Delivering pulses of focused ultrasound to the brains of Parkinson’s patients can reduce involuntary tremors and improve quality of life in those with the disease, according to new research to be presented at next week’s Radiological Society of North America annual meeting.
Traditionally, tremors have been treated using deep brain stimulation, which requires a surgeon to implant a small electrode in the brain connected to a pulse generator placed in the chest. This comes with potential complications, however, such as bleeding and infection.
Magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy on the other hand, doesn’t require an incision and uses focused beams of energy to heat and destroy a tiny structure in the brain responsible for involuntary tremors. This approach is also effective immediately, unlike deep brain stimulation, which requires a “break-in period,” Federico Bruno, MD, a radiologist in the department of biotechnological and applied clinical sciences at the University of L'Aquila in Italy, said in an RSNA statement.
“Additionally, treatment with MRgFUS requires shorter hospitalization and is a fairly well-tolerated procedure even by more fragile patients,” Bruno added.
In the study, Bruno and colleagues administered the ultrasound approach to 39 patients with disabling tremors who did not respond to prior treatment. The researchers compared the participants’ tremor severity and quality of life before treatment, immediately after ultrasound and over the following year. Bruno noted all patients, on average, had experienced tremors for more than 10 years.
Overall, 95% of patients had a “substantial and immediate reduction” in tremors, the researchers noted. What’s more, those improvements were maintained at follow up, with patients also reporting a higher quality of life.
"The study we present reports our experience of over a year in the treatment of tremor by thalamotomy with focused ultrasound," Bruno said in the same statement. "It is worth noting that we had a high number of patients with Parkinson's disease in our series, compared to previously published data, where the procedure was used mainly in the treatment of essential tremor patients."
Although the FDA did approve MRgFUS thalamotomy for clinical use three years ago, it is limited to a handful of institutions throughout the world. Bruno maintained that may change as more research, including the current study, is published demonstrating its benefits.