A New Chapter in Movement Disorder Treatment: Lee Health Leads the Way

For Elaine Monn, the simple act of signing her name on Christmas cards was once a cherished tradition. Her elegant script was admired by family and friends each holiday season. But as tremors took control of her hands, Elaine feared this personal touch was lost forever.

But thanks to groundbreaking surgery for people like Elaine with movement disorders, the Fort Myers resident can once again sign her name - and do so much more.

George Mandybur, MD, a board-certified neurosurgeon with the Neuroscience Institute at Lee Health, pioneered the procedure with his surgical team. The health system became the first in the Southeastern United States and among the few globally to offer the world’s smallest rechargeable deep brain stimulation (DBS) device to treat people living with movement disorders. 

WATCH: Meet Dr. Mandybur

“This is the most promising way to treat patients with movement disorders, and we’re excited to offer this new technology to the Southwest Florida community and beyond,” Dr. Mandybur says. “This battery is going to make a world of difference for our patients with all types of movement disorders."

Understanding DBS for movement disorders

Deep brain stimulation (DBS) is a minimally invasive surgical procedure for the treatment of neurological disorders like epilepsy, essential tremor, Parkinson's disease, and others.

In the procedure, a battery-operated medical device called an implantable pulse generator (IPG) is implanted under the skin near the collarbone. In some cases, it may be implanted lower in the chest or under the skin over the abdomen, according to the National Institute of Neurological Disorders and Stroke.

Dr. Mandybur describes the device as "much like a heart pacemaker, but rather than the wire going into the heart, it goes into the brain. The IPG sends electrical stimulation to the brain to interrupt abnormal signals that cause symptoms. The procedure uses MRIs and CT scans and sophisticated tools to localize a point about the size of a small peanut.”

The Liberta RC DBS System: A game-changer in treatment

The Liberta RC DBS System represents a significant advancement in DBS technology. Approved by the FDA in January, the system’s key benefits include:

• Size: About the size of a smartwatch and 31 percent smaller than other commonly used implantable, rechargeable DBS devices.
• Battery life: It offers the longest time between charges of any DBS technology, requiring recharging as few as 10 times each year.
• Longevity: The rechargeable battery can last 10 to 15 years, regardless of settings, compared to non-rechargeable batteries that last 2 to 5 years.
• Remote programming: Compatible with Abbott's NeuroSphere Virtual Clinic, allowing for remote adjustments without in-person office visits.

"The ease of recharging makes it easier for patients who are somewhat not very tech-savvy or who don’t want to fiddle with recharging their battery,” Dr. Mandybur says. “If they only have to do this for an hour or two once a month, that makes it much easier."

Elaine Monn's journey: From tremors to triumph

Elaine’s story demonstrates the life-changing potential of DBS technology. In 2016, she was diagnosed with essential tremor (ET). A neurological disorder that causes involuntary shaking and trembling in the body, most often in the hands and head, ET affects about 10 million people in the United States.

Her ability to perform simple tasks deteriorated over the years.

"I couldn't do things like write, pour water into a glass, or sign checks," Elaine says. "Simple things I took for granted, like putting makeup on, became impossible.”

She recalls even having to quit doing crossword puzzles, a favorite pastime. 

“I couldn't keep the letters in the boxes,” she recalls with dismay. “I was giving up a lot of things that I enjoyed. It just impacted every area of my life.”

After consulting with Dr. Mandybur in February, she was scheduled just weeks later to become the fifth patient in the world and the first in the entire Southeastern region of the United States to receive the Liberta RC DBS System. 

The procedure, performed while she was awake, yielded immediate results—while Elaine was on the operating table. 

"I could tell when it started working because I wasn't shaking anymore," she recalls. 

Asked to do some tasks to check her fine motor skills ability, Elaine reports she stayed within the lines of a spiral crossword puzzle and wrote her name legibly for the first time in years.

“I was so excited,” she exclaims. “If I could have jumped off the table, I would have because I thought this was the answer. It was so simple.”

Elaine, like most patients in the first few months after surgery, had several adjustments made to her system. Like a car engine, the system needs to be tuned for optimal performance, as Dr. Mandybur puts it. 

These days, Elaine’s in tip-top shape. She can now sign checks in restaurants and leave tips, and she looks forward to sending Christmas cards again. 

"I can do anything I want now," she says.

The future of movement disorder treatment

Dr. Mandybur notes the ongoing nature of DBS treatment: "DBS, especially for Parkinson's disease, is not an install it, turn it on, and you're done. This is, once it's installed, the initial programming is just a first try and see how well this is working."

The system’s TeleHealth capabilities are particularly promising, he adds. 

"If patients have Wi-Fi, they can contact us if any operational issues arise with the system. We can remotely investigate their system to determine what's going on,” Dr. Mandybur explains. “We can also program the device as needed. TeleHealth is a great feature of the device because it lets us make real-time adjustments, which ensures our patients get the very best treatment.”

A call to action for those with movement disorders

Elaine urges other people living with movement disorders to consider the procedure. 

"Anyone with a movement disorder who’s eligible for the procedure should take advantage of this unique technology. It will change their life."

Dr. Mandybur echoes her sentiment, noting that the improvement patients experience can be significant.

“One study found that the procedure increased people's active time by six hours,” he says. “For some people, that’s half to one-third more hours of their day they didn’t have before to do something.”

He stresses that “Ninety percent of the implanted patients are happy they had the procedure done, and almost no one states they should have waited.”

WATCH HEALTH MATTERS: Dr. Mandybur discusses DBS technology and new hope for patients