Essential tremor (ET) is the most common movement disorder. It is estimated that 10 million people in the U.S. alone live with this progressive condition. ET is 20 times more prevalent than Parkinson’s disease – another cause of tremors – yet Parkinson’s disease is in the public eye far more than ET.
When a person is first diagnosed with ET, medication is offered as a possible way to control the tremors. However, drugs only work for about half of patients. Then, as tremor progresses, the dosage must increase. Eventually, patients either tire of the side effects, or the medications simply no longer work.
There is a breakthrough, non-surgical intervention that can provide durable tremor control for those whose aggravated condition is beyond medications, or who don’t wish to take drugs. It is called MRI-guided Focused Ultrasound (MRgFUS). Studies with ET patients consistently show that most people who undergo this noninvasive therapy have significant, lasting improvement in their tremor.
Does MRgFUS work for tremors with other causes?
Although ET is the most widespread cause of tremors, other conditions also create tremors of the hands, head or other limbs. Parkinson’s disease was already noted. In addition, there are tremors associated with conditions or diseases that have practically unpronounceable names like cervicobrachial dystonia or dystonia gene-associated tremor. (Dystonia is marked by involuntary muscle contractions that show up as twisting or repetitive movements. As with ET, some forms appear to run in families). Parkinson’s and dystonia are distinct conditions from ET, though they may share some common features. There are several pharmaceutical and other therapies, but when their effectiveness diminishes, it raises the question as to whether MRgFUS can help.
Study shows success
A new study by Fasano et al. (2017)i applied MRgFUS to 6 tremor patients who had conditions other than ET. The ultrasound was used to destroy the very small area of the thalamus that relays the dysfunctional motor signals that cause tremor. As with all MRgFUS, success is immediately apparent even before the patient gets off the MRI table. For this study, each patient was then evaluated at 1 week, 1 month, 3 months and 6 months. The average improvements in percentages were
| Time Elapsed After Treatment | Improvement (%) |
|---|---|
| 1 week | 42.4% |
| 1 month | 52% |
| 3 months | 55.9% |
| 6 months | 52.9% |
This study demonstrates that MRgFUS is effective with non-ET tremors. The authors noted, “Future studies on larger samples and longer follow-up will further define its effectiveness and safety.”
The Sperling Medical Group offers MRgFUS for the treatment of tremors. Our expert staff and neurology team can determine if a person suffering from tremor is a candidate for this treatment. For more information, contact the Sperling Medical Group.
iFasano A, Linas M, Munhoz RP, Hlasny E et al. MRI-guided focused ultrasound thalamotomy in non-ET tremor syndromes. Neurology. 2017 Jul 26. pii: 10.1212/WNL.0000000000004268. doi: 10.1212/WNL.0000000000004268. [Epub ahead of print] https://www.ncbi.nlm.nih.gov/pubmed/28747452
About Dr. Dan Sperling
Dan Sperling, MD, DABR, is a board certified radiologist who is globally recognized as a leader in multiparametric MRI for the detection and diagnosis of a range of disease conditions. As Medical Director of the Sperling Prostate Center, Sperling Medical Group and Sperling Neurosurgery Associates, he and his team are on the leading edge of significant change in medical practice. He is the co-author of the new patient book Redefining Prostate Cancer, and is a contributing author on over 25 published studies. For more information, contact the Sperling Neurosurgery Associates.