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The Making of Medicine

Focused Ultrasound for Parkinson’s Tremor

A few years ago, our Dr. Jeff Elias conducted the first test of focused ultrasound for the treatment of the most common movement disorder, a condition called essential tremor. A trial participant went into an MRI machine with a hand that shook so violently he couldn’t feed himself cereal. When he came out, he could do a crossword puzzle in the recovery room.

As you might imagine, response to this news was tremendous. We were overrun with phone calls from people who wanted to join the clinical trial, from people who wanted to know if this approach could help their loved ones, from people who wanted to know if focused ultrasound could be used for other conditions. In particular, a lot of folks wanted to know about Parkinson’s disease: Could focused ultrasound help with those tremors?

Five years later, focused ultrasound is FDA approved for the treatment of essential tremor, and Dr. Elias has wrapped up his first clinical trial looking at the safety and effectiveness of focused ultrasound for managing tremor in tremor-dominant Parkinson’s. And things look promising.

In a nutshell, trial participants who received the scalpel-free form of brain surgery saw a 62 percent median improvement in their hand tremor three months later. That’s significant — Dr. Elias says it could make the difference in being able to write or not being able to write. One complication, though: Trial participants who underwent a sham procedure — meaning they thought they received the procedure but didn’t — also improved. It was to a lesser degree, but they improved, suggesting there was a placebo effect. (The trial participants who received the sham procedure were later offered the opportunity to receive the real procedure.)

So what does all that mean? Dr. Elias’ team concluded that further research is warranted. That sets the stage for a larger study that will shed more light. For now, the researchers say it appears the approach is most likely to benefit patients with Parkinson’s that is well controlled by medication but for whom tremor reduction alone would improve their quality of life.

We’ll keep you posted as the work continues.

Reply & View Comments

  1. Ganesh khot says:

    1. Is this therapy(focused altrasound) is available in India?
    2. Is it possible to cure PD by medicine itself

    1. Josh Barney, blog editor says:

      Thank you for your interest. There’s no cure for Parkinson’s — there’s not even a standard treatment. Instead, doctors tailor treatment to best manage the patient’s symptoms. This can include both medication and surgery. Focused ultrasound would represent a new surgical approach — one that doesn’t require cutting into the body. Dr. Elias’ trial looked specifically at whether focused ultrasound can help manage the tremor (shaking) for patients with tremor-dominant Parkinson’s. So far, it appears this approach would be most helpful for patients whose other symptoms are well controlled by medication.

      To track the availability of focused ultrasound around the world, you might visit the site of the Focused Ultrasound Foundation, a group that advocates for the advancement of the technology. According to their list of treatment locations, there are sites offering it in India. However, it doesn’t appear that any offer it for Parkinson’s symptoms.

      Here is their page on focused ultrasound and Parkinson’s.

      I hope that’s some help. Let me know if you have other questions. I may not have the answers, but I can either try to get them for you or point you in the right direction.

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