A multi-center clinical trial has revealed that a second-side treatment using MRI-guided high-intensity focused ultrasound is safe and effective for patients with essential tremor who have previously undergone the procedure on their dominant hand. The study, published in JAMA Neurology, offers new hope for individuals seeking relief from tremors in both hands, potentially improving their quality of life significantly.
Addressing Bilateral Tremors with Focused Ultrasound
Essential tremor, the most common movement disorder, often manifests in both hands, impacting daily activities. While unilateral treatment has been available, the need for bilateral tremor control is increasingly important in modern life. The clinical trial, sponsored by Insightec, evaluated the safety and efficacy of repeating the focused ultrasound treatment on the opposite side of the brain. The trial involved 51 patients across seven academic medical centers in the United States, including Weill Cornell Medicine and NewYork-Presbyterian/Weill Cornell Medical Center.
Clinical Trial Results and FDA Approval
The results of the trial indicated that second-side treatment is indeed a viable option. While some participants experienced mild to moderate side effects such as numbness, tingling, speech difficulty, and gait/balance issues, the majority of these complications resolved within a year. Dr. Michael Kaplitt, professor of neurological surgery at Weill Cornell Medicine and lead author of the study, noted the low frequency of adverse events relative to the dramatic and immediate results. The findings led to FDA approval in 2023 for the procedure on the non-dominant side, making it accessible to a broader range of essential tremor patients.
Patient Impact and Perspectives
Patients who underwent the bilateral procedure have reported significant improvements in their ability to perform everyday tasks. One patient, George Vann, regained control after struggling with tremors for years, calling the treatment "a gift from God." Similarly, Robert Harris, who had tremors since his late 20s, experienced a new lease on life after the procedure. These personal accounts underscore the profound impact of the treatment on individuals affected by essential tremor.
Mechanism and Procedure Details
The high-intensity focused ultrasound technique uses MRI technology to pinpoint the precise location in the brain where tremors originate. Once identified, ultrasound waves are administered to ablate the problematic tissue. The outpatient procedure typically takes only a few hours, allowing patients to return home the same day. This non-invasive approach offers a significant advantage over traditional surgical interventions, reducing the risk of complications and shortening recovery times.
