Findings from the University of Virginia Health System’s trial of a scalpel-free form of brain surgery for reducing the hand shaking associated with essential tremor have been published by the New England Journal of Medicine.
The trial used focused ultrasound, guided by magnetic-resonance imaging (MRI), to ablate a tiny aspect of the brain circuit responsible for the tremor. Ultrasound waves are focused to single site in the thalamus for the treatment. Because sound waves can pass through the skull, there’s no need for scalpels or anesthesia. Another benefit of the approach is that it allows the surgeon to target the sound waves very precisely and monitor their effect throughout with MRI before delivering a permanent treatment to the brain.
Key findings of the study include:
•Ultrasound can be focused through the scalp and skull without surgery and with great precision, reducing tremor by creating a small ablation (average size 3-5 millimeters) deep in the brain.
•All 15 study participants saw “significant improvement” in their dominant hand tremor.
•All participants reported substantial improvement in their quality of life with essentially no residual disabilities from their tremor at one year after treatment.
The most common side effects reported in the trial were unsteadiness or tingling in face or fingers, but these resolved or were mild. The most serious adverse effect was a persistent uncomfortable sensation in a single participant’s dominant index finger.
Based on their findings, UVA researchers have partnered with InSightec Ltd, the maker of the focused ultrasound device, to design a multicenter, international study that is FDA-approved to further assess the safety and long-term effectiveness of focused ultrasound in treating essential tremor.
