Sound waves to treat tremors

I have been involved with focused ultrasound since the early days of the first research cases. At that time, I was a resident at the University of Virginia and Dr. Jeffrey Elias was the leading investigator in an Insightec-sponsored pilot study to evaluate MR-guided focused ultrasound to treat essential tremor.

While at UVA, I participated in treatment and data analysis of two randomized clinical trials sponsored by Insightec, one for Essential Tremor (ET) and one for Tremor-dominant Parkinson’s Disease (PD).  Participants in both trials were medication-refractory meaning that treatment by medications did not help alleviate their hand tremor or that the side effects were not tolerated well. Since then, the FDA has approved the use of focused ultrasound first for essential tremor and then later for tremor-dominant Parkinson’s disease.

While Essential Tremor and Parkinson’s Disease are distinct, neurological conditions, the focused ultrasound procedure for treating hand tremor symptoms from both is basically the same. Sound waves, under MRI guidance, pass safely through the skull to target and ablate the Vim region of the thalamus, a small spot in the brain considered to be responsible for tremor.

Focused ultrasound is being performed at many medical facilities across the USA. At Regional One Health in Memphis, where I treat patients, the focused ultrasound treatment will be offered soon. People living with hand tremor from Essential Tremor and Parkinson’s Disease will have access to this incisionless and outpatient treatment option.

As new technologies, such as focused ultrasound, are adopted by medical facilities, one challenge is spreading awareness for the new service line. While ultrasound is familiar as a diagnosis tool, many people are not aware that it can be used as a treatment. We have developed a webpage to explain the treatment to patients and their families.

In my experience working in the Memphis area, many patients with essential tremor are either undiagnosed, or are treated by their primary care physician and not a neurologist specializing in Movement Disorders.  In discussions, I hear that patients assume their tremor is a sign of old age and don’t realize that there are treatments out there which can potentially eliminate their tremors.  Medical technology has advanced and there is now three-year safety and efficacy data [Download Brochure] from the focused ultrasound randomized Insightec-sponsored clinical trial. It is important to inform general practitioners and neurologists about the incisionless treatment option for their patients and where to guide their patients to learn more.

In the US, suitable patients must be over the age of 22, for essential tremor, and over the age of 30 for Tremor-dominant Parkinson’s Disease and must have been treated by currently available medications without satisfactory tremor improvement.  [Read safety information]

If you are interested in learning more about essential tremor, please visit https://www.regionalonehealth.org/east-campus-imaging-services/essential-tremors/ or visit Insightec’s patient website to learn about focused ultrasound treatment  https://usa.essential-tremor.com/

Dr. Aaron Bond is a neurosurgeon at Semmes Murphey Clinic, a physician owned medical practice in Memphis that specializes in providing care for patients with neurological and spine disorders. He also treats patients at Regional One Health.