Washington University neurological surgeons at Barnes-Jewish Hospital are using a new method of deep brain stimulation -- a procedure that delivers continuous, high-frequency electrical impulses to the brain -- to disrupt the signals that cause some of Parkinson''s most aggravating symptoms, including tremor, slowness of movement, stiffness and difficulty walking.

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Previously used in the brain''s thalamus to control tremor, the new bilateral usage of deep brain stimulation targets the subthalamic nucleus, one of the regions of the brain that controls movement and that is overly active in persons with Parkinson''s disease. The new procedure, approved by the Food and Drug Administration (FDA) early this year, has proved successful in relieving not only tremor, but also the other symptoms of the disorder.

Deep Brain Stimulation may be one of the best treatment options for selected patients with advanced Parkinson''s disease. Patients who have undergone the procedure have shown dramatic improvement, but not all patients are good candidates for the surgery.

Joshua L. Dowling, MD, assistant professor of neurological surgery, and Keith M. Rich, MD, associate professor of neurological surgery, already have implanted the device in about 100 patients with Parkinson''s and other forms of tremor. Their hope is that this new surgical option will become more accessible to patients and that insurance companies will more readily pay for the procedure now that it has gained FDA approval.

"We''ve had remarkable success using this procedure in Parkinson''s patients, "says Dowling. "Many return to a relatively normal, active life, usually with a significant reduction in their medication."

Drugs help to "unfreeze" the muscular system, but often causes frequent, exaggerated, involuntary movements, limiting their functional benefit. Deep brain stimulation of the subthalamic nucleus provides good symptomatic relief with much lower doses of medication, reducing the side effects.

The device can be turned on and off or removed if necessary, and stimulation levels are adjusted according to individual needs.

In addition to its clinical uses, the deep brain stimulator provides a unique way to study the underlying cause and manifestation of Parkinson''s disease. Researchers at the Washington University School of Medicine are combining imaging techniques with deep brain stimulation to find out more about the disease.