Focused Ultrasound is a non-invasive, non-surgical procedure that can relieve hand tremors caused by essential tremor with no hospital stay and few side effects.
The procedure, which is available at Regional One Health’s East Campus, is designed for patients age 22 and over who have a confirmed diagnosis of essential tremor.
Patients will need a consultation and CT of their skull to make sure they qualify for Focused Ultrasound, and must be able to withstand an MRI and communicate sensations during their procedure.
Severe hand tremors from essential tremor or tremor-dominant Parkinson’s disrupt your independence and ability to enjoy favorite activities. At Regional One Health, patients can find relief thanks to a state-of-the-art procedure called focused ultrasound.
“Tremors can progress to the point where they’re debilitating. It impacts your ability to write, eat and take care of yourself. Many patients tend not to go out due to embarrassment,” said neurosurgeon Aaron Bond, MD. “With focused ultrasound, we can reverse that.”
Here’s what he wants patients to know if they’re considering focused ultrasound:
What is focused ultrasound?
Focused ultrasound uses ultrasound energy guided by MR imaging to treat the spot in the brain responsible for tremors.
Because high-intensity ultrasound waves can pass harmlessly through the skull and surrounding brain tissue, there is no need for surgical incisions or a hospital stay.
Which conditions can it treat?
Focused ultrasound is for treating a confirmed diagnosis of essential tremor or tremor-dominant Parkinson’s. Other types of Parkinson’s and tremors caused by other factors don’t respond.
While some patients notice an improvement in voice or head tremors, focused ultrasound is only approved to treat hand tremors.
During a focused ultrasound, patients move in and out of an MRI several times over the course of 2-3 hours. MR imaging is used to guide ultrasound imaging to treat the exact spot in the brain that is responsible for tremor.
The procedure treats one hand. After nine months, patients can have their other hand treated.
Who qualifies for focused ultrasound?
Along with having a confirmed diagnosis from a neurologist, patients must:
- First try two medications without relief
- Be 22 or older
- Have a CT scan to make sure their skull density ratio is compatible
- Be able to tolerate lying on a treatment table and being in and out of an MRI for 2-3 hours
- Be able to communicate sensations during the procedure
What happens during the procedure?
Patients are given an IV and medication. They have their head shaved so ultrasound waves aren’t disrupted. “That’s one of the downsides,” Dr. Bond said. “But we’ve actually treated more women than men, and they tolerate it. They know the hair will grow back.”
Patients are fitted with a helmet to keep their head still and circulate cool water to help conduct the ultrasound waves.
The team uses an MRI to identify the exact spot in the brain for treatment. Patients move in and out of the MRI for several treatment sonifications that create a tiny therapeutic burn.
Between each treatment, patients are asked about side effects and their tremor is tested. “We can adjust our target in real time to minimize side effects and improve the tremor,” Dr. Bond said.
Once the treatment is done, the patient has another MRI, and then goes to a recovery room for snacks and water prior to going home. “It takes a total of 2 and a half hours from the time we sit down with you to the time we take you off the table,” Dr. Bond said.
Focused ultrasound is an outpatient procedure that usually takes less than 3 hours. Patients go home the same day with immediate, lasting tremor relief and very few side effects.
What does it feel like?
Some patients describe feeling some pressure and warmth during the sonifications. Some say the room feels like it is spinning. Typically, these side effects are short-lived.
What results can I expect?
“As we progress through treatment, we can eliminate the tremors. Most patients go home with their tremors gone and a significant improvement in quality of life,” Dr. Bond said.
Because there are no incisions, there is little risk of infection or complications. The main side effects patients have reported include numbness and tingling in their fingers, lips and teeth; and minor instability or balance issues. Usually, the side effects go away quickly.
Clinical studies show three-fourths of patients continue to have significant tremor improvement and quality of life improvement three years after the procedure.
What about follow-up care?
Patients see the focused ultrasound team for a follow-up visit after their procedure. After that, they can resume treatment with the neurologist they were seeing prior to the procedure.
Is it covered by insurance?
Medicare and most private insurers cover focused ultrasound for essential tremor. Medicare and some private insurance also cover the procedure for tremor-dominant Parkinson’s.
“We’re getting more and more insurance coverage, so it’s becoming more accessible,” Dr. Bond said. “Contact your health plan’s member services division to make sure you’re covered.”
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