New treatment proves safe, effective for tremors
UNC School of Medicine focused ultrasound research allowed patients to play guitar and golf again.
Patients with involuntary and rhythmic shaking so profound that typical life tasks become difficult had their tremors reduced with focused ultrasound treatments, reports a study published in JAMA Neurology. The study is co-authored by Dr. Vibhor Krishna, associate professor of neurosurgery at the UNC School of Medicine.
“There are medications to treat essential tremor patients, but often their effectiveness wanes over time, or the side effects are too profound,” Krishna said. “Focused ultrasound can offer another route for some patients to regain their ability to live their lives the way they want. Sometimes, the positive effects are very profound.”
Frank George, a neuroscientist and professional guitarist, received his second side ultrasound treatment a few months ago. His essential tremor greatly affected his ability to strum a guitar, give lectures, and eat with family and friends.
“They treat you two or three times for about 20 seconds each time. Then you are asked to draw a circle and draw a line,” George said. “Every time I came out of the machine, my line became less of a squiggle and finally turned into a perfect line. I had never seen anything like it.”
After the procedure, George raced back home to pick up his guitar.
“It was like I was 25 again,” said George. “I could instantly, one day later, go from not being able to play a note to being able to play like I had years ago. I had tears in my eyes. It was about as close to miraculous as you can get. I’m even back to playing professionally again.”
Sally Richey, a 70-year-old woman from Michigan, received her second (bilateral) treatment at UNC-Chapel Hill. The avid golfer received a unilateral focused ultrasound treatment three years ago to address an essential tremor in her dominant left hand. As the tremors dissipated in one hand post-procedure, symptoms in her right hand progressively worsened.
“It got to the point to where I could no longer zip up a jacket, do my own hair or putt,” said Richey. “There were so many basic, little things I couldn’t do. I would often have to ask for help from others.”
With her tremors greatly affecting her daily and social life, Richey decided to reach out for focused ultrasound treatment for the residual tremors. She walked out of the procedure with some slight headaches and imbalance, which improved over time, and has returned to playing golf.
“Because of this procedure, I don’t have to give it up. It’s a wonderful thing to be able to keep doing what is important to me,” said Richey.
Development of procedure
Since 2016, neurosurgeons have been able to perform a highly technical, incisionless focused ultrasound procedure to inactivate the diseased tissue in the brain. The results are instantaneous, with many patients walking out of the procedure room without a tremor. But for patients with significant tremors or a tremor originating from both sides of the brain, one treatment is not enough to control symptoms.
Researchers at seven U.S. academic medical institutions performed a trial using focused ultrasound treatment on the untreated side of the brains of patients with residual tremors. The procedure is “staged,” meaning that the procedure is performed one side at a time, with several months in between each treatment.
A secondary benefit of the treatment is that patients no longer need to take medications with hefty side effects. Future research will explore the treatment’s possible use for patients with Parkinson’s disease and other movement disorders.
