man in his mid-50s, affable, articulate, faces the camera and talks a bit about a medical procedure he’s had. He holds in his hand what looks like a remote control. “I’ll turn myself off now,” he says mildly. The man presses a button on the controller, a beep sounds, and his right arm starts to shake, then to flap violently. It’s as if a biological hurricane has engulfed him, or perhaps it’s that his arm is made of straw and some evil sprite is waving it about. With effort, the man grasps the malfunctioning right arm with his left hand and slowly, firmly, subdues the commotion, as if he were calming a child in the throes of a temper tantrum. He’s breathing hard, and it’s clear he can’t keep it up much longer. With an almost desperate gesture, he reaches out for the controller and manages to press the button again. There’s a soft beep, and suddenly it’s over. He’s fine.

Composed, violently afflicted, then composed again. All with the flick of a switch. As before-and-after moments go, this one is potent, verging on the miraculous. It’s the kind of thing you’d expect to witness under a revival tent, not in the neurology ward of a British hospital. Once you’ve seen it, you’ll have an indelible image of Parkinson’s disease. The word “tremor” doesn’t convey what can happen to people—the way they are thrashed and harassed by their own bodies. But this scene, involving a patient of ours, informs viewers about more than a disease; it’s a vivid window onto a powerful medical technology known as deep-brain stimulation (you can watch the video at www.kringelbach.dk/nrn).

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