New U. of Virginia study 'verifies long-term benefits' of focused ultrasound treatment for tremors

A new study shows that a high-tech, scalpel-free form of brain surgery pioneered at the University of Virginia (UVA) could offer long-term relief for patients with essential tremor, a common movement disorder.

According to a release by UVA Health, the study showed that focused ultrasound treatment can reduce essential tremors by more than 70%, and its benefits last for at five years or more after the procedure. The outpatient procedure, which doesn't require incisions, involves focusing sound waves inside the brain to disrupt faulty circuits, causing the unwanted movement. 

The treatment is guided by magnetic resonance imaging, which allows doctors to pinpoint the spot in the brain before delivering treatment. The research team, led by neurosurgeon Dr. Jeff Elias, followed 40 clinical trial participants for five years, finding that most enjoyed long-lasting benefits after the treatment. 

“This important 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,” said Shayan Moosa, a UVA Health neurosurgeon who partnered with Elias, in the release. 

“As this is an incision-less and outpatient treatment, we are able to effectively reduce tremor in patients who may not be able to or may not want to pursue more-invasive options," Moosa added.

Study participants, entering with uncontrollable hand shaking, often emerged with restored ability to write or feed themselves. Other quality-of-life measures also showed improvement, doctors reported. 

“It is important to note that most of the patients had very long-lasting benefits, but there are some cases where tremor can recur," Elias said.

The procedure's long-term benefits and safety paved the way for the Food and Drug Administration (FDA) to approve it for the treatment of essential tremor in 2016. The new study is the largest long-term follow-up study of the procedure, known as "unilateral thalamotomy," UVA reported. 

The FDA has also approved focused ultrasound for the treatment of Parkinson’s disease tremor and dyskinesia based on research at UVA Health and elsewhere, the release said.

UVA is exploring a variety of medical applications for the procedure, from treating cancer to opening the brain's protective barrier to deliver, previously impossible, treatments for diseases such as Alzheimer's disease. 

The research team published its five-year follow-up results in the Journal of Neurosurgery.

The team included researchers G. Rees Cosgrove, Nir Lipsman, Andres 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 Santini, Kullervo Hynynen and Elias. 

Elias is a consultant for InSightec, the manufacturer of the focused ultrasound device.