The AdventHealth Neuroscience Institute’s (NSI) Movement Disorder Program has treated the largest number of patients in Central Florida using the MR-guided Focused Ultrasound (MRgFUS), a new, non-invasive treatment option for patients with essential tremor and tremor-dominant Parkinson’s disease. The procedure is available at AdventHealth Celebration.
Essential tremor and Parkinson’s disease cause uncontrollable shaking that can impact a person’s ability to live an independent and active lifestyle. When medications fail to offer relief, MRgFUS can help these patients achieve tremor relief without the need for invasive surgery or hospitalization.
About MRgFUS Treatment
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. Low energy is applied first, allowing the patient to inform the physician of any sensations they feel or other potential side effects. The physician can make individualized adjustments to the target, and the energy is gradually increased to create a small therapeutic lesion.
“This technology allows us to very precisely ablate a small, tiny focus in the brain that is part of the tremor circuit," explains AdventHealth NSI neurosurgeon Chandan Reddy, MD. “It is lower risk than other treatment options, has a favorable side effect profile, and most patients experience immediate improvement.”
- Through a partnership with Insightec, the device manufacturer, each potential MRgFUS patient is screened to ensure they are a candidate for the procedure:
- The patient completes a short questionnaire.
- An educator then helps the patient record their tremor in the convenience of their own home, and the neurosurgeon examines these recordings.
- The patient schedules a meet and greet (in person or virtual) to meet the neurosurgeon and care team.
- The patient’s educator will help them schedule a CT scan as part of the qualification process.
- Once the case is approved, the AdventHealth team will schedule the patient’s MRgFUS treatment.
The entire MRgFUS procedure, including prep and scan, takes about 2.5 hours to complete, and the patient is awake the entire time. After each lesion is delivered, the patient is pulled out of the MRI and tested to check the impact on the tremor. The patient is asked to draw a spiral and a straight line and also sign their name. The care team has the patient do this multiple times throughout the procedure, and the information gathered is used to gauge treatment effectiveness.
“What is so exciting is that the patient can instantaneously see the results,” explains Dr. Reddy. “Prior to MRgFUS, treatments for essential tremor involved brain surgery or Gamma Knife radiosurgery. While both were effective, they were higher risk, and it could take several months to see improvement. This new technology is a real game-changer for essential tremor patients.”