Parkinson's tremors disappear with use of machine that sends heat waves to the brain
Published in Health & Fitness
DELRAY BEACH, Fla. — Delray Medical Center cut the ribbon on its newest high-tech machine last week that targets brain areas to treat movement disorders such as essential tremor and tremor-dominant Parkinson’s disease.
The machine can stop the involuntary trembling of the heat and hands experienced by people with neurological disorders in one treatment using focused ultrasound guided by MRI.
Neurosurgeons at Delray Medical Center already have been treating patients with uncontrollable tremors or stiffness with the earlier version of the machine developed by Insightec. During treatment, ultrasound waves enter a patient’s skull to precisely heat and destroy specific regions deep inside the brain that generate tremors.
Typically, the tremor is gone immediately and the patients go home the same day with minimal complications, said Dr. Lloyd Zucker, chief of neurosurgery at Delray Medical Center. Neurosurgeons at Delray began using the original machine 10 years ago as an alternative to surgery.
A video shown at the Thursday ribbon-cutting for the new, modernized machine highlighted a patient with Parkinson’s Disease whose hand went from shaking to still in a matter of minutes. As the patient readied to go home, he teared up seeing the difference.
Zucker said the next generation of the Insightec machine, called the Exablate Prime, will get even better results. It uses algorithms, data management, and a higher resolution monitor. “The amount of imaging and style of imaging has improved … There are things we couldn’t do with the original machine that they have given us the ability to do now,” Zucker said.
With improvements, this new version can treat more patients in a day than the previous one. Rather than surgery, the Exablate Prime system sends 1024 beams of ultrasound to pass through the skull and focus on a point in the brain, Zucker explained. At first, low-energy ultrasound is applied to the targeted area, allowing the patient to provide feedback so the neurosurgeon can adjust the treatment before applying high-energy ultrasound to destroy a lesion causing the tremor.
“What you are seeing is the next step, and the next step ensures patient safety, improves patient outcomes, and gives us the opportunity to treat diseases we only dreamed about treating … not just Alzheimer’s, not just movement disorders,” he said. “I am talking about chronic pain, addiction, neurooncology, and things we all know reside in the brain.”
Zucker said the hospital has a wait list of about a year for patients with essential tremor or tremor-dominant Parkinson’s to be treated with focused ultrasound. The new machine allows his team to complete a few more patients daily, requiring less downtime in between.
Delray Medical Center also has been treating Alzheimer’s patients using focused ultrasound technology as part of a study done in collaboration with Florida Atlantic University’s Institute for Human Health and Disease Intervention.
Dr. Arif Dalvi, physician chief of the movement disorder program at Delray Medical Center, says for Azheimer’s patients, the ultrasound shakes up the blood-brain barrier enough to allow the amyloid plaque that builds up in the brain to leak out. He gives the patients three treatments with the machine and plans to monitor them over five years.
“I think this, in some ways, is the most exciting time for Alzheimer’s,” Dalvi said. “I think we have some infusion drugs, we have focused ultrasound, and we have drugs that address non-amyloid pathways. Once you put the three together, you will have a cocktail that really helps. I think we are right at the beginning of that now.”
Dr. Augusto Grinspan, chief medical officer for Insightec, said the need for his machines is increasing.
“About 500,000 people have tried medication and found it ineffective. They are desperate to find a solution,” he said.
Nationally, 79 treatment centers use Insightec’s focused ultrasound machines, including nine Florida locations. Each machine costs about $2 million and must be integrated with an MRI.
Medicare covers focused ultrasound in Florida for essential tremor patients. Some private insurers will cover it, too.
At the ribbon-cutting Thursday, Heather Havericak, CEO of Delray Medical Center, said the administration saw a benefit in the investment. “We’ve already been able to touch so many lives, and we’re going to be able to touch so many more with this new technology.”
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