had suppression of the tremor ... I thought, aha, this might be the
solution.”^31
There can little doubt that Benabid’s discovery must rank as one of the
most spectacular moments in the history of surgery. Had it been a
haphazard, accidental finding, it would still have been amazing. But in
context, where the surgeon-scientist dared to believe that he might affect a
change, and then witness an instantaneous cure of tremor, an ancient
malady with religious insinuations, Benabid’s breakthrough is a marvel, a
eureka moment of the highest order.
For an encore, Benabid left the wire, with four metal contacts at its tip,
in place in the patient’s thalamus. Benabid connected the wire to an
external battery source, and then programmed the device using a small box
with buttons and archaic-looking switches. This allowed him to
individualize the settings and continue to experiment with the frequency
delivered. Benabid immediately reported his miraculous results^32 when
implanting the electrode in the thalamus. It doesn’t seem possible, but in
1987, there was still no Institutional Review Board (IRB) in Grenoble, and
no French equivalent of the FDA (the Agence du Médicament was
established in 1992). With permission from his neurosurgical boss at the
UJF, Benabid continued placing the world’s first deep-brain stimulation
implants.
Concurrently, across the Atlantic, DeLong was finalizing the map of the
“functionally segregated parallel circuits”^33 and homing in on the
importance of the previously ignored subthalamic nucleus. After the
successful reversal of parkinsonism by the Emory team in 1992, Benabid
began altering his technique in Parkinson’s patients, placing the DBS wire
implant in the subthalamic nucleus. Shortly before DeLong’s 2003
publication of comparative subthalamic lesioning, the FDA approved DBS
implants for PD.
I have been fortunate to be in the operating room for the neurosurgical
placement of DBS implants for PD. The experience of watching six-inch-
long rigid needles being coaxed to the deepest parts of the brain utilizing
intra-operative CT scan guidance is phenomenal. But this pales in
comparison to the postoperative appointment a couple weeks later, when
the neurologist and the assisting technician program the transistor-filled
electronic unit that has been implanted in a patient. In one moment, the
patient sits rigidly in her chair, hands tremoring with every attempted