A new treatment has been found to improve the life of those with Parkinson’s Disease tremors through a minimally invasive procedure that sends pulses of focused ultrasounds to the brain. Previous treatments, such as surgery and deep brain stimulation, were more invasive. This new treatment, called magnetic resonance-guided focused ultrasound (MRgFUS), is less likely to cause complications and infections. While it is not yet widely available, research is being published to support it, and technology is improving. Because of this developers hope that it will soon be ready for patients in more places.
About Parkinson’s Disease
Parkinson’s Disease is a disorder that affects the central nervous system. It is a progressive disorder that affects movement, characterized by five different stages. These stages increase in severity as the disease progresses. Stage one is characterized by subtle tremors on one side of the body. In stage two the symptoms become more noticeable, with tremors and rigidity in both sides of the body. Stage three brings loss of balance and slow movement while stage four makes it impossible for one to live independently. Stage five is the most severe, as patients cannot stand or walk. They may also experience hallucinations or delusions.
Parkinson’s Disease is caused by the breaking down or death of motor neurons, some of which produce dopamine. When these neurons are lost, abnormal brain activity occurs, which leads to Parkinson’s. As dopamine aids in the transmittance of messages to the muscles from the brain, the loss of dopamine results in the loss of motor functions. Doctors are unsure as to why these motor neurons die, but they do suspect a few factors that play a role, such as genetics, environmental factors like toxins, and Lewey bodies.
Symptoms of Parkinson’s Disease are tremors in one or both hands, slowed movement, rigid muscles, impaired posture and balance, loss of automatic movement like blinking, changes in speech, hallucinations, dementia, and neuropsychiatric issues. Once these symptoms are noticed, a clinical evaluation and an examination of family history are conducted. Diagnoses are confirmed through imaging tests like MRIs and carbidopa-levodopa tests.
There are no FDA approved treatments for Parkinson’s, but there are treatments meant to help with symptoms. There are dopamine substitutes, carbidopa-levodopa, MAO-B inhibitors, catechol-O-methyltransferase (COMT) inhibitors, anticholinergics, and amantadine.
About Magnetic Resonance-Guided Focused Ultrasound (MRgFUS)
MRgFUS is a radiology procedure that does not require an incision. It sends focused sound energy into the brain to destroy a small part of the thalamus. This destruction provides relief from tremors in the opposite side of the body, meaning that if the energy is focused on the left side of the brain, then the right side of the body will feel the effects.
This treatment was evaluated in a study conducted by Dr. Federico Bruno of University of L’Aquila, in which they enrolled 39 patients who experienced disabling tremors for more than ten years without responding to prior treatments. Researchers looked at the severity of tremors and quality of life before the treatment, directly after, and for the year after treatment. The results were that 95% of participants experienced immediate and considerable improvements. These results were very exciting, as MRgFUS has many advantages over prior treatments like deep brain stimulation.
While this treatment is new, more research is being published to support it, and there are more developments that will lead to wider use. Not many patients are aware of this treatment, as it was only approved by the FDA for clinical use three years ago. Researchers hope that as this treatment develops and advances that it will be able to treat both sides of the thalamus and be applicable to conditions beyond movement disorders.
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