When you look at the number 1024 what comes to mind? Probably not much (unless you’re a fan of the logic game called 1024). As it happens, 1024 has power—mathematically speaking. It is the number 210 or two to the tenth power. It is also 32 squared (322). Mathematicians love stuff like this, right?
1024 has a medical power, too. It is the number of small but powerful ultrasound “beams” used to noninvasively treat essential tremor (ET) by deadening a small part of the thalamus deep within the brain. This treatment is called MRI-guided Focused Ultrasound (MRgFUS) and it uses no cutting, drilling or radiation. It power interrupts what is called the tremor pathway so that abnormal movement messages don’t reach the hand with the tremor.
A safe treatment
Intervening in the brain is always a delicate matter. It is made up of separate cells called neurons. Neurons operate by “firing” signals to other neurons. It is estimated that if the human brain were a computer, “…it could perform 38 thousand trillion operations per second.”i Neurosurgeons who perform all kinds of brain operations literally have a person’s physical and mental function in their hands!
One of the great things about MRgFUS is that there is no physical surgery. No skin must be cut, and there is no need to drill a hole in the skull. Instead, a helmet-shaped apparatus is placed over the patient’s head, and within the lining are 1024 tiny “lenses” that aim the ultrasound waves or beams at the target area of the thalamus. Each beam passes harmlessly through the skull and intervening brain tissue, so no damage can occur on its path. Then, when all 1024 beams meet at the desired point, they create enough heat to ablate (destroy) the target. The results are known immediately as the hand tremors stop, and the patient can once again perform normal hand movements.
While the idea of any invasion of the brain seems risky, in fact MRgFUS has a solid safety record. The latest review of its side effect profile shows that it can avoid the potentially serious complications of other invasive surgical ET treatments.ii An analysis of data from five published studies showed there were no cases of bleeding or infections in the brain. According to the report, “Adverse events were usually transient [very temporary] and were commonly rated as mild (79%)…” Only 1% of those who experienced side effects described them as severe. The most frequent complaints were abnormalities in sensation and balance.
The authors of the analysis concluded that MRgFUS has an overall safety profile that supports its “role as a new options” for patients whose ET does not respond to medication. Sperling Neurosurgery Associates is very proud to be able to offer this exciting treatment. Learn more at our website.
iFishman PS, Elias WJ, Ghanouni P, Gwinn R et al. Neurological adverse event profile of magnetic resonance imaging-guided focused ultrasound thalamotomy for essential tremor.
Mov Disord. 2018 Apr 27. doi: 10.1002/mds.27401. [Epub ahead of print]