Treating Essential Tremors Noninvasively

Deep brain ultrasound could aid those with Parkinsons epilepsy brain tumors

(RxWiki News) For patients with essential tremor, characterized by involuntary shaking often associated with Parkinson's disease, a brain tumor or epilepsy, the effects can be embarrassing and make work and daily activities difficult.

Preliminary results of a clinical pilot study suggest that a noninvasive deep brain treatment may safely and effectively help treat essential tremors. Essential tremor is a common neurological condition that affects up to 10 million Americans.

"Ask your doctor about medication therapy before seeking surgery."

Dr. W. Jeffrey Elias, principal investigator, and a University of Virginia neurosurgeon and director of stereotactic and functional neurosurgery at the university, said that so far the treatment has proved to be life-changing for patients. He said that all patients had improved their ability to use their dominant hand to perform tasks that they could not do before treatment such as writing legibly and drinking without spilling.

So far results from the initial 10 study patients have showed a 78 percent improvement in hand tremor scores through an assessment with the Clinical Rating Scale for Tremor (CRST).  Functional activity scores of the patients also improved by 92 percent, according to CRST assessments. 

An additional five patients will be treated through the pilot study, with a larger trial expected to begin later if results are promising.

Outcomes and complications were similar to more invasive treatments such as deep brain stimulation, which requires surgery. Researchers hope to determine whether magnetic resonance imaging-guided and focused ultrasound is safe, effective and offers benefits beyond the current surgical options.

Researchers have been enrolling patients between the ages of 19 and 80, who have tried unsuccessfully to control their tremors with at least two medications, but had opted to skip invasive surgical procedures. Most reported they had experienced essential tremors for decades. Participants are followed for at least three months after treatment to assess general and neurological health and measure tremors.

During the noninvasive treatment, focused ultrasound pulses are administered through a patient's skull to a targeted section of the thalamus. Patients remain awake during the procedure so that they can provide feedback after each pulse. As part of the study, only one side of the brain is treated, which results in single hand tremor control in the patient's dominant hand.

MR-guided focused ultrasound already is approved by the U.S. Food and Drug Administration for treating uterine fibroids. In Europe and other countries it is approved to treat uterine fibroids, and also pain associated with bone metastasis.

The research, which has not yet been published, was recently presented at the Congress of Neurological Surgeons.

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Review Date: 
October 10, 2011