Debilitating Essential Tremor Treated with Innovative Incisionless Surgery at Regional One Health
Posted: October 14, 2020 | Word Count: 650
As Dr. Aaron Bond, a neurosurgeon at Semmes Murphey Clinic in Memphis, Tenn., prepares to treat a patient, the scene may look familiar to anyone who has undergone brain surgery, or possibly viewed it on television. A nurse shaves the patient’s head and a local anesthetic is applied. Dr. Bond dons a surgical mask and gloves to prepare a stereotactic frame that will keep the patient’s head stationary during the procedure. However, once the patient is lying down on the bed and the treatment is ready to commence, Dr. Bond leaves the room. He sits down at a computer in the control room of an MRI suite, viewing his patient through a glass window. Instead of a scalpel, Dr. Bond selects different tools for this procedure: a computer workstation with highly advanced software and a mouse.
The patient is suffering from essential tremor, a movement disorder, with an estimated 10 million people affected in the US alone, and the treatment is MR-guided focused ultrasound, an incisionless technology that uses sound waves to perform surgery without incisions, implants or harmful radiation. Regional One Health, in partnership with Semmes Murphey, is the first to offer this innovative outpatient procedure in the region.
For those living with essential tremor, focused ultrasound treatment has the potential to offer a new lease on life. Anne Collum, a 77-year-old resident of Senatobia, Mississippi, had to give up her livelihood as an artist when the uncontrollable shaking in her hands made it impossible to steadily hold a paintbrush. Collum lived with essential tremor for her entire life, but, like many patients, her condition worsened as she aged, and prescribed medications proved ineffective.
“In the past, patients in Anne’s position were left with only one option, deep brain stimulation — requiring an implant within the brain and a pacemaker-like device in the chest,” Dr. Bond said. “However, many hesitate to pursue this option as it requires open brain surgery, and a lifetime of maintenance.”
Focused ultrasound treatment is FDA-approved to treat one side of the brain to alleviate a hand tremor for patients like Collum. Patients must have been diagnosed with essential tremor (22 years or older) or tremor-dominant Parkinson’s disease (30 years or older) that has not responded to medication. Collum elected to have her dominant hand treated, and Dr. Bond had her record her illegible signature to compare results pre and post procedure. During treatment, Dr. Bond uses MRI imaging to target the precise spot in the brain responsible for the tremor.
“We move the patient in and out of the MRI scanner throughout the procedure to see how the patient’s tremor is diminishing and test for side effects in real time,” Dr. Bond explained. “The immediacy is amazing — you can witness a patient regain functionality before your eyes.”
After the procedure, Collum signed her name clearly for the first time in decades and was home that same day. Returning to painting is now a possibility for her. The most common side effects include imbalance and numbness/tingling which in most instances resolve within one month, but can last longer. Safety information associated with the procedure can be found at https://usa.essential-tremor.com/safety-information.
“My tremor made so many tasks that are often taken for granted — holding a cup, using a computer or getting dressed — a constant struggle,” Collum shared. “After receiving focused ultrasound treatment, I immediately felt more independent than I have in years.”
Dr. Bond has a long history of involvement with focused ultrasound. As a neurosurgery resident at the University of Virginia, he worked on data analysis of the clinical results of some of the early research cases, sponsored by INSIGHTEC, the innovator of the focused ultrasound device, Exablate Neuro, used in these procedures. Now he is experiencing the impact focused ultrasound can have on the lives of patients like Collum through this partnership with Regional One Health.