Focused Ultrasound

Revolutionaly Treatment with Focused Ultrasound

Focused Ultrasound: A Revolutionary New Treatment for Essential and Parkinsonian Tremor

Focused Ultrasound (FUS): A Revolutionary New Treatment for Essential and Parkinsonian Tremor

Do you or a family member suffer from a tremor that significantly affects your quality of life? A new and innovative non-invasive treatment is available at Rambam Health Care Campus, which uses guided magntic resonance imaging (MRI) of focused ultrasound (FUS) to treat tremor syndromes caused by Parkinsonian or Essential tremor.

What is Focused Ultrasound for Treatment of Tremors?

Focused ultrasound is a non-invasive treatment for tremor. High-intensity ultrasound waves are used to precisely target the diseased area of the brain without affecting any of the surrounding tissue. The ultrasound rays pass through the intact skull and pinpoint a particular area in the center of the brain (the thalamus) for ablation. The result is interruption of the abnormal flow of electrical signals with and cessation of tremor.  Magnetic resonance imaging (MRI) is used by the surgeon to accurately direct the ultrasound waves to the specific site in the brain where the tremor is initiated—hence the treatment name—MRI-guided FUS. The doctor monitors the results in real time and adapts treatment to a patient’s specific condition for optimal results.

More About Parkinsonian and Essential Tremor

Tremor is a neurological problem that occurs with many illnesses such as Parkinson's disease and Essential Tremor. When the tremor is of moderate to high severity, it also affects the quality of life of you or your loved one. When this happens, the tremor affects eating, drinking, writing, and other activities that require controlled and accurate movement. Tremor may be more severe on one side of the body than the other, and over time it may get worse, resulting in disability.

Many patients with significant tremor that is unresponsive to medication are offered the possibility of surgery to implant a pulse generator and electrodes in the brain, referred to as deep brain stimulation (DBS).

Rambam Health Care Campus offers an innovative and non-invasive treatment, performed in the MRI room by means of a focused ultrasound system with no incisions or implants. The treatment produces significant and immediate relief of the tremor. Approximately 400 patients have been successfully treated worldwide. Rambam has treated a few dozen patients to date.



Scroll down beneath the pictures to view answers to commonly asked questions.

More about MRI-Guided FUS in Pictures

Frequently Asked Questions

Who can benefit from MRI-guided FUS?

This treatment is suitable for people suffering from hand tremors that significantly impair quality of life and function, and which are not well controlled by medications—specifically those suffering from Parkinson's disease or Essential Tremor. Currently, the treatment performed at Rambam is for one hand only.

Candidates for MRI-guided FUS must be capable of undergoing an MRI scan.

Contraindications: Patients who take anticoagulants or antiaggregants that cannot be stopped for two weeks, or who suffer from a brain tumor are not candidates for this treatment. The treatment is for relieving the tremor only and not for other symptoms associated with Parkinson's disease or Essential Tremor.

What Does a Treatment Look Like?

A special frame is attached to the patient’s head, to ensure no movement during the treatment. A helmet that emits the ultrasound waves is placed over the top of this frame, covering the patient’s head. The patient is then asked to lay down in a magnetic scanner (MRI) that allows the doctor to examine the structure of the brain and define the focus of treatment.

After determining the target, the treatment begins. Ultrasound waves are directed at the target (in the brain) at increasingly higher temperatures, while the patient is constantly monitored and adjusted so as to relieve/stop the tremor. Throughout the treatment, the patient is monitored to prevent any side-effects.

What Happens after Treatment?

With all patients, there is a significant decrease of tremor immediately after the treatment. The patient remains under observation for 24 hours, during which time an initial functional test and an additional MRI scan are performed.

Over time, the effect of the treatment is maintained. It has been found that the treatment is still effective in patients examined after one year. All patients have reported a significant improvement in their quality of life.

These findings have been reported in the world's leading medical journals, including the New England Journal of Medicine (Elias WJ et al. N Engl J Med 2013;369(7):640–8).

 

What are the Advantages of MRI-targeted FUS for Treating Treatment for Tremors?

  • No need for cranial incisions or implants
  • Immediate and ongoing relief of the tremor
  • Usually only one treatment is required
  • Reduced dependence on medication can improve quality of life
  • No harmful radiation
  • The side-effects, if any, are few and most of them appear only during treatment; side effects persisting after the treatment are resolved shortly afterwards

What are the Risks?

No serious long lasting side-effects are known. There have been documented cases of temporary sensory disturbances or lack of stability after the treatment, but these generally pass after a short time. There is a theoretical possibility of damage to other tissue, but this risk is reduced by the control achieved with magnetic resonance imaging.

Is this Treatment Approved in Israel?

The Israeli Ministry of Health has approved MRI-guided FUS for treatment of tremor in Parkinson’s Disease and Essential Tremor and other movement disorders. This treatment is also approved for patient use in the EU. This treatment was approved in the United States by the FDA in July of 2016.
 

Read this Open Access article about MRI-Guided FUS

What's Next?

Outside of Israel: Contact Dr. Schesinger by Email ([email protected]). You can also call between 8:00 am and 4:00 pm to: +(972)-4-777-1686 or +(972)-4-777-1651 to receive all the required information about MRI-guided FUS treatment of tremor at Rambam.

Inside Israel: Call 04-777-1495 or send an email to: [email protected]. We look forward to helping you get your life back!