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Physician Resource

The Results Are In: Focused Ultrasound’s Impact on Essential Tremor

A decade ago, neurosurgeon Jeffrey Elias, MD, saw a patient whose hand shook so violently he couldn’t eat a bowl of cereal. He became the first in the world to receive focused ultrasound ablation for essential tremor, a treatment Elias pioneered at UVA Health.

The results were immediate and dramatic. The patient filled out a crossword puzzle in the recovery room, something he hadn’t been able to do for years.

In August, UVA Health researchers published the final results from a pivotal study showing the effectiveness and safety of the treatment in the Journal of Neurosurgery. Those participants who could be tested five years later still maintained a 73% tremor reduction. Focused ultrasound is an incisionless, MRI-guided outpatient procedure. Previously, patients could only achieve these results from an invasive brain surgery to implant neurostimulator devices.

“These data confirm that focused ultrasound can be a durable treatment for essential tremor,” Elias says. “And the procedure is relatively new, so we expect continued improvements in the technology.”

FDA-Approved Treatment Available in 8 Countries

Shortly after the study team published 12-month results of their international clinical trial in the New England Journal of Medicine in 2016, the FDA approved Insightec’s Exablate Neuro device to treat ET.

Since then, 7,800 patients worldwide have received the commercial treatment. In the U.S., Medicare and several private insurances reimburse for the procedure. It is also reimbursed in Canada, Germany, Italy, Switzerland, the UK, Israel, and Japan.

New Treatments for Parkinson’s and Cancer

Last year, the FDA approved focused ultrasound to treat dyskinesias in advanced Parkinson’s disease. Previously, available treatments for Parkinson’s included drugs, which not all patients respond to, and invasive brain surgeries. 

“This FDA approval of focused ultrasound pallidotomy allows for more treatment options if medications become ineffective or cause disabling side effects,” Elias explains. “While this procedure does not provide a cure for Parkinson’s disease, there is now a less invasive option for patients suffering with medication-induced dyskinesia or severe motor deficits.”

Earlier this year, UVA Health launched the Focused Ultrasound Cancer Immunotherapy Center, the first of its kind in the world. There, researchers are combining focused ultrasound technology with immunotherapy, which could lead to new treatments for many forms of cancer.

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