The Cutting Edge of Medicine: Dr. Roy Hwang on Deep Brain Stimulation

Dec 22, 2021 at 07:09 pm by pj

The Neurohealth Sciences Center, an affiliate of HCA Healthcare’s Central Florida Regional Hospital, recently welcomed board-certified neurosurgeon Roy Hwang, MD. With a background in biomedical engineering, Hwang specializes in deep brain stimulation surgery, a developing therapy that can help reduce symptoms in patients with movement disorders.


What drew you to medicine?

Back in high school, I thought I was going to spend my life building airplanes. That’s why I studied mechanical engineering as an undergraduate, and all the way through college, that was what I planned to do. But during my engineering internship, I found myself working in an office cubicle without really seeing anyone who was benefiting from my work.

I wanted something more hands-on, more interactive – something that helped people directly. I didn’t land on medicine right away. I completed my master’s in biomedical engineering because it was like a hybrid of what I wanted to do and what I was already doing. Over time, though, I started to realize that I really wanted to work directly with patients. Medicine was the next step.

It was a pretty big change to make in just one or two years, but you never really know where life will take you. Sometimes you just fall into something new.


Has your background in engineering been useful in your current career?

It definitely shaped my outlook. For me, the appealing part of engineering was the theory behind it, more than the practical side. While I may not be designing parts, things like currents, amplitude and frequency come into play a lot with my line of work.


After you made the switch from engineering to medicine, what led you to specialize in neurosurgery?

As I’ve said, I’m a hands-on person, so surgery always appealed to me. When I got my master’s in biomedical engineering, I worked with a surgeon and focused on robotic surgery, which was just beginning to get really big. Later, I went to Cleveland Clinic for medical school, and I planned to pursue general surgery. That school has a very prominent spine program, focusing on spinal nerve surgery. My mentor was a spine surgeon, and through my classes, I had a lot of opportunities to meet other people who specialized in that field. All those factors together got me to where I am now.


In your neurosurgery practice, one of the therapies you specialize in is deep brain stimulation (DBS). Tell me a little about what that involves and how it helps your patients.

Deep brain stimulation was initially developed for pain indications. By implanting electrodes into areas of the brain that handle sensory inputs, researchers hoped to block the pain signals. It is no longer primarily used for that purpose, but the technique migrated to treating movement disorders.

For example, patients who have a central tremor or Parkinson’s Disease often have a dysfunction in the brain’s motor circuits. Researchers found that you can use electrodes to manage the signals going into those circuits, correct a patient’s motor function, and improve quality of life.

The precise mechanism is different depending on what we’re treating. tremors are caused by abnormal cerebellar signals going into the thalamus, so we can place an electrode in the thalamus to block those signals. That very effectively stops the tremor. With Parkinson’s, there’s a problem with the basal ganglia. We stimulate the subthalamic nucleus and Globus pallidus all part of the basal ganglia. That alters the circuit, and they're able to get relief from their symptoms – not only the tremor, but also slowed movement and rigidity.

As research continues, we’re also seeing possibility in some other applications for deep brain stimulation, including epilepsy, depression, addiction, OCD and Alzheimer’s disease.


What do you think are the most important qualities for a neurosurgeon to have? What advice would you give to students considering a specialization in neurosurgery?

Always stay focused on the patient’s perspective. Even if I can’t help a patient with surgery, I always try to listen to them, understand their goals and keep trying to find solutions. It is a partnership, so you have to work together.

Neurosurgery is a field that is always innovating, always trying to make procedures safer and less invasive. If you love to learn, are willing to work hard, and you like taking on a challenge, then it is a great field to be in, because you can make really significant improvements in your patients’ lives.


You previously worked in Pennsylvania. What brought you to Florida?

My wife is from Florida, and we decided that we wanted to live closer to her family. Central Florida Regional Hospital struck me as a great opportunity. The therapies I use are underutilized in the area, so there were a lot of patients who could benefit from having access to them. And, of course, my colleagues are great people.


How do you maintain a work-life balance?

I’m lucky because I have a great support system: my wife and three kids. Every chance I get, I’m spending time with my family. I also love to travel and, although I’m a little rusty, I really enjoy playing musical instruments like guitar and drums.

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