Ultrasound, not scalpel, treats tremors

University of Virginia neurosurgeon Jeffrey Elias, principal investigator of clinical trials, calls the treatment “profound.” Elias presented the findings in April at the 80th Annual Scientific Meeting of the American Association of Neurological Surgeons in Miami. “These people have problems doing the basic things we take for granted, like eating soup, or teeing up their golf ball, using a screwdriver,” Elias says. “They can do all those things after the treatment.” All 15 participants in the trial saw a substantial reduction in their involuntary shaking after undergoing the experimental procedure using focused ultrasound. The rate of side effects was similar to that of traditional brain surgery. The patients were able to leave the hospital the next day. Inspired by the success of the trial, researchers at the University of Virginia are looking to expand their research to include 15 more essential tremor patients and to evaluate focused ultrasound’s potential for treating tremor in patients with Parkinson’s disease. Early results were reported last year when Billy R. Williams, a 74-year-old man from Fort Valley, Va., was the first participant to receive the treatment. Williams went from being unable to feed himself cereal to doing a crossword in the recovery room after his surgery. Focused ultrasound was subsequently tested in 14 additional cases. All 15 participants underwent the same procedure, in which sound waves are used to heat a tiny area of troublesome brain tissue enough to kill it, a process called “lesioning.” By using an MRI-guided focused ultrasound made by InSightec, Elias was able to target a highly precise location—he could actually determine the effects of the procedure before creating the lesion. The standard treatment for essential tremor is a technique known as deep brain stimulation. That requires surgeons to drill holes in the skull—while the patient is awake—and run wires into the brain from a device that is permanently implanted in the chest. Due to the procedure’s invasive nature, many patients prefer to live with their tremor. Focused ultrasound may one day offer a noninvasive alternative for an estimated 10 million Americans with the condition.from futurity