Focused ultrasound, or MR-guided focused ultrasound, is an incisionless, noninvasive procedure that treats movement disorders, including essential tremor and Parkinson’s disease, through focused beams of acoustic energy. Using heat, these beams create a small, targeted lesion in the brain. This lesion destroys the tissue causing abnormal brain signals that lead to symptoms of movement disorders. Penn Medicine is the only health system in Pennsylvania and one of the few in the Northeast to offer this procedure.
Twitter @PennMDForum
That's my, that's the tremor in my hand. I actually have. It's not so bad in my right hand. It's just mostly it's all in my left hand and then I can feel, you know, I can try to stop it, but it just, it just wants to keep going. How is your tremor this morning? Can you bring out both arms? Just for comparison here? Ok. Good. From this dot Trace all the way to this dot Joe had tried medications for many years. He did get some relief but he was starting to get to the point where the medications were no longer helping. So he opted for the focused ultrasound procedure. High intensity focused ultrasound is a technology that allows us to take thousands of ultrasound beams and focus them on to a point down the size of millimeters to create lesions within the brain all without having to make incision in the scalp or the bone. You can see our lesion here. We just, we can use the ultrasound to create ablations in either the thalamus. In which case, it treats tremor or the globus palatis. In which case, it treats not only tremor but also dyskinesias and stiffness and slowness associated with Parkinson's. We are able to do this with a patient who is awake and comfortable in an MRI scanner. With real time imaging, the patient will feel relief immediately and the patient will go home the same day. We can apply low levels of focus ultrasound to the thalamus, watch the temperature increase using the MRI technology that's called M thermometry. And as we apply these little bits of energy to the thalamus, we can see responses in the tremor and we track those responses by having the patient draw spirals or reach out and hold their hand out. Now, what we're going to do is create a lesion in the area we've been targeting by going above 55 degrees. The orange lesion is our target, which we've planned. And you can see that white area around it is the lesion that we've actually created. So we're going to do our last ablation and then be done. All right. That looks very good. I'm happy with that result. How are you feeling? Yeah. Yeah, you got it. Yeah. What do you think? Look at my, touch, my finger here and touch your nose over here. I'd say that's pretty good for day one. Just gonna check your strength here. Squeeze my fingers, squeeze, squeeze, squeeze, pull me towards you. Good. Super strong. Excellent. All right. Just relax. I'm glad that you're doing well. We're able to get you through this. OK? You're very welcome. The effects of focus ultrasound are quite durable. We have data out in five years. It shows that 80% of patients continue to have significant control of their tremor. While this therapy is performed at Pennsylvania Hospital, it is available to patients throughout the Penn Medicine system. From Lancaster to Princeton. I think that neurologists should be aware that there are more options now than there were five years ago for their patients with essential tremor and Parkinson's disease both surgically and medically. If a patient feels that the medication is not addressing their symptoms and they're not meeting their goals. Despite that medication, that would be the right time to refer a patient. Pet medicine is the only center in Pennsylvania that offers high intensity focus ultrasound for Parkinson's disease and tremor and one of the only centers in the northeast as well. And because of that volume that we've experienced, we have that expertise here and that expertise is unique to pet.
