A five-year assessment reveals that patients with essential tremor, a common movement ailment, can experience long-term alleviation thanks to a high-tech, scalpel-free method of brain surgery developed by UVA Health.
The study provides crucial information about the longevity of the advantages of targeted ultrasound therapy for essential tremor. The researchers indicate that five years following therapy, the treated tremors of clinical trial participants continued to decrease by more than 70%. There were neither delayed nor increasing issues.
“It is remarkable to see such persistent improvements following an outpatient operation for a sometimes crippling disease like ET,” stated study principal investigator Dr. Jeff Elias of UVA Health. Although the majority of patients saw very long-lasting benefits, tremors might occasionally reappear in certain circumstances.
Focused ultrasound for tremor is essential.
Through a concentrated ultrasound technique, malfunctioning brain circuits that cause unintentional movement are broken apart. It does not call for opening the skull or making incisions, unlike conventional brain surgery. Magnetic resonance imaging (MRI) is used to guide the minimally invasive technique so that medical professionals may identify the precise location in the brain where the treatment will be most effective.
Initial trials of the treatment at UVA and a few other locations frequently resulted in striking outcomes: Participants in the study would enter an MRI with trembling hands and leave with the ability to write or feed themselves restored.
Although encouraging, those preliminary studies were unable to determine how long the procedure’s advantages would remain. After following the clinical trial participants for five years, this new study discovered that they continued to experience a significant reduction in their tremor. Additionally, several indices of life quality improved. There were no side effects from the procedure.
Shayan Moosa, MD, a UVA Health neurosurgeon who collaborates with Elias to do focused ultrasound operations, said that this crucial trial “verifies the long-term benefits and safety of the focused ultrasound procedure that we have performed for hundreds of patients with tremor at UVA.” We are able to effectively diminish tremor in patients who may not be able to or may not want to pursue more-invasive therapies because this is an outpatient, incision-free procedure.
The results of 40 trial participants from the initial research group were described in the study. It is the largest “unilateral thalamotomy” long-term follow-up study that has been made possible to date.
Focused ultrasound for the treatment of essential tremor received federal Food and Drug Administration approval in 2016 thanks to the innovative clinical trials conducted at UVA and a few other locations. That made the treatment accessible to patients outside of clinical trials, though there are currently few hospitals that have the cutting-edge equipment and knowledge required to provide it.
Based on research conducted at UVA Health and elsewhere, the FDA has also approved focused ultrasound for the treatment of tremor and dyskinesia (involuntary movements) associated with Parkinson’s disease. UVA is looking into the technology’s potential for a wide range of further medical uses, such as the treatment of cancer and the opening of the brain’s protective barrier to administer therapies for illnesses like Alzheimer’s that are currently untreatable.
UVA opened the first targeted ultrasound cancer immunotherapy center in the world earlier this year as a result of its highly encouraging research. The facility aims to boost the immune system’s capacity to fight cancer by combining targeted ultrasound with immunotherapy.
The focused ultrasound research at UVA Health has long been supported by the Charlottesville-based Focused Ultrasound Foundation, which helped open the new center.
The Journal of Neurosurgery has published Elias and his team’s five-year follow-up findings. Nir Lipsman, Andres M. Lozano, Jin Woo Chang, Casey Halpern, Pejman Ghanouni, Howard Eisenberg, Paul Fishman, Takaomi Taira, Michael L. Schwartz, Nathan McDannold, Michael Hayes, Susie Ro, Binit Shah, Ryder Gwinn, Veronica E. Santini, Kullervo Hynynen, and Elias made up the study team. The focused ultrasound device’s producer, InSightec, employs Elias as a consultant; the report contains a complete list of the authors’ disclosures.
