by Chris Casey, CU Anschutz Medical Campus
edited by Lisa Lock, reviewed by Andrew Zinin
A woman began walking with a more fluid gait, while another patient could suddenly eat using utensils. Both patients, in advanced stages of Parkinson's disease, experienced immediate relief from severe tremor on one side of their body.
The technology behind these dramatic patient outcomes is a high-intensity focused ultrasound (HIFU) procedure that targets two tracts of the brain only a few millimeters—6 to 9, to be precise—apart.
The two recent treatments were performed by the Advanced Therapies in Movement Disorders (ATMD) Program at CU Anschutz. They were the first dual-target procedures using HIFU in the Rocky Mountain region.
Immediate symptom relief
The team leading the procedure included Drew Kern, MD, MS, associate professor of neurology, and Daniel Kramer, MD, associate professor of neurosurgery, both at the CU Anschutz School of Medicine. While the treatments provided immediate relief of motor symptoms for the two patients, further study is needed to determine HIFU's durability, potential cognitive effects and the merits of a bilateral treatment approach.
"We did it one week, and it worked great," Kern said of the dual-target procedure performed on the woman. "Then we thought about it for another patient—a man who had dementia. And sure enough, afterward he had zero rigidity and very little slowness of movement, plus no tremor. His wife said that was the best night of sleep they've had in years because he wasn't having a tremor. And, for the first time, he actually ate breakfast without any difficulty."
Dyskinesia, or involuntary movement, and bradykinesia, or slowness of movement, are among the motor complications affecting people with advanced Parkinson's disease. More than 1.2 million Americans have Parkinson's, a progressive neurological disorder with no cure.
Deep brain stimulation (DBS), in which surgeons implant electrodes in a targeted area of the brain, has been used to treat motor problems caused by Parkinson's disease for decades. In recent years, another therapeutic option, incisionless HIFU, has become available for patients with advanced Parkinson's who haven't found symptom relief from medications and aren't candidates for DBS due to infection risk and other reasons.
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