CoreBrain Journal

CoreBrain Journal


221 Essential Tremor & High Frequency Ultrasound – Smith

May 17, 2018

Essential Tremor Responds to High-Frequency Ultrasound
Steve Smith (his real name) owns a small technology reseller and has been dealing with Essential Tremor - ET - a widespread but little-understood condition, for over ten years. It impacts his quality of life daily, as he struggles to drink a cup of coffee, hold a screwdriver and type.

Last year, his symptoms worsened, and his golf play deteriorated to the point where he could no longer compete. 

As you will hear in his report he couldn't hold a club.
High-Frequency Focused Ultrasound - For Essential Tremor
Then one year ago, in March, Smith underwent a new non-invasive procedure approved by the FDA just last year. Suddenly, his hand wasn't shaking any longer.

Of Note: More than eight million people suffer from Essential Tremor and other movement disorders, but many remain undiagnosed and ineffectively treated. This avid golfer loves to share his story with others - it's truly inspirational.

Also called High Intensity Focused Ultrasound - HIFU - Steve was treated in New York by Dr. Michael Kaplitt.

Note: We have Dr. Kaplitt scheduled as a CBJ Guest quite soon, and his interview will come through our publishing schedule about a month from this CBJ/221 publication date. See more info on Dr. Kaplitt below, and stay tuned for that interesting conversation. One question I plan to review with him is the subject of the application of HIFU for Parkinson's. 
About Essential Tremor
In addition, ET is hereditary, and in Steve's family was passed down by his mother. His brother and sister both suffer from ET. Essential Tremor started to show when he reached the age of 50. He's now 62.

Essential Tremor occurs while doing normal things, for example, holding a cup of coffee, holding a fork or spoon to eat, etc. In particular, Essential Tremor became obvious in his golfing, putting and while at rest with the club in his hand. Smith reports, "It's very difficult to putt when your hands shake."
His Doctor, Dr. Michael Kaplitt, MD, Ph.D. Reports on HIFU
"Yesterday I became the first doctor in New York to perform an exciting new procedure on a patient with essential tremor, using high-intensity focused ultrasound to target the source of the tremors. I’m happy to report that the patient did extremely well, and the surgical team watched throughout the procedure as his tremor diminished visibly before our eyes.

Focused ultrasound takes advantage of a technology that has been successfully used to treat uterine fibroids and breast and prostate cancer, but of course, any procedure involving the brain is far more complicated than treating any other part of the body. Ultrasound waves have been shown to be benign in the body, but they normally scatter when passing through the skull.

The new procedure relies on magnetic resonance imaging (MRI) to pinpoint the exact location in the brain responsible for the tremor, then uses MRI guidance to focus the many ultrasound waves on that location.

In yesterday’s procedure, the patient was fitted with a helmet that held an array of 1,000 sources of ultrasound energy, each beam so small and low-energy that it passed harmlessly through healthy brain tissue on its way to the lesion that was causing the tremor. When all 1,000 beams reached that lesion together in one tightly focused treatment pulse, the combined energy destroyed the lesion — without damaging any healthy brain tissue.

All of this was accomplished without a knife or an incision.

My team and I mapped out the target and then monitored the procedure as MR thermometry measured the temperature at the target site; it automatically adjusted the energy emanating from each of the 1,000 sources so that precisely the right amount of energy reached only the target,