Arnav Uppalapati was arrested by Cary police on Friday after more than a year for the death of his 51-year-old mother Nalini Tellaprolu who worked at Duke Medical Center.
Tellaprolu was strangled on December 17, 2015 with a plastic bag over her head.
Friends of the family were shocked when the police charged Uppalapati with her murder.
"It's very devastating. There's never been an incident where a son has taken the life of his own biological mother. It really sends shock waves," Satish Garimella, a Morrisville town councilman of Indian descent, was quoted as saying by the local 'The News&Observer'.
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Uppalapati was a person of interest in the case from the outset, said Wake County District Attorney Lorrin Freeman.
One telling clue were early reports that indicated there were no signs of a forced entry into the family's two-story, USD 450,000 home at the Upchurch Farms subdivision, Freeman said.
"I still don't believe it. This is completely out of the blue," said Vijay Javvadi, another family friend.
It wasn't clear how police finally broke the case or what motive played a role.
Police said in a statement that Uppalapati would be tried on a class B1 felony charge, which is punishable by a maximum sentence of life in prison without parole.
Tellaprolu's death was ruled a homicide by the Medical Examiner's Office. Her body was covered with bruises and scratches on her face, neck, torso and arms. There were minor blunt force injuries, and the cartilage in her neck was fractured, the report said.