AdventHealth Neuroscience Institute’s (NSI) Movement Disorder Program recently began offering bilateral (second-side) treatment of essential tremor (ET) with MR-guided Focused Ultrasound (MRgFUS) following the U.S. Food and Drug Administration’s (FDA) expanded approval in December 2022.
Available at AdventHealth Celebration since July 2021, MRgFUS is an incision-less surgery where up to 1,024 ultrasound waves pass safely through the skull and brain tissue to precisely heat and ablate a deep brain target while magnetic resonance (MR) imaging allows for treatment monitoring. It is a non-invasive alternative to deep brain simulation (DBS) or traditional surgical thalamotomy and was first approved by the FDA in 2016 for unilateral treatment of the brain in ET patients who have not responded to medication.
The most common movement disorder in adults, ET affects up to 10 million people in the U.S., causing disability that can negatively impact their quality of life. While ET usually affects both sides of the body, MRgFUS could only be performed on one side of the brain — typically the one responsible for tremors on the patient’s dominant side — until the recent expanded approval. Now, based on results from a new clinical trial currently in press, appropriate patients can receive treatment on the second side of their brain at least nine months after the initial procedure, providing the opportunity for additional tremor relief. Since the first of May 2023, AdventHealth NSI’s Movement Disorder Program has treated 21 second-side patients with MRgFUS.
“Many activities of daily living are bimanual,” shares AdventHealth NSI neurosurgeon Chandan Reddy, MD.
“While treating one side is revolutionary for most people with essential tremor, some find that they still struggle because there are still tasks that require both hands like holding a plate or operating a cell phone. DBS is approved for bilateral treatment and has been around for over 20 years, so we’re thrilled that MRgFUS is also now approved for bilateral treatment of ET.”
In addition to treatment of ET, MRgFUS is approved for unilateral treatment of patients with tremor-dominant Parkinson’s disease. An international clinical trial is currently investigating the safety and efficacy of bilateral MRgFUS treatment for the treatment of motor complications in patients with bilateral idiopathic Parkinson's Disease.
Chandan Reddy, MD, is a dedicated researcher, a Fellow of the American Association of Neurological Surgeons (FAANS) and obtained his master's degree in electrical engineering (MS).