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This really isn't new, but...jmr Implants May Aid Tremor Victims By JEFF DONN - Associated Press Writer (AP) Feb 16, 2000 - Electrodes implanted in the brain work better than more conventional surgery in helping patients with severe tremors fromParkinson's and other diseases lead normal lives, a study found. Scientists say the research is likely to expand use of the newer electrode technique and perhaps even spur study of its effectiveness against disorders like depression. The work is also likely to further reduce the use of the older tremor-control brain surgery, called thalamotomy. Thalamotomy is a decades-old operation that destroys overactive, tremor-causing nerve cells by burning or freezing a pea-size spot in the brain. But it leaves many patients with speech problems, weakness or numbness. Actor Michael J. Fox, who has Parkinson's, underwent a thalamotomy. The electrode technique, known as deep-brain stimulation, was approved by the Food and Drug Administration in 1997 and already overshadows thalamotomies at many hospitals. A study published Thursday in the New England Journal of Medicine offers what researchers say is the best comparison of the two operations. "Do the results ... signal the end of thalamotomy? They offer a strong argument for the use of deep-brain stimulation as the treatment of choice for eligible patients,'' Dr. Gunther Deuschl of Christian Albrechts University in Kiel, Germany, said in an accompanying editorial. An estimated 2 million Americans are afflicted with essential tremor, a hereditary disorder that causes violent shaking. Up to 1.5 million more suffer from Parkinson's, which brings tremors, rigid limbs and a shuffling walk. Parkinson's sufferers include Muhammad Ali and Attorney General Janet Reno. Drugs help many but not all tremor patients. In deep-brain stimulation, a wire is implanted within a walnut-size area known as the thalamus, which acts as a relay station for sensory information. The electrode is connected to a thin cable running down through the neck to a half-dollar-size pulse generator that is implanted just below the collarbone. The generator supplies a tiny electrical current that disables the overactive nerve cells and turns off the tremors. The study of 68 patients at the Academic Medical Center in Amsterdam, Netherlands, found that such electrodes suppress tremors as effectively as surgery, produce fewer side effects and do more to help patients perform daily tasks like cooking or shopping. More than twice as many patients said they were functioning better with the electrodes. However, even the leader of the study, Dr. Richard Shuurman, said some patients will still prefer thalamotomies because the electrodes are expensive and involve high technology. Deep-brain operations cost $20,000 to $28,000 in the United States. A thalamotomy might cost $12,000 to $20,000. Though the study dealt only with stimulation of the thalamus, it gives a boost to the growing use of electrodes on other parts of the brain to control tremors, since it shows few side effects, scientists said. Dr. Chistopher O'Brien of the Colorado Neurological Institute said the study should give a push to research on conditions such as compulsive disorder and depression. -- Judith Richards, London, Ontario, Canada [log in to unmask]